Is race and gender a fact or thought?

After studying models for the first time it makes since to me how people can say things I thought were facts (gender, race,age) are choices. I always thought that was cra cra (and I still do!) but studying this model I see where it starts to not sound crazy but logical. I love the model and want to use it, but I am resisting some of the beliefs that some circumstances are only thoughts.

C: A 46 year old white woman says she is a black man and believes it.
T: Endorsing that this thought is optional creates confusion in community (gender and racial identity on bathrooms and forms), supporting psychotic thinking.
F: concerned
A: Question model; i refer to thoughts as ‘optional’ as opposed to not true. (Though with many thoughts i help them see its not true at all…that involves judgment).
R: i feel confused about the C and T line and can’t fully endorse the model in its purity.