I think it's pretty obvious that I'm not talking about basic gender affirming surgery, but if you decide to get inhumanly large beach balls, I might crack a joke at it. You're welcome to feel differently, but if people spend vast sums of money to look entirely inhuman, I see no reason that jokes are off limits.
I also make fun of people that dress in absurd ways. That doesn't mean that I'm going to make fun of a trans woman wearing a dress, but I'm going to poke fun at Sam Smith showing up to an event in what looks like overinflated BDSM gear.
Ultimately, my opinion and tastes don't matter, and people are going to do what people are going to do. I won't shame someone for intrinsic characteristics, but I see nothing wrong with poking fun at bizarre aesthetic choices.