You speak as if people are going around "oh geez I wish I was a man today! It's so boring having this vagina... !"

I take it you've never spent any time with transgender persons. It's easy to dismiss someone's suffering as an internal issue and any sort of cosmetic adjustment as a cruel mutilation... until it's you or someone close to you.

What I know is that of the people I've met who transitioned, they are 10000% more productive, happier and healthier living in their new bodies and genders than they were before.

If you think about all the things we do in every day life that require us to have our bodies and our internal genders aligned, you'd be surprised. It's so easy to sit and judge from outside the experience of a handicap. and I'm sorry but you can't change a persons internal gender without changing/destroying that person entirely. Not even lobotomies work. So what is left? You change the body. It's much easier and much more effective and compassionate.

In the meantime you work on changing society so that people aren't compelled to pick one side or another in a world where existence hinges upon maintaining a false dichotomy. (Male or Female. Man or Woman. With no Other and no in between. Ever. Case Closed).

We can also sit and nitpick about the legitimacy of certain body modifications all day, but the issue at hand is not whether or not people are really changing their sex, but, what are the real options for people who fall outside of the gender binary? Nobody gets to opt out of this gender game; we are all assigned to live as one gender or another at birth. Most of us are not going to have a problem with our original assignment. But many people do.

You can say that that's psychotic, or genetic, or environmental or delusional but none of that makes it go away. It doesn't work for sexual orientation and it doesn't work for gender dysphoria either.