I also wonder why you are attacking her as just "a desk job worker" instead of a medical professional.
According to the Chicago School of Professional Psychology:
The most common certifying board for health care case managers is the Commission for Case Manager Certification.
In order to sit for the certification exam, candidates must meet educational and work experience requirements, including:
A current health or human services licensure or a bachelor’s or master’s degree in a health and human services discipline.
Completed work experience in case management...
https://www.thechicagoschool.edu/insight/health-care/how-to-become-a-certified-health-care-case-manager/
Case managers don't have the medical training to evaluate or treat transgender patients because they're not doctors. Whatever misgivings they may have is immaterial: the experts support current transgender treatment.
Case closed.