I will be honest in that I do not believe that using a sex change is a solution to the transgender issue. A forthcomming and honest appraisal of current techology for plastic surgery will tell you that we just are not capable of making a credible and workable sex change at this point in time. Many things we can change, we can change how they look, we can make them look something like the opposite sex, but we cannot really make it work. A man who is taller than most women, for him we can do nothing to reduce is hight, nor his jaw structure, or any other part of his skeletal structure significantly. True we can break his jaw and reset it, but This would not work very well. We can do other cosmetic surgeries, but we cannot truly make them work. We still do not have the technology to cause his mamery glands to develop, even though we can remove hers. We still cannot cause him to have the correct hormones without giving them to him with drugs. Above all we cannot make a man go unto the way of women, nor women like men, even though we can make them look something like them; Although with stem cell technology this could very well soon change.
But that is not quite the point of this post. There is a jewish tradition within the kabala that each person has a mission to accomplish, that they are uniquely suited for. Given the (at times dourly) noted seperation of the sexes both in school and in life, beginning from a young age, A young boy going through trouble may never see anyone who has the capacity to nurture him and care for him because of the troubles he sees at home. There are other examples of these problems as well, and I will leave you to puzzle it out, but thesedays I think that perhaps the birth of transgender people is inorder to bring a little bit of the feminine in the the masculine world, and to bring a little bit of the masculine in to the feminine world; something that would seem to me to be a necessity. It is therefore that I think that specificaly choosing to make a sex change is almost like suicide, turning your back on the mission that you have been entrusted (I am thinking specificaly about some midrashim in berashis rabba, around perek (ed. note: I think that more properly its probably around perek 18 or 19 as it arises in the section dealing with the snake), speaking about a snake that went somewhere because he was on a mission, as well as other examples). this is not to say that we should judge those who do, but I think that this is the case. This I think is the purpose behind it.
(note, transgender is what leads someone to have a sex change and thereby become a transexual. It is not someone who has already had one.)
I think that I should, perhaps, rephrase this post. The Intent is that I neither think that transexuals are people who choose their lot in life, nor do I think that it is ok for them to simply say that they cannot live their lives as the sex they were born. I think that the placement of transgender people in this world by hashem is inorder to help intermix the genders to usefull purpose, allowing the kochos of one in to a section of the world that they might not otherwise penetrate. As such, I think that, while they are unjudgable, the solution for the transgender individual is not a sex change. The solution is to rise to the chalange that g-d has placed before them; and to use their unique abilities to effect a positive change in the world, on a micro scale, beginning with the individual. One does not effect this change by waging campaigns and wars against the established order, but by using your gifts to change peoples lives for the better; and they are to make them happier, one by one, with each person you meet.