I remember reading many years ago that F2M surgery can shorten your life by 10 years. I don't know if that is still the case, but it struck me then that people who go through with surgery must really believe they need it, to accept such a risk
I think the overall health consequences are worse than that but I think a big issue here is that when they are taking these decisions, a lot of people are in serious emotional distress. That is not a good state of mind to be making informed decisions on life changing surgery.
More and more detransitioners are reporting that they felt pushed into surgery or that they were so set on surgery being the answer to their distress that they would do anything but then they find that it was not the answer and that their distress is still there or worse.
The other aspect to bear in mind is that many people deciding to have surgery have their moods and decision making altered by cross sex hormones. Taking oestrogen in males and testosterone in females can have specific mood enhancing effects on the brain which entrenches the idea that they are doing the right thing and definitely’ trans.
Equally, it can also have a depressive effect which, once on the path of medication, surgery seems like the only solution left.
We need far more research on outcomes - current research is showing that medical transition does not improve the mental health outcomes for many patients and some countries are stoping treatment in children and young people.