Sex change theory The idea of sex change is based on the notion
that a person of one gender can be born "trapped" in an
opposite-gender body. The theory plays havoc with traditional
ideas of masculinity and femininity. Transgendered patients seek
to undergo surgical sex change operations (also known as gender
reassignment surgery) to change their external appearance to to
that of the gender with which they identify. Patients often
undergo psychotherapy, hormone treatment, and facial surgery as
well. In the United States, a patient must undergo counseling
before being approved for the surgery. Patients in the US are
also required to have two letters of recommendation from
certified psychiatrists, and must have lived a year acting as
the gender that they identify with.  Patients sometimes choose
to have the surgery done abroad in places like Thailand for
three reasons: 1. It is often less expensive for the patient, 2.
The patient may be able to bypass some legal restrictions, 3.
The surgeons in Thailand have a