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Honestly I think it has a lot to do with the brain chemistry. A little more of this and less of that here and there and you get some anomalies. Which is why I can't hate on gay people, I feel like most of it is out of their control.
I have 2 friends that have fully transitioned.
One was very odd before and i feel like he didnt work through everything properly before getting the surgery. I never saw her after because i had moved away. She ate a bullet a couple years later. Id definitely say he had other problems before and she had additional issues later.
The second transitioned a few years ago. It was a surprise to all of us. I had known him for 7 years or so. Others who had known him for 20+ were equally surprised. He seemed to have mental/emotional issues and was not even remotely effeminate. He approached it the right way. Counseling and the works.
When we are around her she is treated as the woman she chose to become.. I dont know any of us that dont think it is weird, though. I dont tbink weird is quite the right word. Odd, maybe a bit off? Id bet none of us hug her quite the same as we do the females we've known all our lives and id never want to have sex with her, either.
Shes not the kind that tim describes above (pretransistion) and is a normal person. Loving, successful parents. Sharp mind that you are hard pressed if you get into a card game with him or her.
Frankly, i was more worried there we underlying issues which might cause her to eat a bullet than what she was becoming.