I’m not sure, what you’re trying to tell me. If someone’s broadly built and muscular, but happens to have a vagina in their pants, they still need a higher dosage than someone who isn’t broadly built and muscular. Well, that’s assuming the medication doesn’t cause trouble with e.g. an uterus (and assuming they’ve got an uterus to go with their vagina).
That’s what I mean with “nature is messy”. Whatever assumption you make about whatever categorization, you’ll find lots of examples that don’t fit. It’s easy to think in categories, but you have to always be aware and accepting that it’s going to be mildly wrong.
And especially a doctor should know what they’re doing, treating people according to their actual needs, not according to some category that may or may not fit.