Keffals is a big narcissist, so I feel like the root cause of his depression doesn't stem from
just the dick chop: he doesn't care as much about being trans as he does at using it as a weapon against his enemies (still works) and to coom (which barely to doesn't work). He tends not to care about misgendering as much as other troons, only when he can use it as a weapon. He hasn't even talked much about breaking down due to dysphoria.
Honestly, Keffal's natural state seems to be depressed: he's shown to be the type of cluster B who doesn't get happiness from basic things. He likes more extreme thrills that are fast, happening NOW NOW NOW. This includes bullying, power dominance, drugs, risky and more deeply kink oriented sexual behavior, lying, conning people, and so on. The problem is, a lot of these are running out of power or money. Everyone fucking hates him that he could bully aside from his underlings, and they've thinned out like his hair too. He's made himself a laughing stock or too #canceled to care about, and sabatoged his friend network for cheap thrills and powerplay (and cash). No more clout, no more bully power, no more cash to fuel drugs (aside from his recent grift), no one for him to terrorize because
nobody fears him anymore. Becoming a laughing stock has been the worst thing for him, his easily bruised ego is black and blue all over from the constant pummlings it's getting.
He doesn't think like a normal person, he doesn't have empathy or care for others or gain pleasure from accomplishments. He is a cheap thrills person through and through, made worse by breaking his brain through years of drug abuse and internet fights. His brain is just structured wrong, like how BossManJack is slave to meth and slots with his long term pleasure receptors being fried - but worse. At least slot machines don't disappear if you use them too much. He's depressed because
his brain doesn't receive dopamine like a normal person does from normal activities, his social power is < -100, and little cash.
TL; DR: he lost his bullying power, internet clout, and drug money, he's cryin' rn because his only three dopamine sources are gone. He don't care about being trans and misgendered, he care he can't press the pleasure button for more dopamine. He stupid.