The health impacts are different for men and women and also depend on how much surgery they have had and when they had it. Men dont normally get their cock and balls removed, women often get their breasts removed.
Yes a lot of research is of poor quality because there has been opposition to, and refusal to co-operate with, any research. There is actually a higher suicide rate in those who transitioned in the past, lots of debate about why. Debate too about what impact it will have on the brain when hormones are started young.
Yes it's probably worse for women because they go through an early menopause - and they usually have surgery when men dont. You really dont want to try and read up on the complications if men do have surgery, they are horrendous. The quoted complication rates are about 3 in 4 for men having surgery.
Some people, mainly detransitioners, do talk about it but their stories are pretty harrowing.