One of my friends was born without a pituitary gland and he has the classic castrato / eunuch, sterilized before puberty look. However, he’s a straight cis man and identifies as such. He definitely looks different from a regular guy though, despite having been given hormones.
I try to get down to very low bodyfat so the real problem is with bone structure. So far I’ve been on Provera and Letrozole for quite some time. Ultimately my dream is to get everything removed and then take Letrozole for life.