Gender is a social construct. I many cases, it is aligned with the assigned sex at birth. However, for transgender people, it is NOT aligned with the sex assigned at birth. Mental health issues come into play when people are not allowed to be their true selves or are denied the support that they need. This parallels the experience of gays and lesbians.
The notion that being gay, lesbian or trans is a “choice” is BS. The proof is that praying the gay away doesn’t work. It creates its own set of mental health issues because people eventually realize that you can’t change something that is innate to your being…
