They convey what gender the person feels they are. You don't have to find it useful if you really want to know what genitals they have.
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It certainly does not seem to be a choice. Signs are often evident in childhood for both of them. Gender atypical interests & mannerisms etc
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Yes, like sexual attraction is not a choice but having sex is.
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Studies are done on people who dont but live as trans forever - postmortem. Some have hypothesised a spectrum with homosexuality.
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Which would explain why so many kids who think they're trans later realise they are gay or lesbian. I don't know tho. Very complicated.
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