I actually feel a lot of compassion for the transgendered. I don't think that doctors should perform sex change surgeries. I have no problem with those who cross dress, though. Ru Paul is beautiful as a woman, and kind of plain and ordinary as a man, but he's never had the surgery, so he can go back and forth as he pleases. He probably takes the hormones to grow breasts, though.
Once a person has the surgery, he can't go back. He also faces a lifetime of plastic surgery procedures to maintain the female look (not sure how it works with females to males, but not sure I want to know). In this case, medical technology has created a situation that hurts instead of heals, even if the intention is the latter.
I had a friend at my former church who was a male to female TG. I really liked him, but he never looked very much like a woman. He also still had sex with women-like John Lithgow's character in "The World According to Garp". He had plastic surgery every other year, it seemed, to try to look more female. He was tall and very masculine, with a pronounced adam's apple, it just wasn't going to work no matter what he did. I would never treat someone badly who was TG or TS, but I still feel badly for them.