I am increasingly of the opinion that transgender people can be grouped into the following categories - those with mental health issues, those experiencing common feelings when growing up, a men's rights movement and a sexual perversion (autogynephilia) but I largely accept people's right to live how they choose and certainly not to experience any violence as a result. I completely put sex before gender.
The only area where I feel a touch of sympathy is in clothing and presentation. Women can present in what traditionally might be seen as a masculine way (short hair, no make up, 'men's' clothes etc..) and be totally accepted. A young (particularly young and cool) man can wear make up and necklaces, etc but when it comes to middle aged men they look like ghouls and make people intensely uncomfortable. But, it is what it is.