I had a student last year, female, who was undergoing treatment to appear to be a male. I didn't discuss it with her, just had to keep in mind she wanted to have male pronouns used of herself. I can't say I understand it. It seems like taking lesbianism to an extreme.
Nobody, these days wants to talk of consequences and effects upon the conscious mind. From political correctness, one would think these people would be very determined and be able to take all the effects in stride. But the truth is that that there are consequences and, just like anyone taking a big step, there are doubts. And the consequences and the doubts eat away at the mind.
Sometimes the surgeries do not go well or last very long. In the case of a girl, becoming a guy - they find out they really don't like the guy world. Or a guy becoming a girl, they find out they don't fit into the girl world. And those wanting to become an "it" sometimes find out there are too few places to fit in.
The media makes it look like being transgendered is easy and easy on ones life. Nothing could be further from the truth.