It’s a woman who had a few features surgically altered, and considers herself a man. If it was a man who got the surgery, he wouldn’t have the uterus neccessary for pregnancy. Aside from a few external features cut up and sewn, it’s still a woman.
So this is a woman, with a few minor alterations, who is calling herself a man? And she has an estranged wife? When did she get this wife? When she was still a woman? Or after she underwent some surgery and called herself a man? Who impregnated her? If she got the wife before the surgery, then she was also a lesbian? This is even more confusing than it first appears. It certainly cements the mental illness diagnosis.