Requirements for Surgery
There are several reputable sex reassignment surgeons in the world today, and none of them will perform the procedure without sufficient proof that an individual has met the requirements. These requirements are not law, but are based on a set of Guidelines originally proposed by a Dr. Harry Benjamin.
As applied today, these guidelines require that a person seeking SRS must meet the following specifications:
Live for at least one year full-time in the new gender role (called Real Life Training or RLT)
Engage in hormone therapy for at least one year (which can be simultaneous with the full-time experience)
Gain the recommendation of a psychologist or therapist after an appropriate series of sessions.
Gain a recommendation of a psychiatrist that surgery is not contrary to the mental health of the patient.
When all these qualifications have been met, each surgeon also requires an HIV test to read negative (which they have performed at their facilities) and a personal interview so that they may verify your mental and physical condition personally.
These guidelines are not arbitrary, yet often seem so to those who are so motivated and sure of their feelings. But the surgery is not the big issue in the long run. The real issue is the kind of life you will have to lead afterward. If you were to have surgery before RLT only to discover that you really hated the new role, well that would be a life disaster.
On the other hand, it should be kept in mind that even if one were to have surgery, the option always remains to continue to live in the original role, since exposing one's genitals publicly can usually be avoided, therefore no one would have to know. In fact, I have met one such person who felt a deep personal need to change his physical sex, while continuing to live in the old role. For him, it works just fine.
