Chicken or egg
Autism means some people struggle with gender stereotypes because they effectively believe them to be hard and fast rules. Rule breaking causes a state of anxiety. Thus a male who breaks gender stereotypes feels anxiety because of it. This has an effect on the brain.
Perhaps it is a feeling. But it's not a feeling of being a woman. And the first line treatment should not be to enable and reinforce that someone is female because this makes the problem worse. It is doing harm not helping because it increases the anxiety related response. An anxiety related response often results in a fight or flight mentality - and we are seeing this manifest as anger and threats. Precisely because of the nature of what's going on.
And of course surrounding yourself in an echo chamber creates extremists and perhaps alters brain responses again. Not because someone 'is a woman' but because they've ended up in a doom loop. This may hold off some feelings, but at some point there will be an issue because when someone looks in the mirror they can't escape their sex and they will still see it especially as they've increased their sensitivity because they've fed their negative anxiety response.
It also explains the whole over compensating and ott dramatisation feature of dressing up as a woman because it triggers a response in other people and often it has this sense of promoting confidence because you have to fake it and this gives a certain response within the brain. Again not being a woman and this isn't maintainable because of the level of effort required to sustain it and that lending itself to trigger autistic meltdowns.
Then when you go through the process of medicalisation and it doesn't deliver on unachievable promises and you have a bunch of significant negative side effects you are either going to regress even further into a denial state lashing out and blaming everyone else because of your own unhappiness or you will reach a total rock bottom crash point - which may result in negative consequences of its own.
If you look at it all through the lens of autistic issues with rules breaking and an anxiety response then the whole thing makes perfect sense.
And it also highlights why the ultimate and absolute thing you shouldn't do is facilitate it because it only leads to spiraling responses in line with anxiety led responses.
But no one can actually study this hypothesis because it'd be deemed to be offensive. Even if it ultimately has a hell of a lot behind it to suggest it might well have merit. Because ideology has eroded and corrupted scientific good practice.