Transgender people can have a positive and harmonious relationship with their body and not necessarly show discomfort towards their sexual physical features. 

Transgender people may follow different paths according to their characteristics and personal needs. One of the main aims of psychological consultations is in fact to understand which path is best for every single person. Only some transgender people may need a medical gender affirming path: some may be happy living in a gender role according to their gender identity, while others may request also hormonal and/or surgical gender affirming treatments. 

Transgender and gender nonconforming people have always existed. Changes in the cultural background, greater acceptance of diversity and the increased availability of information on this topic have simply made transgender people more visible.

It has often been argued that transgender people live in a state of confusion caused by environmental factors (e.g. trauma, external influences) and that medicine should "cure" this confusion by alligning the person’s gender identity with the natal sex. However, the scientific literature has never found a link between family features or adverse life events and the genesis of gender variance, which in many cases has an early onset. In line, the so-called reparative therapies, that consist in forcing the transgender person to have a gender expression and a gender identity in line with their biological sex, have never shown any efficacy. On the other hand, reparative therapies are harmful by causing anxiety, depression and suicidal ideation. Therefore, any attempt to allign one’s gender identity to the biological sex is currently condemned as not ethical.

References
Coleman E,  Radix AE, Bouman W, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022; Sep 6;23(Suppl 1):S1-S259.

In the interaction with a transgender person, the use of the person's chosen name and pronouns is always extremely important. This counts of course also also during a gender affirming path. For some cisgender people the request to use a different name (and/or pronouns) may seem useless or may be interpreted as a "whim". However, several studies show that the use of the person's chosen name and pronouns is associated with lower levels of anxiety and depression. Furthermore, respecting how a person identifies has positive effects on self-esteem and psychological well-being as it shows respect, a sincere way of listening and promotes a sense of authenticity in the transgender person.

When we talk about gender identity, we refer to gender and not to sexuality. Indeed, too often the attention is focused on the sexuality of transgender people, while the most relevant aspect for well-being and full self-realization is linked to one's identity. Furthemore, a people’s gender identity does not give us any indication of their sexual orientation. In fact, gender identity is independent of sexual orientation and transgender people can have any kind of sexual orientation.

Sex and gender are are not the same thing. The term sex refers to the set of biological characteristics with which a person is born, for example the sex chromosomes (X and Y), the gonads (testes or ovaries), the genitals, the sex hormones. A person can be born with male, female or more rarely both male and female sexual characteristics (intersex people). The term gender, on the other hand, refers to the socially defined characteristics that distinguish masculine from feminine, i.e. norms, roles and relationships between individuals defined as men and women.

Considering that there are not only two genders (male or female), many transgender people identify with alternative genders, a combination of male or female or with no gender. Therefore, if a person does not identify as male, this does not necessarily mean that the person identifies as a female.

Some people may experience a fluid gender identity that can change over time.

The transgender condition is not a mental illness or disorder. In line, in the latest version of the International Classification of Diseases (ICD-11) gender incongruence is included in the section of conditions related to sexual health.