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To be honest, they are not really changing their gender. That is a bad paradigm. A man cannot "become" a woman, nor a woman "become" a man. Your gender identity is rather fixed since some time before birth. The goal of transition and surgery is to make the outside match who you have always been.

Gender identity is caused by the way the neurons are configured in the brain, and changing that would require brain surgery, and we don't have brain surgery for that. Intense therapy can never change how the brain is configured, nor can it change your "soul."

Lets keep in mind that gender identity is independent from the body, from the social role, and from one's sexual orientation. The reason for gender transition is to make the body and chosen gender role to match who the person (gender identity) has always been.

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Q: Why do some people want a gender change?
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