This is one of the things I find most distressing about the field getting behind transgender "medicine". You cannot just slap together a penis or vagina that appears convincingly "cis" if the only materials you have to work with are the natal genitals of the opposite sex. If you could approximate something halfway convincing, you'd still be working within the confines of human anatomy. Anatomical constraints are actually one of the main reasons why no tranny genitals pass. It's why neophalluses look like they're attached way too high on the body and neovaginas have the introitus/fuckhole inserted underneath the "vulva". Because of sex-based (!!) differences in pelvic anatomy, it's not possible to put the neogenitalia in the correct location.
It just doesn't work that way. Even the most talented surgeon in the world, the guy with the most blessed hands, (for real, I know of a surgeon, a fantastically talented and humble man, who has his hands blessed by a priest every morning on the way to work) can't create something from nothing. Let's just say that the coterie of trans butchers are not exactly counted among the "most talented" cohort of surgeons, either. There's no way that they can give these people what they are asking for. Yet, they continue to promise that yeah huh, they totally can, and if it doesn't take the first time, they can just keep chopping - uh, I mean, "revising" endlessly until the result is perfect. This is so incredibly irresponsible to me. Part of any surgeon's job is to manage patient expectations. You need to ensure that your patient has a realistic idea of what the surgery can accomplish. It's extremely unprofessional for any surgeon to promise a result that literally cannot happen. I actually contend that doing so is a violation of the Hippocratic Oath to "do no harm".
Certainly, it raises a philosophical question about the meaning of "informed consent". Is the patient truly consenting to a surgery if he's been promised an impossible result? How many of these people would not consent to a surgery if their surgeon were clinically, coldly straightforward about the actual scope the surgery and its best possible outcome?
Then, the matter is compounded when the troons go online and hear that all the other troons are totes jelly of their results, that "she" looks perfect and so cute, that it looks just like the real "bonus hole" of a True and Honest transman who braved her horrific and life-threatening *~bOttOm dYsPhoRiA*~ to take a look at her vulva for the first time ever and yeah, totally identical, I swear!!!!1
It's liars and charlatans all the way down. Whether in a professional or personal context, I think we should all consider what kind of person does this to another human being. I know it's easy to mock troons, and they are highly deserving of our derision, but it's still horrifying to think about the human toll being exacted here.