If you're talking post op, that's consistent with physical trauma. Gender reassignment surgery is purely cosmetic and as far as the body is concerned would be a major physical trauma not dissimilar to losing a limb or an major organ. It also fails to change chromosomes and DNA essentially making mind and body be in conflict over gender. Given that starting point hormone therapy and possible immune suppressants would only make mental and emotional states worse. The overall surgery package really isn't very good and likely won't be until chromosomes and DNA can be altered to prevent the body from fighting back. Acceptance of self is probably a better path.