it doesn't seem to be a reliable cure for the distress
Actually, it is very reliable. It's got the best success rate of any treatment in psychiatry, which is one of the main reasons that they're considering de-listing gender dysphoria as a mental illness in the new version of the DSM : If there's a single treatment which is near 100% effective, and which removes the need for further psychiatric assistance, then it's an acute medical problem and not a mental illness. Mental illness usually implies that there's ongoing life-long problems associated with it, which will require continued treatment.
Try to understand... there's a handful of doctors in the world who are licensed to perform gender reassignment surgery, and between them, there's maybe 100-200 people every week who have the surgery, and many more who don't bother to go through with the surgery either because they can't afford it, or because simply living as their identified gender and taking HRT is good enough. While it's a vanishingly small percentage compared against the world's 7 billion population, the 1 or 2 every several years who claims it was a mistake to go through with the surgery is a vanishingly small percentage of the people who transition. Meanwhile, there's a near 50% suicide rate among transgendered people who don't have treatment, and the rate among those who do have treatment is less than the national average. The reason you don't hear about it is that most trans folk just want to get on with their lives, and are not attention-seeking publicity whores. It's actually very rare to find somebody who's willing to publicly out themselves and try to do something about educating the masses.
Further, the state of the art is really good. You could be dealing with transfolk on a daily basis and not know about it: a surprisingly large number of male-to-female transgendered people are able to slip under the radar, as it were, and never need to disclose their past to anybody other than their doctor (and, depending on their ethics, their lovers). As for female-to-male transgenders, it's even easier for them to go unnoticed because the hormones cause voice deepening, muscle growth, and facial hair. For them, it's near 100% that are able to go "stealth".