Gender Reassignment Legal Issues, Social Aspects and Regrets

Legal Issues
An important part of changing genders in the U.S. is changing names. An individual begins the legal name changing process by filing a court order. This usually requires completing paperwork, publishing a notice in a local newspaper and paying a fee. After changing names, a transsexual amends his or her Social Security card and birth certificate.

Most states' antidiscrimination laws don't do much to protect transsexuals from discrimination. Many transsexuals find themselves denied employment, housing, places to worship, marriage and child custody. Surgeons who see their roles as restorers of bodily function or creators of body alterations for self-image purposes sometimes feel gender reassignment surgeries do not fall into those categories and object to performing such operations [source: WPATH Standards of Care].

Social Aspects
Transsexuals face unique issues involving marriage, sex and fertility. Although most states do not allow homosexual marriages, transsexuals are able to marry legally. A satisfying sex life post-operation depends on the transsexual's surgical choices. In female-to-male gender reassignment surgery, an affordable, realistic and functional penis is considered a fantasy. Some female-to-male patients choose to have a metoidioplasty -- a procedure where a clitoris enlarged through hormone therapy is repositioned at the end of a neophallus, or surgically constructed penis that is able to perceive sensation. In male to female transitions, the head of the penis becomes a neoclitoris.

China Photos/Getty Images
­Transsexual Xinr (L) and husband Huang Kunlun relax at home in Changchun, China. Once a man, 24-year-old Xinr underwent gender reassignment surgery in 2004, becoming the first transsexual in the northern province of Jilin.

Fertility issues and reproductive options need to be discussed before hormone therapy begins. Biological males might consider banking their sperm, while biological females sometimes consider cryopreserving, or freezing their eggs or fertilized embryos. In a survey reported by the International Journal of Transgenderism, 76 percent of the respondents favored that transwomen be made aware of the option to bank sperm before starting hormone therapy [source: IJT].

Regrets
So is the therapy, the hormone treatment, the surgeries and legal work worth it? It's generally reported that transsexuals who have undergone gender reassignment surgery are happy they did so. And while there are some who regret their decision, the International Journal of Transgenderism cites a 1992 study that found postoperative regret was less than one percent in female to male transitions and between 1 to 1.5 percent in male to female transitions [source: IJT].

For more resources and additional information about reproduction, gender, gender identity disorder and gender reassignment surgery, see our list of links on the following page.