My late father was a transexual who had gender realignment surgery in 1982 and lived happily as a woman for nearly 40 years before sadly passing away from cancer a few years ago. It is important that we all understand what a "transexual" is and do not confuse it with a "transvestite" which is something completely different. A "transexual" is a person who wishes to change their body, through hormone treatment and surgery, to that of the opposite sex to which they were born. A "transvestite" is a person, often a man, who likes to dress in the clothes of the opposite sex to which they were born, some of the time, but does NOT want to change their body.
My father first started getting advice from the medical profession in the early 1970's but didn't start the transitioning process until the late 1970's. My father followed all the relevant medical advice and guidance that he was given and which was current at the time. During this time he was prescribed female hormones which suppressed his male hormones and caused breast to grow. My father did say that after taking female hormones for so long you reach a point of no return and if you were to stop taking the tablets it would leave a man sterile. I can't confirm this because I am not a doctor.
After the various consultations with the specialist doctors my father did eventually get his name onto the NHS waiting list for gender realignment surgery, however, in the early 1980's it was a long waiting list. Therefore my father decided to go private and, at the time, there was a choice of 2 operations, both major operations, but one simpler than the other. My father chose the simpler of the 2 options and the cost in 1982 was about £2000. The product of this simpler operation was not intended for sexual intercourse and as my father didn't want this he was happy to go for the simpler and cheaper option. In brief the other option was much more extensive surgery and, at the time, wasn't always totally successful.
A family friend drove my father to hospital in 1982 for the operation and I remember waiting for the school bus, at the age of 14, seeing my father leave and wondering if that was the last time that I would see him and if he would die on the operating table. My father did survive the operation and returned home several days later, spending over a week in bed at home, nursed by a family friend. My father was in a lot of pain for a long time but eventually the effects of the operation healed.
My father never had a problem in nearly 40 years of using female only spaces which was normally just using female toilets. My father did have a few problems when he was still using male toilets and this was after he had been on female hormones but before the operation. When he started using female toilets he didn't have any more problems.
People like my late father, "transexuals" don't suddenly wake up one morning and decide that they wish to change gender, they are born like it. "Transexuals" don't put themselves through extensive surgery that could be fatal just for "fun", it is the "power of the condition" that drives them to do it and nothing said by family or friends will stop them going ahead with it. In case anyone is wondering, no it is NOT a hereditary condition.