That completely ignores all the physical differences that a male has compared to a female. Bone density and skeletal structure matter. Men have larger hearts and lungs. These are just some advantages, and doesnt allow for a level playing field. Hormone therapy cant compensate for those.
Also, you do realize that a male undergoing hormone therapy to transition to a female, is really just giving himself cancer. Estrogen is a known carcinogen. That is why we see "bpa free" plastic cups and such, because bpa acts similar to estrogen.
It's a complicated subject, it is.
To the second point - I'm sure they are made aware of the risks prior to doing it.