Im confused about transmed beliefs

I always thought it was obvious gender isnt really "real" per say, and beyond a scientific term its mostly just a social construct which is of course why we dont see supporting Trans people as feeding into delusions. the idea of gender itself is a delusion, and doesnt actually have any physical requirements. As far as im aware people only surgically transition because we associate certain genitals with certain genders because of the relations between social gender, and medical gender.

I guess you could argue socially transitioning and medically transitioning are two very different things, but why does only socially wanting to be a certain gender change how Trans you are? I try to be open but I just dont get it

(Also if im using incorrect terminology, or accidentally said something untrue, ect, please inform me)