In a candid new interview in The Sunday Times, he was asked if he considered himself cisgender, or a person whose gender corresponds to the sex assigned at birth.
The Grammy Award–winning Smith responded by flashing two tattoos of the Venus symbol, which often represents femaleness.
"No. I mean, I've got these tattoos on my fingers," he said. "I don't know what the title would be, but I feel just as much woman as I am man."
Smith, 25, added that he loves buying heels and dresses, saying he was inspired by other British singers.
"People don't know this, but when I was 17, I remember becoming obsessed with Boy George and Marilyn and all that," he said. "There was one moment in my life where I didn't own a piece of male clothing, really. I would wear full makeup every day in school, eyelashes, leggings with Dr. Martens and huge fur coats — for two and a half years."
Smith explained why it was so hard for him to come out when his debut album, "In the Lonely Hour," was released in 2014.
"Looking back on it, it was the fear of saying the wrong thing and offending," Smith said. "And I was 19 when I started writing the first album. I'd just moved to London from a village — I was literally the only gay in the village. I didn't know what I wanted to say."
He continued, "I remember, at the beginning of my career, being called a 'gay singer,' and I didn't want that. I wanted to be seen as a singer first, before people spoke about my private life."
With his sophomore album, "The Thrill of It All," set for release Nov. 3, Smith said he's now more confident in who he is — regardless of what labels may come.
"And now it's changed — I've changed. I realize that maybe I don't mind that title," he said.
Smith has already let fans hear some music from his sophomore album.
The lead single, "Too Good at Goodbyes," has reached No. 3 on the Billboard charts. The heartbreak ballad speaks of a man who will "never let you close" because when he "opens up, it hurts."
Smith, who has won a Grammy and an Oscar for his songs, said his love life served as inspiration for the upcoming album. But don't expect the entire album to be a diary of his past relationships.
"This album actually is not all about me," Smith told Zane Lowe last month. "There's about four songs that are about me, and the rest are about different things and different people in my life and what they've gone through."