The more I think about this issue, the more I have come to believe that what we have here is a colossal knowledge failure in wider culture about gender and gender performance.
What constitutes cultural masculine and feminine behaviour in the west is not a universal set of markers across cultures or history. Therefore these markers cannot be innate or connected essentially to biological sex class.
For example, soccer is a girl's sport in the US, yet in South America, Africa, the Middle East and Europe, it is perceived as a male sport.
Embroidery in Western Europe has traditionally been seen as a women's art. Not so in Kashmir, where fine embroidery is a specifically male enterprise.
Again commerce has been a traditionally male occupation in Western Europe. Yet in west Africa, it was traditionally women that acted as merchants in the market place, running stalls and buying and selling.
When you look at gender performance through history, the subject gets even more murky. Prior to the Georgian period, it was generally perceived that men were the passive sexualised partner and were told to "do their husbandly duty" and pretty much "lie back and think of England" whereas women were the sexually rapacious class.
Pink was once a boys' colour; blue was once a girls'. Tears and showing emotion was once perceived as the high of refined male sensibility. In the 17th century, men did "ballet" in order to refine their movements for court.
And this is all before we get onto variations on warrior culture between men and women.
All I see in this issue is a drive for extreme cultural conformity to a set of cultural and social performance markers that are very much of this place and this time. My feeling is that if you can persuade people to believe these are innate and essential to the point of medical and surgical intervention, you can persuade people of anything.
And that should really worry us all.