Hell, even if you allow them to self-ID outside of their binary status, they sure as feck aren't changing from men or women simply because they've fecked around with hormones or mutilated their bodies. One of the studies that gets flung around by them is something to do with Indo cultures or South American cultures having these spots were they 'create' a third gender. So even in these instances where the odd ones out are accepted as the oddities that they are, they don't simply blend into the two file system, they get their own 'special' status. But it sure as feck not changing their gender.