I don’t think they’re playing out warped fantasies. It’s all about recognizing their “real” sex. Assumedly, starting hormones earlier will make it easier to pretend. I keep seeing really ugly trannys. I know some look alright, but on the whole, they look their born sex. I haven’t researched it, but how does a m2f tranny orgasm? Or f2m? Can they even orgasm?
They keep the original male parts, just cut them up and reassemble them into a pale imitation of the woman’s parts.