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You are confusing aesthetics with being wired for a different set of body parts. Whether or not I am satisfied with my appearance, I am not shocked and startled to discover I have a face. My mind expects a face; a face is prevent. Similarly, if I woke up one morning without my face, i'd be pretty horrified. Dysphoria is more like that. It's not about the details of the body parts, but the presence or absence of parts entirely. Imagine you woke up one morning with a tail growing out of your forehead. Would the sane response be therapy to learn to accept this strange new limb, or to remove it? If you lost your thumb, would you want therapy for self acceptance, or the surgery to turn your index finger into a working thumb? (I had a coworker who had a finger refashioned into a thumb. it looked a little different than a natural thumb, but she was sure happy to have it.)