It certainly doesn't help that there are self-serving "gender clinic" MDs spewing this bullshit:
"Dr. Deanna Adkins stated, 'From a medical perspective, the appropriate determinant of sex is gender identity.' Adkins is a professor at Duke University School of Medicine and the director of the Duke Center for Child and Adolescent Gender Care (which opened in 2015).
"Adkins argues that gender identity is not only the preferred basis for determining sex, but 'the only medically supported determinant of sex.' Every other method is bad science, she claims: 'It is counter to medical science to use chromosomes, hormones, internal reproductive organs, external genitalia, or secondary sex characteristics to override gender identity for purposes of classifying someone as male or female.'"