Wow, do you realise how outdated your thinking is? A lot of trans-people would be incredibly offended by the assertion that there’s something defective about them - in fact a vast, vast majority of trans women do very little surgery and it’s over 92% that keep their male genitalia.
As it happens as well, a trans activist was going to release a paper with medical ‘proof’ of trans-ness but had to recant because a very angry mob of trans people (predominately male) didn’t want it released. Can you think why that might have been?
And what would you have thought about it if only some trans people met the criteria of medical proof? Would you have conceded that some are in fact only in it for the fetish?