I've never really thought about them as being different to people who recognise themselves as Male or Female. My best friend, while born a female, thinks and acts like a guy the entire time. I'm not talking like tomboy acting, I mean it's literally a female form of myself. She recognises herself as a transgender male and really wants a penis to boot. I don't see why people should be grossed out by that idea though. It's probably because I'm used to knowing both transgenders and transsexuals, so I don't find it odd at all.