You’re entitled to your opinion. Plenty of people think ECT to treat depression is sick and twisted. But it works. I suspect in many peoples’ minds, gender reassignment surgery (I believe the preferred term is now gender confirmation surgery) is even higher on the sick an twisted list. But these are still medical procedures. When done for very specific indications, following strict protocols, by qualified and experienced specialists (preferably at medical school affiliated teaching hospitals) it’s no one else’s business.
Yes qualified and experienced people that commit heinous acts. Being qualified and experienced does not automatically remove you from justifiable criticism. There have been some very qualified and experienced people who have committed horrible acts upon other human beings throughout history.
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