Malta has self-id and yet has the strictest laws on abortion in Europe.
If you are a woman with an ectopic pregnancy (which kill women), you have to get the agreement of a panel of multiple doctors that you will die otherwise, before you can access a termination. You cannot self-id as needing a termination, and nor is the word of the diagnosing physician good enough, even if your life is literally at stake.
But men can identify as having gender dysphoria and having a right to access women's spaces without seeing a single doctor.
Malta is now lauded as a beacon of human rights. They've effectively distracted the world from the state's attitude to women, and they only had to sacrifice some additional women's rights to do so.