It is different.
Gender is a social construct, and as such is a product of our minds. If your mind thinks it is feminine gender, then it is. It's not as simple as an anorexic thinking they are fat, because fat is a physical state. Just thinking you are fat does not make you fat, but thinking that your gender is feminine does make you feminine.
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"Wake up, Luigi! The only time plumbers sleep on the job is when we're working by the hour."
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