There is a tendency among many trans people to label their transness as “strictly a medical issue”, usually as an excuse to insist that they do not identify as trans or that they do not consider being trans as something that can be part of an identity, period, for the less offensive version
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As far as whether it is a choice or not, that depends on who you ask. I think for some people it actually is a choice but for others it most certainly is not.
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I don't give a damn how people live their life, unless their definition of living their lives involves contributing to giving community credit to explanations of trans that are, basically, ablist.
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