They're completely brainwashed and almost never fully understand what is really going to happen.
You see pre-trans real womans vehemently dismissing any claims that "it fucks your bone density" and "your axe wound is going to leak shit and never be attractive to anyone" and "hrt at 20 isn't going to magically make you look like a girl"
They see ugly real women and call it the exception, while pointing towards real women with heavy make-up and filters as the general rule.
A lot of the times you see post-op real womans sharing horror stories, they'll mention their doctors withholding side effects or calling their mutilated outcome "a perfect case"
I think it's all pushed because people can grow out of being lefty cattle cacaots eventually, but if you completely destroy them with drugs and surgery they basically have no choice but to support it until they die, or face the fact that they ruined their lives and eat a bullet.
I've seen plenty of post-op real womans in dismay about how they turned out, but it's almost always "just be aware of the potential side-effects" and never "fuck the trans movement, it's ruining lives"
The suicides are bigots' fault, the side-effects are "rare" and they still at least pretend to believe that transitioning is necessary for people. A lot of them will blame all their problems on not transitioning early enough and will project their misery and demand that you drug kids as soon as they start liking pink or playing with dolls "for their own good". They're literally a weapon against humanity in and of themselves once they pass the point of no return.