No, transmedicalism is the belief that somebody isn’t actually trans unless they meet certain medical criteria. I’m saying the opposite: that the lack of any particular medical criteria can’t be used to invalidate somebody being trans.

As for your second question, how a person behaves is a matter of nurture more than nature, but it’s also deeply engrained from a very early age. Even those trans people who put the effort in to overcoming this socialization can have old habits they struggle to get rid of.