re: God dictates gender, which does not exist on a spectrum and cannot be changed

quote:

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altered? elaborate

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Generally males (sex) are masculine (gender). But some men (sex) prefer to be feminine (gender). They often do this through changing their appearance from what is culturally considered masculine dress, speech and mannerisms to feminine dress, speech and mannerisms, and more and more recently through, genital mutilation.

In short, a man in a dress is not a woman (sex), but he is feminine (gender).