Probably a lot less harmful on the population than alcohol . Was the dope mixed with anything else, and had the person any other substances including alcohol on board?
Generally they must have two psychiatrists and other health professionals, live two years full time as females with assessments during that time, the transition can begin at 18 through hormone therapy but varies state to state
Minimum age of 20. (For patients aged 18 & 19, parental consent is required.)
Good general health
https://www.topsurgery.net/surgeons/dr-kamol-pansritum.htm