Realignment is much more empowering. It's saying you're just moving around pieces that were there that need to be in a setting with which you feel more comfortable. Realignment is better than saying 'male turns into female, female into male' as if it were front page news. SRS is considered an elective surgery by the medical profession and by insurance companies, and therefore is viewed as a non-essential surgery. Most medical professionals consider the surgery to be too intensive a blow to the immune system for surgeons to perform on people who are HIV-infected.
Service providers disagree.
Elective versus necessary surgery becomes critical when talking about stress reduction. This is necessary surgery. The first barrier a transgender encounters when trying to access mental health services, is the language that the mental health community uses to define them. The DSM3 classifies transgender people as having Gender Identity Disorder. Transgender people are pathologized before they even walk into a mental health practitioner's office.