This episode provides information on the fourth factor in transgender causation--that o early childhood learning and transgender recognition. Most all children know the basics of the Western gender system including the two gender behavior categories by age 2-3.  They come to recognize which one fits with their genetic gender predisposition.  In the case of transgender children, the category which fits them is not the same as the one they were assigned at birth on the basis of sex assignment. This is not a conscious lifestyle choice.  Like most choices, it involves subconscious processes of which we are not aware. We become consciously aware only after the choice has been made. As for lifestyle, the alternative gender behavior categories are determined by culture, not by biology.