I'm speaking only for myself here.

I didn't realize I was trans until late in life; and, if I ever experienced dysphoria with regard to my factory-installed equipment, I found my coping mechanism long ago. At my age, unnecessary surgery and inconvenience seems pointless ...

... unless I anticipate a relationship with a man. If I were ever to have a serious relationship with a man, I would definitely move in the direction of surgery. I've never experienced the kind of sex you're talking about; but, for me, it wouldn't be the same as having my man the usual way. It has nothing to do with any "normalcy bias"; it's about being held, embraced, face-to-face, while being penetrated. There is something qualitatively superior to such a union, at least for me.