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What if someone feels themselves between/outside binary gender categories? Well, medically sex is complex, so it makes as much sense on a biological level as anything, and again not something I should be judging or interfering with if I respect individual self-determination.
I do have some opinions that are slightly outside the mainstream- I generally think that you can be something outside of your identification with it. (For instance, I think you can be trans and lie about it, or not know it yet.)
However- and this is crucial- I don't think I've got any special ability to know what someone's medical condition/gender identity is. There's no test for it. So, in practice, just believing what people says is the closest anyone can come to knowing whether they're trans or not.
My more medical, more material view doesn't come into practical conflict with someone who emphasizes the socially constructed aspects of identity because listening to what people say and believing them is more accurate than any other test we have.
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