Knowing biology, I’m sure it’s complicated and any generalization will be false. For example, there might be genetic conditions that derive from having two X chromosomes that we could argue are intrinsic to the sex (or more accurately, intrinsic to that karyotype), but for the most part my understanding is that differences relevant to lab ranges are mostly mediated by hormones, so I use female ranges.

Either way, my PCP seemed to indicate I shouldn’t disclose trans status but that the one exception was that I eventually need to find someone for prostate exams once I hit that age (if I hit that age, I guess). The endo that prescribes my HRT has never mentioned whether I should disclose or when to.

I should say, even when my medical chart was shared across hospital systems and my gender dysphoria was listed in my chart, the ER doctors didn’t seem to do uptake or change the way they treated me, even when I walked through my HRT and explained I couldn’t be pregnant. They still thought I was a cis woman and asked if I could be pregnant - I think people mostly just operate based on what they see, and it’s a shock when you say you are trans. It creates an extreme chilling effect sometimes, people stop meeting your eyes, or even interacting (sometimes interacting through a third party instead, like a cis family member). I’ve even talked to a neurologist through the details of my vaginoplasty and he didn’t seem to do uptake that I was trans. Unless I say the words, they just won’t put the dots together. (Meanwhile a trans woman at Sephora’s will clock me from across the store.)