I think his identity was maybe fragile, but that tipped it.
From puberty they gave her massive amount of steroids
and she basically devellopped like a man.
She got HUGE, large big bones, very manly face, tall, large muscles,
Everybody from that point thought she was a man, or a freak
if she tried to be like other women.
That must really mess you up after awhile.
If she wanted to live as a women, she'd have to have extensive FFS
and since he's so huge, both in height and overall size, even that
may not help.
The east german basically gave a male phenotype to tons of east-german athletes.
A kind of forced gender change!! That's how sick they were.