How about, we have medical sex, and gender? 2 things? And stop conflating the 2, which EVERYONE is doing?
It's not unreasonable for a transwoman to say 'I'm female, please use female pronounds, however from a medical point of view, I have a prostate.' Any trans* person who denies they have certain organs is being stubborn and imo a bit silly. That doesn't mean they shouldn't be treated as their GENDER, but they should acknowledge the parts that maybe cause them dysphoria or that don't fit their gender.
And yes, a doctor refusing to use proper pronouns is rude, assuming someone is how exactly how they look (so a transwoman who passes perfectly gets 'she/her' from everyone, and then only gets 'he/him' from someone with priviledged personal information) It does NOT hurt to acknowledge her GENDER while treating her SEX.
The doctor should use the preferred pronouns as that is the compationate and caring thing to do, and treat the BODY as different to the MIND.
If I turned up to a Doctor using they/them, and requested they use those pronouns, I'd be fully open that I have a vagina, I've given birth, have periods, but I'd also expect my GENDER to be respected as WELL as my sex.
A transwoman saying she is female is not lying. She is stating her gender, her identity. The fact that medically this is taken as defining what her body has in it is the problem. And often forms don't have sex and gender. So the answer is: Have medical sex and gender BOTH on forms.
Ideally everyone would get chromosome tested at birth (you know, with those blood tests every baby gets) and then you'd have more idea of what your body might have... And yes, there are cases of men who are seen as medically sexed men having non-working ovaries, but because no one saw them, then they weren't classed as intersex. Sex isn't as binary as you'd think...
If a trans person is saying they're male, they can't be giving birth, not possible, then that's silly. But please don't tar all trans people with that brush. The ones I know acknowledge their biology, even as they present differently.
Stop assuming the idiots are the typical ones, please?