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We talk about trans when a healthy person, deep down, that his gender identity does not coincide with the sex assigned to him at birth. 
Other terms are also used, such as 'transgender'.

Only they can be passive active

Trans men were defined as female at birth, while trans women * were male. 
Trans people live in various ways. It makes no difference whether they have a clearly masculine or feminine aspect,
 if they are operated on or if they behave in a particularly "masculine" or "feminine" way:
 in fact, it is not only trans people who have undergone a gender alignment surgery. 
Being trans is not a disease. It is not known why some people are trans.

I trans milano is the most active city category.

People who are not trans are referred to as 'cis people'.