I'm not playing semantics games of 'socially woman' or 'legally treated as a woman' or 'internally/mentally/inner-self is a woman'
Me either.
That doesn't mean I don't accept that sometimes cosmetic surgery will be the best thing available to alleviate someone's chronic distress. But I do worry about cosmetic surgeons with a god complex promoting unrealistic outcomes to people in this level of distress.
Like chemotherapy, this treatment may be effective, but is still relatively crude.