You cannot make a woman out of a man (unless you are God)
In every case of having "a woman's brain in a man's body" why don't they fix the mind?
Because we don't know how to. It will be a long time before we do.
In order to fix the mind, we'd have to fix the brain. And that doesn't mean anything as crude as surgery. We'd have to remake the whole thing, change the size of some structures, shrink others. We'd have to change the ratio of different cell types in each structure. We'd even have to change individual cells, so they have different cellular receptors for hormones and neurotransmitters.
There are really huge differences between male and female brains, far more than we suspected even 10 years ago.
The problem is... that if something goes wrong with the hormonal balance around week 12 of the gestation.. you really can end up with a male brain in a female body, or the reverse. That's regardless of the chromosomes.
Here's what Prof Ecker wrote to me (I'm a researcher in the area):
Hi Zoe,
Yes, we gave our presentation to 60 plus psychiatrists from the US, AU, FR, IT, EU, UK, Holland etc.
We spoke for 2 1/2 hours on why cross gender identity was a normal inherited variation of humans. We showed how Transgender Brains think, smell, and hear like the opposite sex. We presented internationally accepted guidelines for hormonal treatment of transsexuals to be published Summer 2009.
Here are my slides and with my participants' permission I shall send you theirs. We are now in print in the APA Syllabus and soon in the APA Journal this summer. I am checking if we were recorded.
My greatest personal compliment came from Frank Kruijver, from Holland, whose research of the human brain in TSs started it all. He thought we have taken his work very far in our understanding of the human brain. Hope you can do something with this.
Sid Ecker, M.D.
One can argue about what "natural variation" is. Is Left-Handedness a natural variation, or a disorder? How about colour-blindness? The mutation (only 10,000 years old) that causes blue eyes? Or Red Hair, a mutation found in many races? What about polydactyly, having an extra finger or toe? Anyway, I won't argue about that. Whether "natural variation" or "congenital anomaly", it's real. These are genuinely men with (mostly) female anatomy, or women with (mostly) male anatomy. The brain is cross-gendered compared to the rest, though about 1 in 10 have significant cross-gendering - "Intersex" conditions in other body parts too.
Trying to fix something like this with psychotherapy is like trying to fix a cleft palate through psychotherapy. It's not a psychiatric issue, it's a biological one - though having a cleft palate can cause real psychological issues too. You may be able to help someone live with it, but surgical correction to normalise the body is the preferred treatment. In the case of trans people, hormones and surgery work pretty well. 98% success rate, anyway.