I have been struggling to answer this question for decades and the best I can come up with is that I am somewhere on the gender identity spectrum...if you view gender as two polar extremes...a bit to the female side. Saying that, its not a static sense...some days I can function comfortable as a male and wonder if all this gender angst is just a delusion. At other times I can totally accept being transgender. I am not sure what causes the shifts, but I notice that when my overall mood is positive, I also feel more comfortable with my female self. When I am depressed, then I shift a bit towards male and denial.