It depends. Again, if it's evidenced since they were toddlers and continues to be evidenced through life, the person is probably a trans woman. It's very rare.
Again, the body and brain are different genders. It's easier to change the body than the brain. To really be truly transgender, there has to be a life time of evidence, not just a one time announcement. Whatever gender your brain is is what you are. Also sometimes there are chromosomal anomalies...
True transgenderism is a physical thing. The fetus' body and brain change at different times during gestation. All fetuses start out physically female, and sometimes anomalies happen. These folks who all of sudden wake up and think they are a different gender are rarely really transgender...
Since water may not have been very potable back then, adding something to make it cleaner helped. I think of it as Jesus making things that are not good and making them good.