Whatever anyone thinks of it as an artwork, it is an artwork, not a public service message, a marketing image, educational material etc. I do not think that artists should always concern themselves with ‘representation’.
And plenty of non-TRA Trans people who understand the position of sec based rights do experience prejudice, discrimination and hate simply for being gender non conforming.
What free expression highlights is that the right of artists such as Jess de Wahls who make their work around female imagery must be fought for and protected and not silenced. The censorship she experienced from the RA was outrageous and against what should be the core concern of an arts institution: free expression for artists.
Silencing the opposition leads us down a dangerous cul de sac.
Commenting on and critiquing the work is the most valuable response, IMO.