At the time when Oscar Pistorious was competing, there was an actual conversation around the fear that people would get their legs amputated so they could get prosthetics like he had if it would gain them a competitive advantage. No one actually knew if his prosthetic legs gave a real advantage because there was no way to do a comparison without having a real athlete go through the amputations.

If you look into the scene around body building and the extreme lengths people go to with steroids, extreme diets, dehydration and more, it doesn’t seem all that implausible that some people would transition in order to gain a competitive advantage. Heck, some people deliberately get their legs broken in order to stretch out the bones just so they can be taller (no competitive reason). That’s an extremely painful process undergone for less extreme reasons.