Admittedly I'm not a transsexual or a transgender individual, and I've not been labeled "confused about gender" by others, so that explains why I didn't get your comment as a reference.
I personally think that consciously trying to control the way your culture responds to your physical appearance is kind of bizarre, but then again I also dislike things like make-up and fashion trends on principle, so I'm clearly something of an outlier. If I had my way, gender would be abolished entirely - which I suppose makes me a radical extremist in terms of gender politics.
I do think you're largely right - transgender individuals are certainly more acutely aware of gender within their culture than most, and logically that seems like the obvious influence that leads them to transition in the first place. Much like how those who convert religions typically do so because they actually take the time to study and are far more knowledgeable about religion compared to the average unquestioning believer, those who choose to transition from one gender to another seem to choose to do so only after a great deal of study, reflection, and consideration.
For my own part, being so radical as to wish to eradicate gender entirely, I find it difficult to conceptualize the notion of actively conforming to either set of standards. Since "masculine" and "feminine" are arbitrary, the chief thing one seems to gain by transitioning between genders is to receive the external societal treatment one may prefer. But I'm opposed entirely to the concept of discriminatory behavior based on a person's physical form in almost every regard, so the thought of actively choosing which kind discimination I would rather receive from society at large just seems alien to me.
Then again, I've long been an intensely private individual, with my personal identity largely divorced from how others see or treat me, so that might account for my difficulty in conceptualizing such things. I don't view myself as "masculine" or "feminine", because I exhibit both sets of behaviors varyingly.
Ideally I'd like the world to not discriminate based on whether some behavior I display is "masculine" or "feminine", but I realize that in anything but the very long term, that's really just wishful thinking. I do conform to certain expected behaviors when in public, but chiefly out of convenience, not out of identity or personal need. It's just less effort.
...which is why I can at least sympathize with transgenders, even if I lack the personal experiences to truly empathize. Choosing to transition necessarily involves choosing to actively go against societal expectations, and that's an exhausting and alienating thing to do. You either go crazy trying to explain your non-conformity to every single person you ever meet who balks at it, or you find ways to disguise your non-conformity so other people don't notice it and badger you about it, or you just isolate and alienate yourself to avoid having to talk to people - all of which is pretty darn soul-draining.
That takes a sort of dedication I certainly do not possess. And while I can't personally relate to that sort of drive, I can at least respect it - even if I ultimately wish it wasn't necessary.
In short, fuck gender. It's patently absurd and it makes people miserable. Just try to treat everyone the same way for a given scenario, regardless of what they look like, and maybe in another century or two we'll all collectively be over this nonsense.