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Instead of just looking at passing, there's also the factor of hormones. Due to this, they start to actually have attributes of the other sex in ways that they previously did not, and that are not just makeup and outward aesthetic changes. Of course, that's still limited, and so they remain hard to categorize.
But imagine we had some perfect technology that could fully and perfectly, change someone's sex, down to a cellular level, etc. In that case, we should recognize them as being the opposite sex than they had, I would think. Current treatments are currently very far short of that, while still being something in that direction, which is one reason why there's all this disagreement over what we should do.
If technology is that sufficiently advanced we could presume there'd be a 'cure' for this population to allow them to be happy with their natal bodies.
Some trans people would argue that such a “cure” would fundamentally change who they are as a person, as opposed to say, plopping the same brain in a new body of the opposite sex. It would be akin to having a pill to cure homosexuality when you could instead just accept people for who they are.
I’m somewhat ambivalent about it because going from one sex hormone to the other also changes who you are as a person (I’ve experienced this as someone who went on HRT), and there’s reports of dysphoric biological female teenagers going on testosterone blockers and that significantly reducing their dysphoria to the point they no longer need to transition.
But, given the two options, I would probably go with the perfect transition, because it’s a lot more interesting.
In terms of fundamental change, happy as I am, seems a lesser / smaller change than the alternative.
I would think a pill to cure homosexuals would be popular. Though I can imagine there would be opposition. There's opposition by some in the deaf community to cochlear implants.
I’m much more averse to altering my brain than altering my body. To me a perfect sex change would be plopping my existing brain into a body of the opposite sex, while a dysphoria cure would involve fundamentally altering my existing brain structure.
Me with a different set of genitals is still me; me after a treatment that changes my self-perception and my sexuality… seems like a much bigger change.
To me the gender swap is the cochlear implants, whereas the curing gender dysphoria is like making you OK with being deaf and having you live in an idyllic deaf community. Sure, some of those people are very happy, and it’s better than being miserable because you don’t know what everyone around you is saying, but I would much prefer to be able to actually hear.
Someone that has undergone some kind of sci-fi procedure to wind up in the body of someone of the opposite sex at, say, 25 would be a very interesting person. They'd have had a quarter-century of socialization and life experience in their birth sex. That would have a strong impact on who they were as people afterwards.
Off Armageddon Reef (and the remainder of the Safehold series) by David Weber is one example.
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