Gay\transgender -- not by genetics, not by upbringing, not by choice

I'm not sure we can trust the family's viewpoint on this though. It could just be a case of the natural human tendency to reinterpret and reinvent memories to make a coherent storyline that made sense all along. They might simply be overexagerrating and inventing incidences of girlish behaviour from when he was very young, because that's what they'd expect in retrospect.

Where were you looking? I tried looking on Pubmed, searching for "Sex reassignment" "Quality of life". The first relevant result you get is this one:

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RESULTS:

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Compared with a Dutch reference population of community-dwelling men, transsexual men scored well on self-perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate.
CONCLUSION:

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Results of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS.

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Followed by this

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RESULTS:

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Mental health-related quality of life was statistically diminished (P < 0.05) in transgendered women without surgical intervention compared to the general female population and transwomen who had gender reassignment surgery (GRS), facial feminization surgery (FFS), or both. There was no statistically significant difference in the mental health-related quality of life among transgendered women who had GRS, FFS, or both. Participants who had FFS scored statistically higher (P < 0.01) than those who did not in the FFS outcomes evaluation.
CONCLUSIONS:

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Transwomen have diminished mental health-related quality of life compared with the general female population. However, surgical treatments (e.g. FFS, GRS, or both) are associated with improved mental health-related quality of life.

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Next, :

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This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.

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Next, a metanalysis:

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RESULTS:

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We identified 28 eligible studies. These studies enrolled 1833 participants with GID (1093 male-to-female, 801 female-to-male) who underwent sex reassignment that included hormonal therapies. All the studies were observational and most lacked controls. Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68-89%; 8 studies; I(2) = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56-94%; 7 studies; I(2) = 86%); 80% reported significant improvement in quality of life (95% CI = 72-88%; 16 studies; I(2) = 78%); and 72% reported significant improvement in sexual function (95% CI = 60-81%; 15 studies; I(2) = 78%).
CONCLUSIONS:

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Very low quality evidence suggests that sex reassignment that includes hormonal interventions in individuals with GID likely improves gender dysphoria, psychological functioning and comorbidities, sexual function and overall quality of life.

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Now, on the fifth article, I finally find a less positive result:

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RESULT(S):

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Fifty-five transsexuals participated in this study. Fifty-two were male-to-female and 3 female-to-male. Quality of life as determined by the King's Health Questionnaire was significantly lower in general health, personal, physical and role limitations. Patients' satisfaction was significantly lower compared with controls. Emotions, sleep, and incontinence impact as well as symptom severity is similar to controls. Overall satisfaction was statistically significant lower in TS compared with controls.
CONCLUSION(S):

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Fifteen years after sex reassignment operation quality of life is lower in the domains general health, role limitation, physical limitation, and personal limitation.

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I can't figure out from the abstract what these people are being compared to though. Is it pre-operative transgender individuals, or non-transgender individuals? If the latter, this probably isn't the appropriate comparison for figuring out if the operation was worthwhile.These certainly aren't meant to be a slam dunk response or anything, but the fact that I have to go to the fifth study I found before getting a result that didn't indicate positive outcomes for sex reassignment, suggests that you're looking in the wrong place if you're finding it so hard to find any kind of support.

You assert this three times in this post, but as far as I can see from inexhaustive and unsystematic selection of studies posted to the thread so far, we have contradictory and inconclusive results. Some of them agreed with your personal observation, some flatly contradicted it.

I looked on pubmed for "quality of life" "sex reassignment", and the majority of articles on the first page of results (after which I got bored of looking) were broadly supportive of gender reassignment - I included the abstracts in Message 95.What's more, I'm not sure how you looked at the Google results and decided that research supported your position, unless your results are very different to mine and/or you stopped at the first result. Try reading a bit further down the page and we're back with 'research is unclear'.Edited by Adminnemooseus, : Changed code from MID to MIDT.