The evidence strongly suggests that’s correct. Once set in the womb by neural development in the third trimester, the resultant development paths are tightly constrained, regardless of post natal hormonal environment. Of course, as physiological characteristics such as genitalia are formed earlier, gender and sex may be discordant.
“There are over 6,000 genetic differences, affecting everything from the skin to the brain.”
But a bone marrow transplant changes that. Or can do.
See Bone marrow-derived cells from male donors can compose endometrial glands in female transplant recipients by Ikoma et al in Am J Obstet Gynecol. 2009 Dec;201(6):608.e1-8 & Transplanted human bone marrow cells generate new brain cells by Crain BJ, Tran SD, Mezey E. in J Neurol Sci. 2005 Jun 15;233(1-2):121-3 :It’s really only important when measuring statistical sensitivity to various chemicals. 46,XY mothers exist. 46,XX fathers exist (though far fewer than 46,XY mothers, apparently). And of course 47,XXY people exist.
“The very “best” options are still merely cosmetic.”
A matter of opinion. Womb transplants have proven to be very successful for some Intersex women. It’s only a matter of time before they’re made available to Trans women with similar physiology. And in order to justify that “cosmetic” opinion, you’d have to justify why you’re picking one set of physiological characteristics – say height – over another, say bust size. Or vice versa.
I think you’re right in your opinion, but I have no idea how I’d go about justifying that, and could easily be persuaded to change my mind.
It’s anything but simple. Sorry.
Ethics Alarms 
Congrats on the COTD. Well deserved.
Thanks. I think I’m at my best when letting the evidence speak for itself, with citations. And my worst when editorialising, even though I try to make my opinions fit the facts, not coerce the facts to fit my opinions.
That is the hard part, isn’t it?
I struggle with the same issues both here and at work. The facts matter, and opinions only count in as far as the facts go.
At work, facts are easier to come by, as it is a smaller pond to work with. Here, getting to the facts can be a challenge as fact becomes less important to the extremists and unsupported opinion is treated as fact.
Again, well done.
Zoe can you give me some insight into what is going with Rapid-onset gender dysphoria? Maybe the key things that us ethics alarms readers should know when reading pieces talking about such.
To learn all about ROGD, see Phyllis Shaffley’s words in the 1970s regarding Gays. Sometimes word for word, replacing transgender with homosexual.
That’s the short answer. But really, that consideration should be irrelevant, this is a question of fact and evidence, so who said it and why shouldn’t come into it.
The evidence is based on a self selected survey of 3 ideologically “trans critical” sites, testimony of “parents of trans children”, or rather, their impressions of what their children are going through. None of it is based on testimony of the trans kids themselves, nor corroborated by independent sources.
Examination of the social media of the purported “parents” show that slightly more than 50% don’t actually have any children.
See the only paper on the subject at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330
There might be a grain of truth amidst the dross. But how could you tell? There’s one paper. Results not replicated. Over 50% of sample known to be falsified.
A good summary is at https://medium.com/@juliaserano/everything-you-need-to-know-about-rapid-onset-gender-dysphoria-1940b8afdeba
Thank you Zoe, I appreciate your time and thank you for providing the info.