I mean, the first step is actually determining what the sex-specific mechanism is. Microbes in your gut generally aren't checking sex chromosomes. They interac

I mean, the first step is actually determining what the sex-specific mechanism is. Microbes in your gut generally aren't checking sex chromosomes. They interact with sex hormones (see Rizzetto et al., 2018 cited in the paper for this very thing) which often reflect sex chromosomes. Hormone levels or response may not match what is typical of sex chromosomes for a number of reasons including: 46XY women (androgen insensitivity), trans people on HRT, women post-menopause, and sometimes cancer treatment. IMO it would be less alienating and lead to better health outcomes for everyone if we talked more about testosterone-dominant or estrogen-dominant endocrine systems (or other systems as appropriate). Also whether dimorphic effects are a result of a one-shot process (e.g. grow testes or ovaries, grow breasts), or a recurring process (hormone levels triggering lactation, sweat patterns).