I am of the opinion, that much of the controversy should be laid at the feet of the first people mentioned in this sentence. If doctors and surgeons took their oath seriously, there would really be no discussion. Mental health issues aside, I can't see how any doctor can reconcile with preforming these surgeries.
The surgical removal of breasts, or penis, carries with it inherent risks. As does the introduction of hormones. There may be cases where these treatments are necessary, but I would suggest those cases are rare.
The fact that so many doctors are willing to castrate young males, or preform mastectomies on young girls, tells me that they have strayed from the basic premise of "Do no harm" , to promote a political ideology, or purely for greed, which is even worse.
What saddens me is that I think the Trans community has really set Gay rights back, after making progress for decades. I truly believe that being gay is not a choice. People are born gay or bi-sexual and admitting that has historically been a tough road for many. But gay men and women did not often push an agenda the way Trans people do. Insisting to use woman's bathrooms and locker rooms, or compete in woman's sports, even though they are biological men. And I think too often the gay community suffers for it. I'd be willing to bet that most gay women would prefer to not share a locker room with a biological man, just because they choose to wear lipstick and a wig. And for the life of me I can't understand the need to dress like a woman and read books to young children. Introducing sexuality to young children's story hour crosses a line weather conducted by straight, gay or trans people. Young children should be off limits.
I'm sure that most trans folks are not pedophiles, and I know some gay couples that are awesome parents, but demanding access to young children sure does set off some alarms, and frankly it should also set off some alarms about the parents that choose to participate. It also speaks volumes about the mind set of those in public education that feel it is their place to make this an issue, rather than things like science, math etc.