@BillRM,
I understand your comments, but I think you are very much seeing this from your own perspective. That is, creating opinions by trying to understand what would make someone want to do this based upon your own experiences. That's what makes this so difficult. I don't think we can possibly have the ability to understand what a person in this condition is going through. How strong the feeling might be, etc. At some point we have to accept that. 'She' feels that she is really a man and wants to live as a man. That doesn't have anything to do with whether or not she was a cute or pretty little girl. Many people have surgeries for much less of a reason and I do not understand why they would do that. I don't understand why anyone would get piercings. But, many people do and seem well adjusted to it. I accept that I don't understand and don't need to project any judgment that way. Living in a woman's body and believing (knowing) that you are really a man would be much harder to accept than thinking your nose was too big.
It doesn't have anything to do with how attractive she was or is.
It comes down to the realization that these people have much more difficult issues to deal with and this is not just a 'decision' one makes for convienence.
Unlike some people, I don't think this is something someone can be 'counseled' out of. It's not a mental defect, it's who they are.