You only have to look through certain Reddit forums (or Himdia's X account) to find people who genuinely think they've changed sex. I've also seen comments from trans identified females who think they can grow their breasts back if they change their mind after top surgery.
It's hardly surprising that there is a fundamental lack of critical thinking, even for such life changing surgery. Transgender forums are echo chambers - much as MN gets accused of that, those who disagree with us don't get banned - and dissenting or questioning voices are absolutely not heard. And these are often people looking for a solution to a problem: an escape from harassment or abuse, an explanation for why they don't fit in, a way out of gender stereotypes or whatever. Social transitioning, puberty blockers, cross-sex hormones, none of them were the answer so surely surgery will give them the relief/safety/answers they crave, yes? And why would they want to hear from those who say it won't?
Throw in health care professionals who are busy signalling their virtue, pushing agendas and/or making money and careers out of this, and you've got vulnerable people being let down by those whose very job it is to protect them.
And by the time the reality is clear it is far too late. This was always a huge scandal waiting to happen.