Not many people here are going to fuss about gender identity and are open to shades of gray. A few will, but on the whole this is an open-minded group. I mention birth in posts about biological sex from a medical standpoint since for appx 98% of humans, biologic sex is easily determined at birth.
I asked you how medical practitioners should identify sex and you defer to experts. Two good expert sources are listed above: Grey's Anatomy and Merck Manual.
Here's what Merck has to say about the terminology:
Excerpt:
Concepts of Sex and Gender
Various terms are used to talk about sex and gender. Sex and gender are not the same thing.
- Sex refers to a person's biologic status: male, female, or intersex.
- Sexual identity refers to the sex to which a person is sexually attracted (if any).
- Gender refers to a person's public, lived role as boy or girl, man or woman.
- Gender identity is the subjective sense of knowing to which gender one belongs; that is, whether people regard themselves as male, female, transgender, or another identifying term (for example, genderqueer, nonbinary, agender).
- Gender role is the objective, public expression of gender identity and includes everything that people say and do to indicate to themselves and to others the degree to which they are the gender with which they identify.