I suspect they mean had breast implants removed which shows how obfuscating terms like gender realignment are.
I raise your suspect to suspect you are right. It is a problem because many of the greater public and even those pushing the TRA agenda don’t realize post op can mean implants, or shaving the Adam’s apple, or heck, nowadays laser facial hair removal.
Many don’t understand the concerns over protecting our spaces as women because they aren’t aware most of these TIMs still have their penis and have no intent to remove them because “ladypenis” is so “dainty and feminine”.