I usually start questions with 'Do', or are you trying to tell me how I think?
I think we are all different, and to varying degrees. The question is how do we deal with those differences? If those differences cause harm to another individual, then yes I would consider them a 'defect' and need to be dealt with. Certainly there are differences that are clearly outside the norm, but do they cause harm to others? Homosexuality is outside the norm, but there are tens of millions of homosexuals that are strong contributing members of society in all walks of life. There are a lot fewer transgender people, but does that suddenly mean they are not strong contributing members of society? What about those people who like to dress up in Star Trek costumes, do we suddenly ignore their other contributions and send them to therapy?
If you read what I wrote, you would know I don't recommend surgery just like I don't recommend conversion/conformity therapy. I think the risk is high with both of them of failure, and possibly creating a worse situation. The point is that is a recommendation, not a decree. Only the individual gets to make the decision. Hopefully when medical treatment such as these is being sought, our medical practitioners can directly and/or through support staff help fully inform the patient of the choices and associated risks.
You bring up the issue of trust. To me trust is not built on superficial characteristics, but something earned over time. Yes the superficial characteristics will influence my initial impressions of an individual and they might have a harder time earning my trust. I know when I was young I would have had a hard time accepting someone that was openly homosexual because that was the attitude of society at the time. Now many decades later after getting to know many homosexual people both as friends and colleagues, I have no problems accepting anyone new. Like everyone else it takes time to build trust in an individual, but they don't start out with a disadvantage. I don't see why transgender should be any different. I think far more harm is done by creating outcasts than being accepting. I don't immediately distrust someone because they are transgender, just like I don't immediately trust someone because they are straight.