Par for the course for this godless president.
In the womb, every single human starts out as a woman. What happens in between a woman becoming a man is a series of complex biological changes. One of the first changes involves the formation of primary genitalia (testicles form before a penis does, since testicles are required to secrete male hormones), but even after that formation occurs, there's no guarantee that the transformation will go all the way.
It's medically possible, therefore, for a child to be born with male genitalia yet in many other ways be more a woman than a man, and vice versa. The latter is much less common (a woman feeling trapped in a man's body), and this is because female is the default human gender. Gender confusion is much more common in men because all men have undergone varying degrees of the biological transformation from being a woman, whereas people who look like women on the outside (who have female physical characteristics) likely haven't undergone any gender changes in the womb, or if they have, they're insignificant to the outcome. A great illustration of this is a genetic condition I recently learned about called androgen insensitivity, which means that in the womb, a woman has begun the transformation into a man, and testicles have developed in the cavity in the hips, but that person's body does not respond to the secretion of male hormones from those testicles. So, the child is born with undescended testicles, and with testosterone secretion levels that are typical of being male, yet the child, because of a total lack of biological response to those male hormone secretions, hasn't undergone any of the other changes associated with being male. They have a vagina, and upon puberty develop breasts, armpit hair, leg hair, pubic hair, and no facial hair, no widening of the jaw, no muscle bulking and no breaking of the voice. The undescended testicles continue to produce levels of male hormones that you would expect in males, but the body, because of a total lack of sensitivity to those male hormones, looks like it is female.
Generally, most women have
some level of sensitivity to male hormones, and the female body will produce very small levels of those hormones. In androgen insensitive humans, there is no response to those hormones at all. This means the woman will have no outward male characteristics at all. She'll have ovaries, a womb, and she'll probably be stunningly beautiful, too. Estrogen (the famale hormone) is responsible for the female characteristics we men tend to find most attractive (full breasts, wide hips, a very feminine face, blushing, flawless skin and healthy hair and nails).
Technically, that person will feel totally like a woman, she'll look totally like a woman, and she'll be able to reproduce like a woman, but given that her body contains levels of male hormone that are similar to those found in human males, if her body did not have a complete insensitivity to androgen she would most definitely have been born a man.
Gender isn't just about what genitalia a person has; it more often has to do with a combination of hormone balances and levels of hormone sensitivities, self-perception, and outward physical characteristics.