Not really. Even if someone genuinely believes that they are "a woman in a man's body", they might still have the wits to understand that being a woman in a eunuch's body isn't an improvement, or they might be too poor to be exploited as a cash cow by some unscrupulous plastic surgeon. The latter group would account for the lunatics who want their mutilation to be funded by their insurer/the government, and probably at least some of the ones begging on GoFundMe for surgery money.