Once upon a time this suspicion wasn't really likely to come up because there wasn't an identity game being played with the public where, if a man says he's a woman, he is recorded across all forms of media as a woman, with no trace remaining of any transition being made. As a result of this new practice, if a woman's bone structure is somewhat masculine, many people these days start to wonder whether she might in fact be a man passing himself off as a sex into which he was not born.
It was an article in The Times recently that started me thinking about this. Apparently there is a successful writer who has the pen name Freida McFadden but is actually called something else. These are pictures of Freida McFadden. Judging by McFadden's advice to other writers, gender is a complicated issue in this writer's mind. The killer apparently can be a he and be a mother and a daughter.