According to some, they say they were mentally ill (often multiple overlapping problems like bipolar with Borderline Personality Disorder etc.) and couldn’t get therapy/treatment.
After years of crippling depression and dysfunction, trans activists told them that there was an answer to all their unhappiness, they just needed to ‘transition’ to correct a mistake and their emotional struggles would leave.
When they first had surgery, they experienced a period of euphoria because they believed they were free to experience happy lives like the people they saw around them. It meant there was never anything wrong with them and they would never struggle like that again. The doctors who cooed encouragement going into the transition no longer took their phone calls after the surgery and complications set in, or after they had severe medical problems from the hormones.
One thing they don’t tell the girls is that if male pattern baldness runs in your family, testosterone will cause your hair to fall out.