* it usually relies on very narrow definitions of gender dysphoria. The relation between gender dysphoria and gender euphoria for instance is often discarded. Gender dysphoria itself is poorly defined and often does not specifically manifest as gender-related until the idea is confronted. Lots of trans people suppressed for years or sometimes decades because they thought their pain was not specific enough to not be rejected by gatekeeping.

* it does not account for people that feel more comfortable outside the gender binary, no matter if they want to medically transition (some do). Transmeds and "truscum" often require strict adherence to binary gender norms, in alignment to historical guidelines where doing anything not absolutely in alignment with your binary gender would set you back significantly.