Firstly I feel I must state the obvious since I hold an unpopular opinion about a controversial topic. I support LGBT and I support a persons right to do whatever makes them happy.
Now that we got that out of the way lets talk about the effectiveness of sex reassignment as a treatment for gender dysphoria, and why I have a few issues with it.
1. Reclassification of a disorder to ease social stigma
The term gender dysphoria is the result of reclassification of the diagnostic label gender identity disorder. The reclassification was an attempt to "remove the stigma associated with the term disorder."
What is the chilling effect of removing an association of disorder from a person that is suffering immense mental anguish due to a condition they have?
The first step in treatment is recognition of the problem. If we call people bigots for suggesting that a person with gender dysphoria has a problem and needs psychotherapy, then who gets hurt by this in the long term?
2. What is the general mental health of people post transition?
"Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behavior, and psychiatric morbidity than the general population."
The suicide attempt rate among transgender persons ranges from 32% to 50%, and data suggests this rate is not significantly reduced by sex reassignment.
The causes of this may not be related to the surgery itself, but it suggests sex reassignment alone is not enough to treat people with gender dysphoria effectively. We must give more focus to the social health of trans individuals.
3. Social backlash for speaking out
Questioning the efficacy of treatment is important in medicine, but society is more sensitive to dissent than ever before. What type of society will we have when questioning common medicine leads to you losing friends and possibly your job?
I have been called a bigot, a right-wing nutjob... I've been banned from places, I've lost more than a few friends, and I've been judged an idiot over questioning the effectiveness of sex reassignment.
I believe we should treat each other with respect regardless of sex or gender or the surgeries we've had. But this is not enough to please the growing out-rage culture that refuses to accept people that ask the wrong questions.
3. In conclusion
It is my unprofessional opinion that sex reassignment should be followed by extended psychotherapy and monitoring of social health.
A person unwilling to attend psychotherapy should be denied sex reassignment surgery due to the high suicide rate associated with it. I believe we MUST make psychotherapy a MORE important part of sex reassignment.
Even if I'm wrong, which is quite possible, the fact remains that trans individuals are committing suicide and we need to deal with this problem.