Sex reassignment surgery
Main article: Sex reassignment surgery
Sex reassignment surgery consists of processes transsexual women and men take in order to match their anatomical sex to their gender identity; however, this surgery to correct genitalia (SRS) is also very expensive and not everywhere covered by public or private health insurance.
Prior to surgery, trans men and women are often referred to as pre-operative (pre-op); those who have already had the surgery may be referred to as post-operative (post-op) or simply identified by the sex and sexual status to which they have ascribed. Not all transsexual people are able to or choose to have sexual reassignment surgery (for several reasons, for example financial reasons, due to the high cost of such surgery, or medical reasons, or simply not wanting it for other reasons), although they live constantly in their target gender role; these are often called non-operative.
A more modern idea suggests the notion that the focus on surgery status is misplaced, and therefore more and more people are refusing to define themselves in terms of operative status.
Legal and social aspects
Many Western societies today have some sort of procedure whereby an individual can change their name, sometimes also their legal gender, to reflect their gender identity. Medical procedures for transgender people are also available in most Western countries. However, because gender roles are an important part of many cultures, those engaged in strong challenges to the prevalence of these roles, such as many transgender people, often have to face considerable prejudice. One such case is chronicled in the movie Boys Don't Cry.
A few persons undergoing sexual reassignment surgery will adopt or provide foster care for children in the corresponding sex role which they have assumed. Societies are in some instances challenged to assimilate these men and women into their social institutions such as marriage and the role of parenting. Also, often children exist from the time before SRS. Many of these children stay with their transgender parent. A recent report shows that this does not harm the development of these children in any way.
Style guides used to publish more accurate information about the public and private lives of individuals pursuing or having changed gender and/or undergone sexual reassignment surgery to assist journalists or news reporting agencies to use the appropriate pronouns. Family members often confused about pronoun usage or the definitions of sex are frequently corrected by either the transsexual or the professionals who assist them as they approach that point at which they begin to "pass" as a member of the sex they wish to adopt.
After this level of transition and development has been achieved, many transsexual men and women may wish to blend back in with other members of their new sex and will avoid revealing their past preferring the relative peace and security they find on the other side of a stressful and potentially dangerous transition.
This behaviour is known as stealth, and is somewhat a contentious issue. Some people, including some transsexual people, feel that they should be upfront about their past, and that stealth living is somehow dishonest; however, others claim that transsexual men and women should be able to live in their true gender role in a normal way and be in control of whom they reveal their past to.
As with every transition, in children and in adults, "experts" often raise the spectre of transitions gone wrong, that is people transitioning back to their original sex. These cases do in fact exist, however, every recent study done on the number of these cases states that their number is below 1%, and that the reasons for retransitioning are very diverse. See this article in the International Journal of Transgenderism for examples.
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