It's mental illness, plain and simple. They think becoming a woman will be sexy and solve all of their problems. They think HRT is capable of doing all these things it can't actually do because these people spend their days participating in online circle-jerks. They also think being a giant, hairy, non-passing gorilla makes them "more oppressed" (because i mean they're more likely to get "misgendered") and therefor more worthy of peoples' attention and sympathy. I've seen troons accuse each other of "passing privilege" if you can believe it.
I've read this whole thread, and I can't tell you how many times I've looked at a troon's post and thought, "Damn, why don't you just learn to accept yourself as you are?" Enabling their delusions is not making these people happier or healthier. Therapists and psychiatrists need to stop using dysphoria as an explanation for everything and start acknowledging that these peoples' problems can't be caused by one thing. Clearly these people have other problems that vary from person to person, be it autism, endocrine disorders, unaddressed trauma in their past, personality disorders, eating disorders, body image issues, relationship problems, or any number of other things.