For those who actually have a mental illness, treating them with hormones and surgery is like trying to cover up an infected wound with a band-aid. Their problems are in their brains, not their bodies; hacking them up isn't going to solve their dismorphia; it's still going to be there because their brain is still fucked up and still views its body as fundamentally wrong. If anything, it's going to be even worse than before because every time they look in the mirror or take off their pants, what they see won't even look human anymore. If they were having trouble finding reasons to stay alive before the surgery, they're going to have even fewer after. Ditto for those who jumped on the tranny bandwagon or were outright groomed into it. They look hideous, their fertility is gone, they have a slew of health issues they didn't have before, and unlike the goths, emos, and punks before them who just went through a phase, they can never undo the damage they've done to themselves.

And on top of all that, both types are now going to live forever under the paranoid delusion that everyone is out to murder them because some shitty 90s movie said so. Hell, just living under that state of mind constantly by itself is going drive most people to suicide.