Courtney Penniman of Phoenix changed gender from female to male in February 2012 after many years of feeling that his male gender identity is an innate part of him, an integral part of who he was born to be. It is clear that there are people who are aware that they are transgender from their earliest memories. Sex and gender are complex issues.  A huge variety of factors are at work in making each individual the person that they are and there is no one reason that causes people to be transgender. Trans people are part of the variety that makes up the human community.