Up until about 100 years ago, people were too busy farming and working on getting their next meal to have TIME to spin delusions about what “gender they are”. Pronoun Insanity didn’t exist until about three years ago. Trannies COULDN’T EXIST until about 1970 or so. And men have NEVER been able to give birth.
What is new is the ability to surgically change the parts up.
IIRC they were doing some of this type of surgery in Germany prior to the Nazis taking over.
Renee Richards is the first surgical case I can recall here in the US.