Back in the day, surgeons emphasized that SRS wouldn't give them a real vagina, just an approximation of what one would look like. They also operated on a very different population of tranny. Mostly male, mostly HSTS, all had to go through years of therapy/ living as a woman (cross dressing) for years to even qualify.
Today, SRS patients are less informed (becuase they don't want to hear the truth), younger and increasingly coed (ROGD), get treatment faster than ever (wait times are bigoted), and handed to them ("do what I want or ill kill myself").
Thankfully the public is openly beginning to get sick of this shit.