A doctor friend of mine (who is very gender accepting/variant herself) told me a story from one of her cohorts. They were going to perform some abdominal procedure on a woman, but after they had opened her up, they did not find the organs and abdominal layout they were expecting. They called off the surgery and had to reschedule after they had gotten more information.

These doctors were super pissed off that this woman had chosen not to disclose that her body was internally male, even if externally it looked indistinguishably female. This is a relevant medical concern that has nothing to do with gender identity. Her identity doesn't matter when she's lying on the operating table, they need to know her medical and biological history.

So yes, reasonable people (like doctors) look at the trans movement's attempted reclamation of 'male/female' and it doesn't work for them, in a professional sense.

I thought you were sincere in your question. It seems like that's not actually the case. What I don't understand (sincerely) is why an mtf/ftm person would have such a hard time with this proposal. If the issue is sex/body dysphoria, then take hormones and/or get surgery, and the label shouldn't matter. If the issue is gender dysphoria, then present as a woman (possibly taking hormones/etc), and society will treat you like one, and again the label shouldn't matter. In my proposal, you can use any identity label you want ('woman' 'femme' 'feminine' etc), but when you insist on co-opting 'female', that's what makes ordinary intelligent people look askance at the cause. We agree about the construction and performance of gender and are rooting for transgenderism to take us beyond this pitiful man/woman duality we live in. But a transfeminine body is not a female body, full stop. This is obvious once you stop and think about it for a second, and insisting otherwise is just going to give reasonable liberal people pause, and the conservatives a wedge to discredit us.