Italian, my perspective on the question of 'gender dysphoria; v 'sex dysphoria'.
Transsexuals believe their bodies are just somehow wrong. It is focused on the body, not on personality, or hobbies, or likes or dislikes.
We don't know how or why. So we come up with words like 'born in the wrong body' because that's how it feels.
It is the body, not the mind, or personality or self expression.
We KNOW that biologically our sex is one thing as defined by various obvious features but we FEEL innately and deeply that it should be different.
So it becomes a necessity to bridge that gap by whatever physical means are available.
Hence we remove all visible signs of maleness, sex organs, facial hair, adams apple removal if necessary, even altering voice pitch by surgery, facial reconstruction and so on. And, of course, alter our hormonal make up to match female normal levels as best as possible.
The amount done depends on many things - cost, availability on NHS, etc. But we do it even though much of it is extremely painful with possible complications because it is a necessary step to us towards the only end goal we have to reach.
We know it does not change biology. But we almost certainly would do that or any new procedure made available to push us further along the path if it became available.
It is very strange - because we understand the apparent madness of what we are doing. We recognise the futility of it as in it being a literal transformation. We could be told it will shorten our lives (as we often were) and that the outcome will be uncertain (as they often are). Possibly permanent body malfunctions and so on.
Yet we do it because it is a necessity to achieve that balance or harmony between body and how we feel our body should have been.
It is a bit like having a tumour inside that you notice all the time as a pain deep within your body and you just have to remove this in order to survive regardless of the risk of doing so.
I don't get the sense that there is this level of physical transformative necessity about transgender people.
They seem really to want to express a gender identity that they feel they possess in the easiest and most adaptable way. They tend not to be that risk friendly so any work done is likely to be the soft kind.
One question we usually get asked by psychologists seems to be if there was a magic cabinet you can walk into and emerge from as one sex or the other, which would you choose? Transsexuals always apparently give the same answer. Transgender people say one, then might say the opposite the next week. They have no such surety.
Transgender people do not always feel any kind of physical anomaly at all and that is why you hear the absurdity spoken of a woman happy to transition and retain her 'lady penis'.
A statement that I (and I suspect most transsexuals) find impossible to comprehend and - well - absurd.
Much as I am sure you find what I am describing to you about being transsexual as absurd.
Because I know perfectly well it will appear utterly bonkers. And it is bonkers. But it is what somehow happens and when you have it you know that it just will not go away, because you hope it will and it just stays there all the time unless you deal with it.