To get the surgery, candidates are screened psychologically. Again, no moral issue. Medical practice ethical issues? Sure. But nothing that deserves the cultural response it gets save for its relationship to gay rights, even though it is not a gay thing. Both issues cover such small groups of people (as opposed to child poverty, which is huge), the wisdom of addressing them at all bespeaks scapegoating, not concerns for the moral development of either trans or gay people. They provide an enemy within to distract from real problems, like capitalistic exploitation of both workers and consumers.