They are rare.
But if you combine the various intersexual conditions with various injuries or illnesses that damage the Hypothalamus, testes, etc before puberty then you get a number approaching the prevalence of Down’s Syndrome. Rare but not so rare that most people never encounter someone affected. Admittedly these things are not as apparent to the eye as Down’s, especially as the afflicted usually prefer secrecy.
So when discussing all the goofy people who want to change themselves into something that they are not (due to some deranged emotional or mental pathology) it is appropriate to mention intersex problems as a caveat and allow for people with problems that are physiological rather than psychological in origin.
They are rare.
But if you combine the various intersexual conditions with various injuries or illnesses that damage the Hypothalamus, testes, etc before puberty then you get a number approaching the prevalence of Down’s Syndrome. Rare but not so rare that most people never encounter someone affected. Admittedly these things are not as apparent to the eye as Down’s, especially as the afflicted usually prefer secrecy.
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Before puberty? More like in vitro/uterus when denied essential ‘nutrients’(as enzymes) which are critical for proper genetic expression when lacking in the maternal diet result in congenital defects in less than optimal progeny.
Many problems thought to be psychological are, in fact, physiological in nature. Furthermore, engaging in negative thought patterns causes a variety of hormones and other signalling peptides that have physiological effect to flood the brain in aberrant proportions. This can change the epigenetic status of genes involved in neurological function, which, in turn, can change the physical structure of the brain.
In some cases, I think that retraining the brain through therapy can help, by diverting those negative damaging thought patterns.
In any case, I would like to see more research into the causes of "transgenderism"--I think that it is often the manifestation of an intense repudiation of self--and real treatments developed. Mutilating patients who become fixated on the idea that they are the "wrong" gender is as barbaric as lobotomizing patients, IMO.