I’m the context of the song the line comes after lists of stereotyped “man“ things - womanizing, wife beating, thieving, blowing up stuff, killing animals, etc. I don’t think it can be taken as a ”gender identity” statement in currently fashionable terms. It’s simply a rejection of stereotyped ideas about what constitutes “manly” behavior, not a rejection of his own manhood as such.
Even in the days of his most fey ways, I never saw him as particularly unmanly or trans or whatever. Neither were his heroes the New York Dolls - despite their more pronounced trans attire and presentation, they were all straight pussy-slaying rockers in the good ol’ days of drug fueled early ‘70s groupie sex.