Eating disorders (AN, BN, BED) are all in the DSM, and clinical psychologists are also looking at the concept of "biggorexia" (or obsessive muscle building in men) as a potential pathology. I also believe that sooner or later there will be some kind of generic "body dysmorphic disorder" that accounts for people who do extreme body modifications like those people you see who spend hundreds of thousands on plastic surgery to look like Ken or a cat or something. I think being transgender is the exact same.
These disorders APPEAR from the outside that they are all based around the body, but it's a mental disorder and the actual body doesn't matter. Whether she is chubby, emaciated or healthy in body type, someone with an anorexic mindset will WANT and TRY to restrict calorie intake to lose weight. Anorexics never say "okay, I'm thin enough, I'll stop dieting now". Similarly, people who get hundreds of tattoos, piercings or plastic surgeries never say "yep, I look just like Justin Bieber, no more plastic surgery for me anymore". They will keep going until some external force stops them (e.g. getting admitted into hospital, running out of money, getting chucked in the looney bin).
No matter whether troons are thin, fat, hot, ugly, whatever, they want something unattainable and will never be happy. Even if in ten years time we had the technology to shave bone from the shoulders and transplant it to the hips, giving men female-shaped bodies - they still won't be happy. Even if neovaginas were perfect imitations of vaginas - they still won't be fulfilled.
It's a mental disorder. No one goes "okay we'll offer the anorexic girl lipo, and because she loses ten pounds she'll start eating healthy again", because they know that being thinner won't stop the unhealthy mindset. Similarly, crazy surgeries, tattoos, muscle gain, etc won't stop body dysmorphia.
I do believe that part of the suicide rate post-op for troons is due to the fact that bottom surgery is fucking monstrous, but I also think that it's frankly because nothing will ever make them happy. They don't want female bodies, they want to be happy. Anorexics tell themselves "if I was thinner all my problems will go away", so when they lose weight and they still are miserable, they just say "okay, I just didn't lose enough".
It's a waste of time to try and improve transitioning methods to make it more "realistic". These people are going to be miserable unless they have intensive therapy. Trying to help them gain the unattainable is never going to fix anything.