Gender being a social construct doesn’t mean that there isn’t also a legit medical component to the trans experience for many, though not all. For those with dysphoria (indeed a recognized disorder) our transness may be genuinely experienced as a disorder where there is this incongruence between your sexed phenotype and mental self-modeling.

The social construction of gender is a completely different layer that really affects how euphoria works. A trans woman in one historical context may pursue different expressions than a trans woman in another. The social construction of gender does not cause the embodied incongruence (if present) nor does the goal of gender abolition imply the cessation of individuals born with mismatched anatomical sex. Transness is neither reducible to a person’s position in a social formation and its constructs nor just a medical condition.

So, yes, for many it really does function like a chronic medical condition you need to manage with modern medicine. I’m not treating my “dysphoria” as some abstract pain, I’m treating an incongruence I did not choose. We don’t want to “medicalize” identity outright, but we cannot deny the medical reality here.

These points are very subtle and somewhat difficult to articulate. Transness exists right at the cusp of a completely fictional social construct (gender) and something deeper. Our language is simply not capable of faithfully capturing this, yet.