(The chick in the lingerie with red eye shadow was what he became.)
I have not seen Kampfer, but I'd like to recommend the Swordsman, or Dongfang Bubai in anime. Although not the main character in the story, Dongfang Bubai is one of the famous supporting characters, who was a dude martial artist who wanted to be the greatest in the East, so he can attain the name, Asia the Invincible. In order to become that, he had to learn from a manual where castration was required. He gladly castrated himself and gave up loving women (asexuality works!)
Gender changes in the East is not unusual because of how many eunuchs were made and how they played such important roles in Asian history. I can tell you confidently that gender cross-over experiences are very acceptable in the East, at least philosophically, religiously, AND surgically. It is probably hard to see this because sexual orientation, gender identity, and wealth are mixed together. Eastern countries indeed have a huge over-population crisis, but do not think for a second that this has anything to do with heterosexual love. For some reason, the idea of having big families = prosperity, or at least the prospects of having a lot of people bring fortune to a family.
The world-view, or gestault, of the East is that the body is temporal. Souls and spirits are eternal. Changes made to the body, and even death (by homicide or suicide) is a temporary matter. In this carnal (meat, flesh, evil) world, it matters more how you live it, not so much what you do to the body or dress it. Gender re-assignment and cross-dressing (even by females) is a small matter for an individual. All this means is that the people who do this would not likely get married and have plenty of children the way most people who want to move into upper-class society do, that's all! So, if they mutilated themsleves, loved the wrong person, or cross-dressed, it just means that they are not part of the reproducing game. The irony is that even if these individuals do marry and have large families, then their work is done; doesn't matter that they stay trans all their lives. It's just, are you in the reproducing game (that will somehow bring you plenty of riches , or not? If not, hmmmmm....ok, now run along.
I have since seen a difference between progeny, relationships, gender identity, and the rainbow community. Before global modernization, it was almost understood that some people would not be reproducing, but as more and more people have closer access to wealth (whether through employment or welfare), then it became sad/weird/embarrassing that some people would live their lives without progengy = $$$$$$$$$$$$$$.