If something occurs that is unusual, then for indigenous people it is sacred, because it takes us out of the ordinary and the everyday. So lightning is sacred, dangerous animals and poisonous plants are sacred. And so are the Two Spirits, those unusual people who feel themselves to be both genders, though being of one biological sex. For Native Americans, it has always been accepted that some men want to live as women, and vice-versa. These people are looked to as leaders and healers, because they have both gender perspectives, each to a high degree.
We have reduced this sacred phenomenon to a biological mistake, that needs correction by surgery, which is why we have the term 'transgender'. And attempts to question this approach are frequently condemned as hate speech, as 'transphobia'.