I guess publicly making a show of being up for it worked. Which means they didn't exclude him but legitimately didn't consider him, although Ollie may already have crafted a narrative of "they thought I was too much of a bigshot to approach me, but I'm such a great person I'll do things for charity".
But if all transexualism is is that you just feel like being the other sex, why should we ever let you take resources away from public health care to transition? If there is no actual innate condition, why should we let you into the changing rooms you want to go into?
It's sort of the end result of queer theory. Sex is a messy blurry social fiction about a variety of bimodally distributed traits and doesn't really exist, the only real thing is gender identity. Someone who defines as a woman is a woman. If a woman went to the doctor's with extremely high testosterone levels, the doctor would treat her, and this should be the case if it's because she has PCOS or because she was assigned male at birth and her puberty caused her body to develop in a way that is incongruent with her gender.
If you help the woman with PCOS deal with unwanted hair growth, anti-androgen pills, estrogen and progesterone, gonad surgery and potentially even genital surgery to address cliteromegally - then you are providing gender affirming care. Therefore you should provide gender affirming care to all women. If you treat the cis woman for PCOS, but require some additional diagnosis for the trans woman, then this is the state enacting violence against a vulnerable minority of women in order to control their bodies.
There's also a broader point that we let women and girls have access to hormonal contraception and abortion. You are not doing this because you've assessed that they are in a state of dire distress about potentially becoming pregnant or being pregnant, you are doing this because women have a right to control the physiology of their own bodies - even if they may later regret aborting that specific baby, you're not going to force them to take it to term, because they don't want to be pregnant and that's a good enough reason to help them stop being pregnant. So likewise if they don't want to have a dick, that's a good enough reason to give them vaginoplasty, even if they might later regret it.
This is obviously insane logic (and I cannot stress this enough, doesn't even really work in the context of the NHS and various healthcare related UK laws). I'll leave it as an exercise to the reader to unpick everything that's wrong. But this is genuinely what Ollie is trying to communicate, and why he makes jokes about being a biological woman "because I'm a woman and I'm biological, not a robot!". It boils down to "I'm a woman because I say I am" as the fundamental premise for the entire argument. If you try and get into the weeds about being biologically male, he'll start arguing that sex is multifaceted and right now his endocrinological sex is female because of the hormones he takes and if you tried to treat him like a cis man you'd run into some issues for not adjusting to his endocrinological sex (or whatever). It's the sort of sophistry that's very persuasive in academic circles and heavily-HR-moderated circles, but rarely works to convince the public in any context where they can blurt out "that's a fucking stupid argument".
