Surgery before HRT, I agree, but I would personally not necessarily be against surgery before full-time. Yes, it might end up being unnecessary, but if there's enough delay, there should be no physical (HRT should be mostly done on the major facial things) or psychological (the person shouldn't live the same anxiety as sysm29, having already experienced many changes of HRT) harm. It could just give the confidence boost needed to jump into full-time.
This, of course, is considering the rather uncommon case of a person still going as male after 12+ months of HRT, but you know what I mean.