They get that semi-hair growth with male hormone shots. The 'beard' of a 14 year old, and they fool themselves into thinking, "Now I am a MAN!!!", and they shave once a month.
A breast reduction, a hysterectomy, their menses dry up, they shop in the teenage boy's section at Macy's, and convince themselves that they "pass". It's sorta sad.
Doctors who are paid enough will butcher anyone. I wonder how many quacks have given a stomach stapling to an anorexic?
As a physician there was a time I would have objected to that remark.