What is the difference between gender identity and presentation to you? One of my biggest problems is that I am female born but do not identify as female. My pronouns are he/him they/them but no matter what I wear because of my born sex, my feminine figure, and my high-pitched voice people always assume I'm a girl and she/her. I don't know what the answer to this problem is to be assumed as male and not female that doesn't result in me getting hormones or surgery. So can someone help or tell me what the difference between gender identity and presentation is to you?

A48-year-old male presents with an 8-day history of productive cough, subjective fevers, and malaise. he is otherwise healthy without any active medical problems. he is a social drinker of alcohol, and denies any tobacco or drug use. on physical examination, the patient is alert and oriented. his temperature is 100.4 0 f, pulse rate is 56, respiratory rate is 18, and blood pressure is 133/64. heent is within normal limits and a chest exam has diffuse expiratory wheeze with decreased sounds to the right lower lung fields. blood labs reveal wbc 14.4, hgb 11.3, plt 233, alt 65, ast 102, and po 4 2.1. a chest x-ray reveals a dense consolidation with bulging fissures. based on these findings, what is the most likely pathogen affecting this patient?