This is insanity on steroids.
If it requires admittedly radical “surgery,” and perpetual follow up with hormone treatment, then it’s a disorder. What else requires such TREATMENT?
Well they do take steroids, so your steroids term is literally in play.
What happens if these people are out in the wilds somewhere? Will the military spend a ton of money to get them their needed treatments so they don’t start looking like what they really are?
Transgender is a fiction, a complete denial of reality. Nobody is born in the wrong body. They are no more anything other than how they are constructed than somebody who claims to be Napoleon is the leader of France.