@Questionable Ceviche
The GRS clinic do this as a living, and the surgery is covered by the province of BC. The surgical justification vs risk is something I would expect them to be well versed in:
"The risk of a morbidly obese alcoholic diabetic dying of complication from surgery is X%, however the risk of him dying by suicide from his Gender Dysphoria is Y%. Given that X<Y, the surgery is justified as a means to mitigate risk of dying by suicide. Please remit payment to Dr. P. Insideout at Le Hachette Du Gache at 111 Rue Theday, Scrotumcity, Quebec"