I’d argue they’re victims of big pharma that sold them on a lie and did not set proper expectations... That there was a silver bullet for their afflictions. That all their problems would go away if they were just “true to themselves.” Whatever that means.
Unfortunately, the vast majority of them have autism or other underlying conditions. Taking hormones only degrades their mental stability further. Big medicine convinced them, intentionally so, that they could have working genitalia. That there is no obvious difference between them and the opposite sex. The issue is that the surgeries will leave them in pain and sooner or later they’ll realize that they weren’t set with the proper expectations but at that point they’re in too deep. Imagine going all that distance, suffering that much, only to realize everyone lord to you. It’s for that reason many commit suicide. Obviously advocating for suicide is wrong, and I’d argue it’s wrong even for people who wish others to die as well, or even those who threaten rape, which is quite common unfortunately.