The first trip should be to the Endocrinologist to see if they don’t have an endocrine disorder throwing off their hormones. Run the initial labs but also demand an ACTH stimulation test. They should also be checked for PCOS or possible tumors on their adrenal glands.
If everything comes back clear, then bring them to a psychiatrist. What’s happening is mental, not medical, and they are not trans.
The answer is to restore the monarchy and make it a protectorate. Remove statehood along with 2 senators. There would be a groundswell of support amongst the native Hawaiians. Allow those living in the CONUS to vote absentee with a promise to give haloe property to the natives upon their deaths. Watch them run for their lives.