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Obviously, but when the narration and descriptions use those as well, it gives it more importance than just having other characters misgender them in conversation.
Which is the otokonoko I linked to. If the term was used today it would be much more ambiguous, but the game came out in 2004 when that term was essentially only used for" crossdressers" in Japan - what I guess we’d these days call femboys - and basically never for trans people. That meaning came almost two decades later, and some would even argue that it shouldn’t be used for them at all.
Maybe, but it could also just be the nature of the culture at the time to talk about trans people that way. “A boy who thinks he’s a girl” is just, by our current understanding, a transphobic description of a trans girl.
I’m not close enough to say with any authority that it was or wasn’t, but the use of that word, even in third person narrative descriptions of her, doesn’t really sound like “they’re definitely just a crossdresser” so much as someone euphemistically describing a trans girl. Especially when the character herself references herself as a girl. That right there is really the most important part.
By all means don’t just trust the word of a random girl on the Internet, but there ya go