I think there are two things. One’s biological predispositions, and then how one sees oneself and fits into society. When they perceive a mismatch, they may change their presentation / behavior in society and also change their biology to some degree to try to close the gap. Do those changes make them in an ontological sense something they previously were not? That really depends on how we want to define what it means to make them something different. In one sense, you’re 100% right, nothing will change their DNA+. I don’t think that’s the sense that they care about though, one in which they are at least partially right (again not the people who say things like there aren’t these two things, there is only the latter thing and it isn’t affected by DNA and who seem to be mostly wrong). Another thought here is that I think nobody should try to push a concept of themselves into someone else’s head. If I want you to think of me as nice, but you don’t.. sucks to be me. Same if I want you to think I’m right about any of this. I think part of this topic is people get to thinking they are being made to think differently than they do by the other side. “I feel I am a women, they say I mustn’t think of myself that way” “I see that person as a man, they say I must see that person as a woman”. Neither of these messages should be communicated.