I weigh in somewhere in between these two positions. I think that most people who are gay, lesbian, bi or transgendered really are queer – that is they possess distinctive traits that are either innate or fixed so early in childhood that they can't possibly be considered culpable, and that they cannot be altered. For example, there are certain formative experiences that have to do with gender-identity development that have to happen during a certain, relatively brief period in a person's life. In some cases, these events don't take place. In my case I never went through the part of adolescence where a girl looks forward to becoming a woman, where she wants to wear training bras, and hopes to get her period, and twitters excitedly with her girl friends about the cute boys in her classes. I read Are You There God, It's Me Margaret, and I felt totally alienated: I couldn't relate to this normal teenage girl who was anxious and excited about her emerging femininity. Reparative therapists tend to opine that experiences like mine are the result of failed socialization, that a lack of close female friendships cause women to be adrift when it comes to developing feminine feelings. I don't think that's how it worked for me, though: I remember the point when the other girls on the playground were discussing these things, and I remember having the opportunity to participate in those discussions. I made the decision to walk away and not get involved, because the subject made me uncomfortable, it didn't seem to concern me, and I wasn't interested in it. The point is that that discomfort and disinterest weren't the result of social ostracization: the causality was the other way. As I reached the age at which other girls were increasingly interested in distinctly feminine activities and concerns, I became increasingly unable to relate to them, and I dissociated myself quite naturally from their world. Instead of hanging with the girls and talking about the New Kids on the Block, I went and hung around with the shy, sissy flute-playing soprano boy who I'm sure has since gone on to be a wonderfully talented gay musician.
The conservative party line is that I was suffering from “gender-identity disorder,” and that presumably I could have been fixed if I'd been taken aside and taught how to conform to certain standard gender development patterns. I've seen enough testimonies from people who were put through that personality-normalization wringer to be extremely wary of this claim. I also have my own experience of trying to gender-normalize myself during late middle-school and early high-school. I made a concerted attempt to enjoy going to the mall, to watch Melrose Place to talk about girly things and to care about the back-biting politics of the high-school popularity scene. I managed to work up a couple of artificial crushes on boys so that I'd be able to participate in the whole adolescent erotic game, but the effect of it was an increasing feeling of depression, isolation and inauthenticity, accompanied by a profound compulsion to escape. A lot of the time I would get out of class, and would be time to head to the lunch room and gab with my girl friends, and I would have this intensive feeling of dread. More and more over the course of those years, my reaction was simply to flee: to get out of the building and go down to the ravine where I could walk along the side of the bubbling creek and lay in the sunlight on the big flat rock that jutted out into the stream, and where I could immerse myself in the worlds of beauty, imagination, melancholy and Truth.
Someone out there is going to object that none of those things listed above are inherently unfeminine, and I'll agree. However when the kind of beauty that appeals is the beauty of the female body, and the kind of Truth that appeals is the rationalism of Immanuel Kant or the Stoicism of Epictetus, and the imagination tends to favour either extremely masculine female role-models or an outright retreat into an explicitly male headspace, then it becomes increasingly clear that gender-identity is at stake. It's not that I'm transgendered, though I think that if I were to honestly peg myself using the LGBTQ taxonomy of sexual identities, I'd have to admit I'm gender-queer.
For obvious reasons, this is an issue that requires a much longer discussion than I have space for in one post. I'll try to return to it soon, particularly in terms of whether alternative gender identities can fruitfully be categorized as “disorders,” whether these identities are fixed or malleable, and what relationship that has with the whole sexual orientation change debate.