What causes someone to be transgender? Are there multiple factors? Some mental condition (gender dysphoria?), hormonal imbalance, sexual kinks for some people, and people who are genuinely born with the brain of the opposite sex?

In India, the majority of transgender people you'll see are men dressed as women, going around begging for money from shops and vehicles in traffic stops (hijras). When travelling by train, if you are on in an AC couch, one of the biggest issues is these trans beggars getting into your coach on every stop and harassing you for money. They seem to have their own religious beliefs and rituals like a cult also the majority end up getting into sex work at some point

I stay in Bengaluru to I have taken many trains from here to Guwahati to visit my family in the past 6 years. There are about 40 places where the trains slows down significantly or comes to a complete stop. The number of times a trans has tried to grab my dick, or put their hands inside my pants, while sleeping at night during the train rides is countless. I am pretty sure most of them don't even believe they are women, but that's just something that their cult requires them to do