The clothes just fit better.

In order to become a speech/language pathologist, I had to study a little at our university's medical school, so we could cooperate effectively with doctors and nurses and physical therapists. We had to memorize some parts of Gray's Anatomy and do some dissection of pertinent parts of human corpses. We learned about the genetic variations that occur in human beings, and some genetic sexual variations were explained. We were guided in learning to be open-minded and open-hearted with people regardless of genetic variation. This is not the simplistic process that Trump and his followers envision. Furthermore, various statues and stories handed down from ancient times show clearly that there have always been some variations of genitalia and other physical features, all around our world.