Way back in the 80's I knew a guy that decided to become a woman. He was a hairdresser where I used to go. At that time it took many years. There was so mu h counseling and therapy that had one had to go through before they would do any hormone therapy or surgeries. Apparently back then they would tell them once they changed they couldn't go back. I think that is what is missing today, they do not require all of that before you can even begin. It seems all they have to do is say they want to transgender and the doctors just say okay.
I believe there are some people born in the wrong body, but a miniscule amount, or the very rare hermaphrodite that needs to decide what they are, but the majority are just nuts in my opinion listening to someone's sick agenda, because that is what it is. An agenda. For what besides doing away with white males, I have no idea.
Mental health care has pretty much been done away with and that's a huge part of these people not wanting to be who they are from birth.