Transgender =/= Transsexual. Anyone who feels that their gender is the opposite of the body they are in (some people say that nonbinary people can still qualify as trans, but I personally don't use the term for myself) is transgender, but a transsexual is someone specifically who is, has or intends/wants to physically transition. Sometimes full transition isn't possible for a number of reasons (money, medical practicality, fear of operations etc). I think the main point is the level of dysphoria a person experiences and whether or not they feel they can live their lives as they are or with just a pronoun or appearance change or whatever. Full hormones and surgery isn't important to some people as long as they are accepted and respected as their preferred gender.