Gender Reassignment Legal Issues, Social Aspects and Regrets

Legal Issues

An important part of changing genders in the U.S. is changing names. A person 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 transgender person amends his or her Social Security card and birth certificate.

Most states' antidiscrimination laws don't do much to protect transgender people from discrimination. Many 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

Transgender people face unique issues involving marriage, sex and fertility. Although most states do not allow homosexual marriages, people who have transitioned are able to marry legally. For those completing sex reassignment surgery, a satisfying sex life post-operation depends on several 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 in which 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.

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].


One question often on the minds of non-transgender (or cisgender) people is whether someone who decides to have gender confirmation surgery will wind up regretting it. It's generally reported that transgender people who have undergone these surgeries are, in almost all cases, happy they did so. And while there may be a few 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.