The problems that arrive after having surgery is that the mortality stats don't really change. The number hovers around 40% before/after surgery. Many times the surgery compounds bad mental states because unexpected medical issues arise and cause further anxiety, frustration and depression. So the "last resort" tactic doesn't hold up very well.
It's akin to carving off body parts of people who suffer from anorexia. They will still see themselves as being overweight.
With so many people detransitioning now, with the same problem, it's obvious that surgery isn't a standard one size fits all key.
I just don't think that the medical field has caught up on this enough to even build a reliable method of treatment. All of the activism pushing kids into the front lines is stalling the process too. As I've said previously the centers in Europe who spearheaded child transitioning have halted the practice because there is no net benefit with too many kids left physically and emotionally damaged for life.
I suspect that this will ultimately be battled out in societal culture, ending in a massive political battle with who pushes the hardest. It may end up being a single issue vote for an election.