For genderqueer people, their internal sense of gender identity is neither solely female nor male. For transgender and transsexual people, this process commonly involves reassignment therapy which may include hormone replacement therapy and sex reassignment surgery , with their gender identity being opposite that of their birth-assigned sex and gender.
Transsexual less commonly transexual  people experience a gender identity that is inconsistent with, or not culturally associated with, their assigned sex , and desire to permanently transition to the gender with which they identify, usually seeking medical assistance including hormone replacement therapy and other sex reassignment therapies to help them align their body with their identified sex or gender. Transsexual is a subset of transgender ,    but some transsexual people reject the label of transgender.
The early days of transgender transition can be a frustrating time for many of us, what seems like an endless wait to get confirmation from various medical bodies to start living our lives in the correct gender. I know for me that when I had my initial referral from the local hospital to the gender identity clinic that I was relieved the process of psychological assessment leading to gender confirmation surgery was at last underway, it would therefore only be a matter of time.
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