Good spot.
@Ilikeanicecupofteainthemorning I agree it doesn't sound good.
I wonder if it is referring to the impact of a compromised endochrine system and/or surgery complications. I could well imagine several of the impacts worsening with age, like incontinence. Females who take testosterone and males who undergo vaginoplasty can sadly expect to be incontinent.
Obviously anyone can get incontinence or double incontinence. But having either or both from a young age doesn't bode well for the future - a worsening impact sounds plausible and would fit the description of a loss of autonomy.