Maybe it is much like a person who is obsessed with plastic surgery. After a nose job, botox, etc. etc. they continue to return to the doctor for more and more and are never completely happy. Why? Because the fundamental issue, whatever that might be, is never addressed. And no one ever helps them by saying “no more” so the cycle continues.
Michael Jackson is a good example. His obsession with his face was only secondary to his real, underlying problem whatever that might have been. And no one was willing to tell him the truth so he continued to butcher his face until it was no longer recognizable.
I just think its unreasoned. Whatever happened to “Do no harm”? I think that there are several paths to gender identity issues. Human beings have an extensive ability to fantasize and develop fetishes and desires and identity issues. What is happening more and more is it appears Drs. are unwilling to even suggest alternatives to the mutilations even though some research has shown that with transsexuals in particular there is no lessening of the mental issues and many times even a worsening after they make transition. I just think its mostly simply malpractice. Drs are supposed to help not become blind enablers of those patients who have issues that make their decisions unsound.