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A she-male (in a nutshell) is female except for the genital area. In other words, a male trying to look like a female and going so far as to get boobs either through hormones or implants or both). He's probably getting hormones anyway to minimize male characteristics like body hair.
A transsexual is in some stage of being transformed from a male into a female (or much more rarely, the other way around).
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