I think what is important is very contingent on where you are in transition. I have passed literally from the first time I put on female clothes and walked out my door, but I still worried mightily. I still had work to do and over the last year I've refined my look, makeup, hair, clothes and just general style. I've always known that SRS was important to me, but I didn't hate my penis. However, now that I pass, I am beginning to really resent it. It is the last remaining holdover and I can feel it every day. No matter how many people tell me that I am a woman, that I look and act like a female, that they can't believe I was ever a guy, I know the truth and I die a little inside every day that I am not right. So IMHO, I would agree that passing is very important. However, it is not an either/or proposition. You may find you need both to feel whole, complete and female.