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Not necessarily, but it depends on the exact person. A lot of what is called transgender can arguably be considered a choice. So in that case, the person should get therapy to see what is making them choose something that might not be in their own best interest. But if they feel the need to continue, then a therapist is still good to help the person to adjust and deal with all the stress that they world will give them.

While everyone doesn't necessarily buy the theory, there are supposedly people who don't fit in at either end of the gender binary or who consider themselves as gender non-binary. In some ways, there isn't much transition to do. They likely are not distressed by their genitalia and likely won't get surgery there. But if they want to keep some "male energy" about them for instance, I suppose they might opt for breast surgery to get breasts without taking hormones.

Now, those born with transsexualism (often confused with transgender folks) tend to need transition, as there is no way to be accepted on the other end of the gender spectrum without doing so. If everything you say or do is taken as if a person of the other gender said it or did it, then obviously they could find more acceptance by transitioning. Those born with transsexualism should also see a therapist, since that's the only way they can get the clearance letters, and it may help them with issues such as self-acceptance, social pressures, sexual harassment, etc.

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