It doesn't, this is based on one specific person's (OOP) gender. It's more about how having a bajillion dollars makes gender dysphoria into an incredibly easy problem to solve.

Thess 99%/1% questions usually have the 1% be something bad and the bad in this case would have to be dysphoria

I think the spirit of the question is "what if it was a trickster genie and you didn't get what you thought and were unhappy?" Like, rather than the question as phrased, I imagine the intent was "what if the 1% chance was permanent gender dysphoria regardless of any practical steps taken to alleviate it?"

I wonder how many people would just go "eh, whatever" if this happened to them, especially considering all the disadvantages of being a woman in today's world. Plus if their mind stays constant enough that becoming dysphoric is a possibility, they'd have to deal with suddenly being a different sexuality. All in all it seems pretty traumatic if it wasn't something you wanted.