Transsexuals usually not only wear clothes of the gender to which they wish to belong, but also pursue hormone treatments and sometimes also surgery so that they physically look like a member of the sex with which they identify. They might call this mix and match cross-dressing genderfuck. There are lots more kinds and varieties of people who play with gender in their lives. Some performers cross-dress when they perform. Some people like to cross-dress because it turns them on sexually.
People also play with gender for other serious reasons.
Something inside them tells them that they are different, and the process of searching out a comfortable gender identity begins. In some cultures, people who are not identified as either male or female are seen as having special powers and abilities, and they become shamans or priests, or take on special roles in their communities that normal males and females are not allowed to perform. Transsexuals also usually get a lot of professional counseling before, during and after the transformation. Many countries in the world require very vigorous and strict medical examinations and therapy before allowing a transsexual to get the therapy and surgery they might want to complete their transformations. Even though they can spend a lot of time in transition, most transsexuals who are interested in getting to the other side will identify themselves as transsexuals or by their goal gender, and usually be known by their goal gender, no matter what their stage of transformation.