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Instead of receiving help for gender-transition from medical professionals, many transsexuals were forced into mental institutions, where psychiatrists tried to "cure them of their mental illness" by electroshock therapy and aversion therapy.
Once no longer intact, the girl might hope to obtain complete SRS in some hospitals here - if she had the money to pay for it. See for example, the story of transsexual pioneer Aleshia Brevard.
After a self-castration to further feminize herself, Aleshia was able to undergo SRS in the U. She went on to become a showgirl, a "Playboy Bunny" (a hostess at one of the famous "Playboy" clubs), a widely recognized actress in movies, on stage and on TV, and got married three times.