"Sex change" is sometimes used to describe the result of medical procedures trans* people may pursue during the process of changing gender role, or specifically to genital realignment surgery. Since so-called transition, the changing of gender role (i.e. living as a woman instead of living as a man, or living as a man instead of living as a woman), is more important to daily interactions than genital surgery, this use is even more inaccurate in describing the changes undertaken.
In addition, many also see "sex change" as simply factually inaccurate. Sex in humans is usually determined by several major factors: chromosomes; the reproductive tract, specifically (ovaries or testicles); the predominant sex hormone; and primary sex characteristics, sometimes also secondary sex characteristics. While many secondary sex characteristics can be changed medically, not all of these factors can be changed.
- Chromosomes cannot be changed with current medical technology.
- Gonads can be removed, but not replaced with currently used procedures. There are also no current procedures to create the ability to reproduce genetically similar offspring (spermatogenesis in trans men and gestation in trans women).
- Existing sex characteristics can to some extent be changed; existing ones mostly through surgery, non-existing ones can be induced to grow through hormones.
Changing a male genital anatomy into a good or even excellent female appearing and functioning one is complicated, but entirely possible; changing a female genital anatomy into an even reasonably male appearing one however is extremely complicated and not successful very often; function is always limited. Gender reassignment is usually precluded by a period of hormone therapy as part of medical transition to the trans person's inner gender identity in conjunction with social and/or legal changes.
Natural sex change in humans
Several medical conditions can result in a natural sex change in humans, where the appearance at birth is somewhat, mostly, or completely of one sex, but changes over the course of a lifetime to being somewhat, mostly or completely of the other sex. The overwhelming majority of such changes are from a female appearance at birth to a male appearance after puberty, due to either 5-alpha-reductase deficiency (5alpha-RD-2) or 17-beta-hydroxysteroid dehydrogenase deficiency (17beta-HSD-3). A relative handful of male to female changes have been reported, and the etiologies of these are not well understood.
- Pfäfflin F, Junge A (2003). Sex reassignment thirty years of international follow-up studies after sex reassignment surgery: a comprehensive review, 1961–1991, International journal of transgenderism. Symposion: Düsseldorf. OCLC 244295488.
- Cohen-Kettenis PT (August 2005). "Gender change in 46,XY persons with 5α-reductase-2 deficiency and 17β-hydroxysteroid dehydrogenase-3 deficiency". Arch Sex Behav 34 (4): 399–410. doi:10.1007/s10508-005-4339-4. PMID 16010463.
- Bertelloni S, Maggio MC, Federico G, Baroncelli G, Hiort O (September 2006). "17β-hydroxysteroid dehydrogenase-3 deficiency: a rare endocrine cause of male-to-female sex reversal". Gynecol. Endocrinol. 22 (9): 488–94. doi:10.1080/09513590600921358. PMID 17071532.
- Salt D, Brain Z (June 2007). "Intersex: Case studies". Cosmos (15).
- Khan U. "Father of five naturally turning into a woman", Daily Telegraph UK, 2008-07-02.
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