There are very few people who have bizarre sex chromosome variabilities like XXY, XYY, XYYY, XO,....to those unfortunate ones, I can understand their gender “confusion”.
To the rest of the normal XX, or XY (male, female) who believe they are other I would consider as delusional and/or stricken by FOMO and/or socially contagious Munchausen disorders, or socially naive followers.
I understand that in Japan, if you want to change your gender you must remove all of your birth genitalia. I would suggest one should also change all other sex related physiological differences, and TRANSPLANT the other sexual different parts..e.g.lots of prostatectomies and prostate transplants..or ovarian, uterine, vaginal, fallopian tube, testicular, penile, pelvis, brain transplants too. Let’s see the gender affirming “Dr.Frankenstein” surgeons do that.
Even so, all of those chromosomal abnormalities are still definitively male or female. They aren’t either-or. Yes, they may be feminine males, or masculine females, but still set.
There are some issues where the external body develops opposite the chromosomes, but that is very rare. Chimeras also can happen, but they’re extremely rare too, and normally one chromosomal set is dominant over the other.