"I have no ethical qualms with it. But when you actually start to believe you're an actual woman, that's where the problems start. When there's a community of people who are actively encouraging an irreversible surgery that leads to suicide in roughly half of those who undergo it, that's when I have a problem with it."

Almost as if people identifying and believing that they belong to the opposite sex might be delusional. People who exhibit delusional tendencies and beliefs tend to harbor certain types of mental illness... Misleading other people with similar forms of mental illness because of certain delusions from reality can most definitely cause problems.