All of these are measurable. I’m not sure what’s the source of your confusion. Yes the terminology becomes a bit ambiguous unless we make up a new word/term for the tuple, but gender identity is just one dimension of it. It can be measured with a standardized questionnaire.
Because they work three jobs to get food on their table and have to remortgage their house to pay for an ambulance. Privacy is a first-world problem and the US is a third-world country.