The test is much simpler than that. Just look at the hands and feet.
They are "shaving" adams apples now and have you seen the feet and hands on Uma Thurman?? She is also 6-1 and has huge, huge feet and manly hands. I think her feet in man's size is a 11 or 12. Check them out in the dance seen in Pulp Fiction
You’re partially right. There is no reasonable surgery to reduce the size of the bone structure in hands and feet. It would require work on every tiny component in the hand. A man with very big hands/feet will always have this ‘tell’.
However, the hormonal treatments they get will alter the distribution of fat in the hands and make the skin smoother. Their hands and feet will have the feminine look but keep the same bone size as before.
A man born with small hands/feet can look just like a woman. Even a man with average hands can pass as a big-handed woman. If the rest of him looks like this beauty contestant, most men wouldn’t care if the hands are above average size.