We've been told by transsexuals on FWR, that when they went for treatment, and/or a GRC, the medics concerned got them to sign a form to say they still knew they were biologically male.
I'm guessing they weren't about to legally validate, or operate on, someone who was actually delusional.
So this concept that a man is literally a woman, is, it would seem, fairly new.
And yes, of course, it's going to throw up all kinds of problems. Which will involve time, money, suing, pain, confusion. All of it, completely avoidable.
If you want to force people to believe you are literally the opposite sex, there is something wrong.
This man was defending his use of pronouns based on religion and reality. The fact that he is also a doctor, is presumably informing his attitude, as well.
It's the coercion that conflicts with so much. Reality, religion, facts, statistics, freedom of speech, the lot. It's never ending.