I got a different read off the article - the satirical term mayogender and third gender was applied to the fact that these obeasts had eaten themselves out of recognizable genitals and whined for a solution that allowed them to continue to gorge without consequences - the Platonic ideal of "muh set point" and "skinny metabolism". From a purely pragmatic point, it's more of a farce that Medicare and insurance will cover bariatric, skin removal surgery, and now this reverse tube horseshit and not reassignment for the currently screened and treated decimal percentage of the population that need it. Fat fucks could just, you know, eat less or have the common sense to not fatten up in the first place but I'm pretty sure a person can't diet and exercise themselves into a mastectomy or labiaplasty. I mean, the numbers are, what, 2 billion fatasses on the planet vs a tiny percentage? I wouldn't be surprised if the sheer number of "cundishuns" per capita begins to approach the bill for transition since so many fatasses don't have the decency to keel over and stop chronically draining skilled medical professionals and supplies.