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Scythians had a concept of being trans and could theoretically have transitioned by making estrogen cheese (CW: terminology about trans women is a bit off)
(www.researchgate.net)
https://en.wikipedia.org/wiki/Enaree
So, I always wondered what I would do if the Apocalypse broke out and all estradiol medication was gone.
I thought that maybe drinking the urine of pregnant mares would do the trick, but you’d die of overhydration long before you could get proper levels. However, it turns out that, similar to the production of Premarin, you could use the urine to make estrogen cheese. 
Unfortunately, I don’t really like cheese. So I’d be screwed either way 
Contrary to Western countries, there aren't any ifs or buts, nor are there any exceptions or separate rules.
Just a pure and simple "trans women are women".