Much as I respect Rainboe's views on the art and science of flying aircraft he is at best misinformed here.
Gender dysphoria is one of the most tragic and difficult to treat of all conditions. It is is no more a mental illness than homosexuality andd no more "curable". Essentially, the physical (somatic) and chromosomal gender is at odds with the mental gender.
Formal physical surgical gender reassignment to the appropriate mental gender is possible to varying degrees (not all patients want this) but somatotype is one of the limiting factors. It is impossible to make a believable woman out of a rugby fullback type and I have my doubts as to whether one should try. Nevertheless, their anguish may be relieved by a discreet orchidectomy and possibly a penectomy and wearing gender neutral clothes. With a more favourable feminine somatotype a very attractive and fully sexually functional woman may be achievable. The chromosomal gender remains, of course, unaltered.
Somatotypic factors also complicate female to male reassignment and the genital surgery is technically very challenging, particularly if penetrative sexual function is desired (many are content with the ability to urinate standing). Nevertheless it is possible.
These are tormented people, trapped in a physical body that they cannot identify with and as Rainboe demonstrates, profoundly misunderstood. Their ambiguity and sufferings make most of them difficult patients emotionally and the reconstructive procedures are not trivial. Selection is all. Nevertheless, they can be some of the most rewarding to treat and it is a joy not given to many to see them finally even if imperfectly restored to the harmony that they deserve.
Mac