You are a little mistaken in a few points. There are actually many many many places that require a gender/sex marker. All legal documents, credit card applications, school applications, rental applications. Your driver's license, insurance forms, social security card, pass port.. just off the top of my head. Because you don't really have to think about it, the number of times that people subtly ask you what your crotch looks like is probably invisible to you. I didn't really notice until I tried to get all my stuff to match.
In most places your birth certificate can only be changed after SRS. Until the BC is changes all national information will reflect your birth assigned sex. This means every time I try to leave the country, I get outed as Trans - no question - plain as day. Getting a job with a state ID that reads Female, but social security that lists me as male gets a letter from the department of homeland security when I was looking for work. "Gender No-Match" letters are a huge pain for US TGs.
Violence against Trans women in increasing or being reported and tracked more. Not having SRS means that if you need emergency care, EMTs can decline to give you treatment and crack jokes about your genitalia (Tyra Hunter) and get a promotion within a couple years. It means if you are arrested, you are housed in with the male prison population - and we know what that means. It means any and all places that have shared changing/shower/swimming facilities feel justified in denying you membership on the off chance you may show some penis by accident. Women feel justified in making an issue as to where and when and how often you use the bathroom at work.
Aside from the emotional needs of some trans women to modify their bodies to align themselves physically with how they understand themselves to be, there are serious practical and safety reasons for SRS. The emotional reasons are, for me, the most compelling. However, most people who are not Trans can't understand the disconnect and the profound weirdness that we feel about our bodies. It is hard to explain, made even harder by the way our individual lives and coping mechanisms complicate an already complex relationship.
If society wasn't so hung up on rewarding a strictly binary m/f sex assignment, there would probably be some trans women who wouldn't have SRS. However, I don't think the numbers would be that much reduced.
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