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That's possible -- I learned about trans-* stuff pretty early, chronologically, due to the overlap in some fandom spaces, and I still didn't learn a lot of the more practical details for trans men until ~2003-05ish -- but I'm not sure it's obviously true. People have already brought up Heinlein, but scifi and general literary fiction already had some heavy genderfuckery already; while not all of it would fit the modern-day understanding of transgender (Woolf's 1928 Orlando: butch woman or nonbinary, greatest thread ever, locked by moderators after 10000 pages), or be particularly palatable to the modern-day trans movement (When Gravity Falls postulates a Muslim-dominant future where the protagonist's girlfriend is a trans woman prostitute, 1987).
More broadly, Ranma 1/2 had its American debut in 1993. In comics, Alan Moore's Promethea (with a very explicit contrast between gender-stuff and homosexuality) wasn't at that part of the plot until 2001 or so, but Camelot 3000 had a person reincarnated into the opposite gender in 1982. Neil Gaiman had Wanda Mann, who outside of the unfortunate name, was otherwise handled pretty well in 1991 (and probably a response to an earlier Sandman series only mentioning trans women as a serial killer's victims. Grant Morrison wrote Lord Fanny in 1994, who... was about as poorly written as you'd expect given the name or Morrison being involved. There were a handful, and of course outsider pieces tended to be even more esoteric.
Transmale characters were much less common, but they did exist.
This isn't to say Robinson had to know of any of these, but neither was it that far off from the opportunity. (Including physically; Davis California isn't San Francisco, but it was only an hour or hour-and-a-half drive, and the DSA circles there in the 1990s had a lot weird people of all kinds.)
((And, on the other direction, I'm pretty sure your point would apply to Woolf; the mechanics and philosophy for gender stuff in that era existed, up to and including Hirschfeld giving out 'gender passes', but was different enough from modern understandings that even had the notorious recluse learned of them they wouldn't have been very predictive for the future.))
An alternative explanation is that regardless of what Robinson could have imagined, he was writing for his audience, and while trans stuff wasn't well-known in that era, The Silence of the Lambs was 1991. I (and the film) would argue Buffalo Bill is not trans so much as just hates himself, but the film had to argue that in part because trans_vestitism_ at least was well-enough known for at least part of the audience to react to that. A careful author can avoid issues, but a careful author can also avoid problems by not stepping on landmines.
People seeking sexual reassignment surgery goes back to the 1950's. Probably the first normie-famous case was Renee Richards who transitioned in the 1970's and played women's tennis as a transwoman. I'm not sure about the legal history in the US, but in the UK the classical legal case was Corbett vs Corbett in 1970 which held that a marriage between a man and an MtF transsexual was invalid on the grounds that she was legally male. So trans people existed at the time KSR was writing, and someone who was familiar with the weirder fringes of progressive politics (as I think KSR was) would have known about them. But even among people who were all-in on the 1990's PC wave, they were not an important left-wing cause. In UK student unions, the "T" got added to "LGBT" around 2000.
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