Someone who believes themselves to be a woman would loathe the idea of anyone thinking of them as a man. Someone who has magically changed themselves into a biological woman has no reason to ever put the idea in another person's head that they were ever a man.
Someone who is married wouldn't care, since they've already attained a mate. And, in fact, being that they accomplished a feat defying nature, they might even be proud of it.
The idea that they would be at all ashamed of it is a modern projection. It's not universal, and for someone who claims to have been reading fantasy for such a long time, you're remarkably ignorant of that.
In a setting where magic exists that will change a person's sex, there will also exist people who will want to use that magic. Any transpersons in the past just had to live with it because there were no options until the 20th century. And they did exist; the bible has rules against homosexuality and crossdressing because they found these people to be abominations.
Because they are abominations. They're mentally unwell. When you're willing to spend $20,000 to cut off your dick and turn it into a gapping, smelly wound to satisfy your sexual perversions, there is something wrong with you.
And I'm sure all sorts of perversions existed in the past, but the realities of life took precedence over getting turned on by weird things. For you to talk about the hierarchy of needs and then not realize that in a medieval fantasy setting there might be needs slightly higher than lopping your dick off because you REALLY want to be able to have lesbian sex (and thus never be able to impregnate your partner again), well, that's just silly.
Ultimately, it's a modern idea that could only exist in a decadent, spoiled society. A society filled with gullible, midwit, sex-obsessed perverts, looking for ever increasing stimulation, attention, and a feeling of uniqueness and control of their otherwise meaningless and unfulfilling lives. This, and the fact that the author herself says she puts that sort of thing in for political reasons, makes its inclusion complete tripe.
That said, if you want to put bad writing in your brain, be my guest. I myself enjoy some bad writing or silly concepts on occasion - but I'm at least honest about it.