There are many people who have never met me as Mario who know that I was assigned male at birth. This is not a problem for me, as long as I know that they know - so I can feel free to speak openly about life. Otherwise, I talk about my life as if I had been assigned female at birth.
Do people immediately sense there is something "Off" about me when we meet? Like the physicist who says that you can't determine the speed or location of an electron without altering it, the same thing goes for me and whether I am perceived as female or not. The minute the question is asked, it puts doubt into a person's mind.
When in doubt, I assume that my presentation is working. And this has likely saved me from a lot of grief over the months I've felt confident enough to go out as Marian for days at a time. Having confidence in one's self is very important. If you can take for granted that your identity will be perceived as you perceive it, you have a much easier time in the world.
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However, what happens for those people who are genderqueer, or who are just not conforming in their gender presentation? One fellow whose Facebook postings I follow is a heterosexual male living in the LA area who crossdresses all the time. And he looks good in his dresses! I wonder how many people have hassled him for his non standard presentation. But his is a simple situation. One of the genderqueer people who appeared with me at a recent transgender forum appears neither male or female - only the voice gives this person away as having been assigned female at birth. And this person insists on the use of gender neutral pronouns when being referred to. (You'll note that I hate the use of the word "they" for a singular use, as it irritates me due to my childhood training on what good grammar is supposed to be. I would prefer to adopt a word from Swedish, "Hen" to refer to a singular person of undefined gender.)
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Gender comes up at so many points in our lives that we don't even think about it. Try to talk for a while without referring to that person's gender. I think you'll find it very awkward at best. So what should you do? I don't know about you, but I'm advocating that the "T" community (inclusive of the genderqueers and intersex folk) start advocating for the use of a new word - either using the Swedish word "Hen", or an more Anglicized version, "Hem", that reduces the cognitive load for all people. Our solution can benefit society as a whole, as businesses need ways to refer to a person without reference to gender - and if gender neutral singular pronouns exist, they will be used instead of the gender specific ones for general, non specific uses....