I'm not horrified, but I'm always so angry when I read about the hoops one has to jump through for gender reassignment surgery. And I'm appalled by "You don't really want female genitalia; you just want to be in a lot of pain!", which I hadn't encountered before.

Is happy anniversary an appropriate response? If so, then happy anniversary! And in any case congratulations for being you; complex, brilliant, charming, and fascinating.