That's pretty fragile behavior for a "man". And if she's soooo upset with being called a woman, why is her name still "Sarah" on whatever social media platform this is?
It's little things like that that make me wonder how serious she is at being Ashton? My guess is she wants to still be associated with being Pixyteri but doesn't want people to refer to her as that because she's totally 100% male. Only her penis is inside her body like all penises are...
... no wait... that's your gall bladder. Never mind.
And we're all that much more traumatized for it.
She claims her name is still Sarah on social media because Debbie would lose her shit if she changed it, which I'm sure is true. It doesn't make a lot of sense because she's doing all the visible things at home (binding, the short hair, the clothes) anyway, and she's constantly bringing up her name being Ashton now on her facebook, when she knows that Debbie reads it sometimes and even posts replies sometimes.
That still doesn't explain why it took her so long to actually use a male name after she began to claim she was trans. I've said it before but the name is usually the first and easiest step people make when they transition, especially if it's a name (like Ashton) that is somewhat gender-neutral.
She really doesn't understand how anatomy or being intersex works. She pretty clearly hasn't done a lick of reading on the subject and just thinks that it works exactly like anime, where a dick can magically be inside of you and can magically come out. I'm not at all an expert on the subject but it's something that I've touched on in biology at uni and I know some basic info about, which I'll put here in case anyone's interested.
There are four different basic categories when it comes to intersex people.
1) XY intersex, where you have male chromosomes but you either have fucked up junk (like underformed/missing testes and an underformed penis), or female genitals. There are lots of potential medical issues/complications with this.
2) XX intersex, where you have female chromosomes and you have some internal female sexual organs like ovaries but you have male genitalia. There are fewer complications with this presentation compared to XY.
3) Complex/undetermined intersex disorders, where the internal and external sex organs are correctly aligned but the person suffers from issues with sexual development, sex hormones and other sex-linked things.
4) True gonadal intersex, where you have gonadal and ovarian tissue (which is sometimes ovarian tissue contained in testes or can be in the form of the person having testies and ovaries, usually one of each). It's quite flexible in terms of chromosomes (you can have XY, XX or even both), and in terms of genital presentation (which could be male, female or ambiguous).
Note that none of these categories contain 'external female genitalia with internal male genitalia'. What Pixy is describing doesn't fit any of these categories and isn't something that happens in human biology.