I get that your ultimate point is that "words shouldn't be self-referential". The issue that you're either missing or deliberately obfuscating is that the words are already self-referential, only instead of meaning "I am male because I say I am male," they mean "I am male because someone else said I was."

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No, you're right, that was something I missed. While the actual definitions weren't self referential the way that the definitions are "enforced" (i.e. not enforced at all) has essentially replaced the actual definition with a self referential definition of, "person who doctor says is x." And that's a serious problem, not just because it destroys the meaning of the words in question but also because its currently used in a very cissexist way.

Thank you for raising that issue. I still don't think replacing a self referential definition with another one is a good idea. I think the word should either have a definition that doesn't self reference or it ought to be yanked from the vernacular. But I don't think you're advocating replacing the one recursive definition with another one, are you? More that doctors are no longer an authority on this sort of thing for turning the word into a self referential word?