Have posted this before I think. I am an emergency/urgent care doctor Over the years, I have seen tens of thousands of people with their clothes off following medical emergencies. I have had many patients who were cross-dressing, some of whom were probably trans and some cross-dressing for other reasons. But, in all those tens of thousands, I have never, ever been surprised to find a patient was male, even if she or he (not misgendering - I don't know how many identified as women) was dressed as female. I have occasionally been surprised to find that someone who presented as male was actually female, but never the other way round.
No TW passes. I don't mean that as belittling - I don't think they should feel a pressure to pass, and I am sorry for those who do. But the idea that there are loads of TW using female facilities without anyone noticing is sheer fantasy. We know.