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From the other side, to take your example of "can you call yourself doctor?", the demand to change identity documents to reflect a fake status is as if someone who didn't go to university, didn't have a PhD, and was not otherwise qualified no matter if it's DEI or not, was sticking up "I am Doctor Smith, address me as such" on their doorbell and letters and the rest of it.
Whatever about driving licences, I do think that "I want to change my birth certificate so it says Mom and Dad had a baby girl on 17th September 1978 in Wenatchee Maternity Hospital at 3:45 a.m. and not a baby boy" is not permissible. A birth certificate is either a statement of fact or not. If we're going to make legal documents like marriage and turn it into "whatever you feel makes you happy, be that two guys can get married, six people are too a real marital unit, or boys will be girls and girls will be boys, sure thing and paperwork is just fiction depending on how you feel at any particular moment in time", then what is even the point of having registers?
I think that in the context of Trump's SAVE act, it popped up that people can -- and might have to -- get a birth certificate with their current legal name on it. I also think that some countries use up-to-date birth certificates to track marriage status.
If birth certificates are updated regularly to reflect changes in the life circumstances of a person, rather than being stored on the blockchain shortly after birth, then it makes sense to also update them to reflect cosmetic changes in things like first name or gender identity.
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