If someone told me that the only factor they were looking at in deciding where to have their surgery was being cheap or merely impatient, then I'd say they were being unreasonable. However, this is not the case for me.
I'm 30 and I don't want to be in my 40s before I can begin to feel right about my body. Of course one can even
start transition in their 40s and beyond and live a full life, but I was lucky to be able to start at 25, so I want to make the most of my good fortune and hard work. In life, time is the only currency we have that matters really. While I never expected the ease of a 2-4 year transition from start to finish like some fellow brothers and sisters, I'm not letting fate and/or circumstance dictate where I'm supposed to go or how long I'm supposed to wait unless devoid completely of options.
As for success and horror stories, all surgeons have them really and it's a matter of carefully weighing multiple factors in deciding where to go. I'm confident that, supportive friends and common sense can win the day

(*)
In regards to having an orchiectomy, I read one can tell the doctor beforehand one wishes to save tissue for SRS and they will keep that in mind. I used to think it was more of an option, but honestly when I go for surgery I want to get done what I need to get done. There's a lot of things I want to do in life that have nothing to do with transition and me being pretty body dysphoric, I know that won't be completely off my mind until I have it done. Being forever on Spiro is not an option either as it wouldn't be very healthy.
PS:
Oh, and US healthcare is... US healthcare

(*): No, I didn't mean "financial support".