This manga was rather frustrating for me. It was interesting reading an unambiguously trans manga, contrasting the massive volume of cross-dressing manga. But Satou-sensei seems to have gotten their information on transition from some strange/out of date sources. For example most of the discussion around transitioning is related to "the surgery." I dislike this focus for two reasons:
First, it makes it sound like surgery is the only medical option, which it isn't. For example hormones are fairly cheap, and can have a big impact on a transwoman's body without spending tens of thousands on surgery. And surgery/hormones aren't mutually exclusive; most transwomen start with hormones, and maybe get surgery later. This is particularly relevant for Kashiwa given how large a role finances play in her choices.
Second, focusing so strongly on surgery frames medical procedures as hurtles that must be cleared on the path to "real womanhood," rather than as tools to help align body and gender identity. Not all transwomen use every medical option that exists, and some don't use any of them. But they're still transwomen, and still women.
I also have problems with how this manga handles romantic relationships, including trans and nontrans couples. Its hard to go into without spoilers, but some of the relationships don't handle consent well, some have shitty views on transwomen, and some are just unhealthy. This isn't necessarily a problem - this is a drama, and a drama needs conflict to maintain interest. However Satou-sensei isn't always good at handling these poor dynamics with grace.
Overall if you're looking for a drama about trans issues, I'd recommend Bokura no Hentai, Kanojo ni Naritai Kimi to Boku, or Fukakai na Boku no Subete o over this. But if you've already read those, this is an interesting story, even though it is very frustrating.