Nowhere in my piece do I conflate sex with gender. The distinction between the two is quite clear, and it's a big part of why the APA and WHO (among other major medical organizations) have since ceased to classify transgenderism as a mental illness. Some of the studies I cited use the term "sex reassignment" (which is now generally regarded as outdated), but if you have an issue with that, you'll have to take it up with the original authors.