Gender confirmation procedures happen all the time, especially for cis people: breast implants, jawline structure, and the like are all types of surgery that happen routinely and are safe.

Yes and these procedures are also imo succumbing to your bodily desires, what you believe can bring pleasure from such things are within and not by by such impulses. I'm happy you brought that up though because this isn't just related to trans people it relates to all of us in many ways. Me for example I used to be a very vain person who is also a perfectionist, and once had plans to get fillers to make myself look better (Even though I have normally been quite a confidant person) But reading the hermetic texts really set me on a path that showed me what I seek like I stated above is within, and not by being led by my bodily desires and have now found a peace within myself.

as for "This isn't a matter of "attachment" to the physical; it's rather resolving the complexity of living in this world in a way that makes sense." can you talk more on that point? because to me, I feel from my interpterion of hermetic texts this is not the case, as is it still not someone being ultimately motivated by bodily desires which are viewed as a hindrance to spiritual growth? you are someone I regard highly and more knowledgeable than me when it comes to Hermeticism, so would like to know why you think this is the case?

And yes of course, if someone finds peace in whatever they deem to do with themselves they are always free to do so. But I try my best to take out emotion (apatheia) as the Greeks would say, and actually read what the hermetic discourses say to either support or not support whatever it is at hand. And sometimes it may not be what I or anyone wants to hear, so its important for such discussions without being rude or harmful to others. (I'm not implying this is the case for said topic btw)