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Being transgender is independent of sexual orientation :  transgender people may identify as heterosexual, homosexual, bisexual , asexual , etc., or may consider conventional sexual orientation labels inadequate or inapplicable. The term transgender can also be distinguished from intersex , a term that describes people born with physical sex characteristics "that do not fit typical binary notions of male or female bodies". 
The degree to which individuals feel genuine, authentic, and comfortable within their external appearance and accept their genuine identity has been called transgender congruence.  Many transgender people experience gender dysphoria , and some seek medical treatments such as hormone replacement therapy , sex reassignment surgery , or psychotherapy.  Not all transgender people desire these treatments, and some cannot undergo them for financial or medical reasons.  
Most transgender people face discrimination in the workplace  and in accessing public accommodations,  and healthcare.  In many places they are not legally protected from discrimination.