well, my girlfriend is an mtf (male to female) transsexual pre-op
so to help her along with coming to terms and coming out to some very religious parents (which she hasnt done yet but she has come out to her sister) ive done a fair deal of research on the subject
from what i remember transsexualism is a birth defect, but not a harmful one basically a gland (im not sure which) that is traditionally bigger in males and smaller in females is for the opposite gender than their genitals + the like are
to their genitals: it is nearly flawless for mtf surgeries but much riskier for ftm (female to male) surgeries
depending on the budget you have you can afford a better doctor and unfortunately unless you have a very big budget the chance of an orgasm post-op is greatly reduced, which would be the only difference
as someone said you can use a sperm bank for mtf transsexuals which my gf and i intend to do, that way she and i can have children.
transsexualism has no cure, if youre born with it thats it. the only option is treatment. and the only treatment is gender reassignment surgery. no credible doctor will ever even consider your (im speaking generally btw, not you personally) case for a sex change unless psychiatrists have deemed you truly a transsexual, since the surgery is irreversible, and then even afterwards you must undergo various other tests like that where youre told to live as your desired gender for x amount of time, to see if thats enough for you
if anyone wants to ask some experts on the situation, real transsexuals, transgendereds, and crossdressers go here its an online support site