Medically and psychologically, there is much debate about gender reassignment with full European change operation. The issue is from male to female vs. female to male is inherently unequal--i.e. the equipment is not fully operational...
Then psychologically, is it enough because someone "feels" like they are the wrong gender without gross genetic evidence, like Klinefelter's or other pseudohemaphroditism.
And the genetic evidence is strong... Sex determination at the zygote occurs roughly 2-3 days after fertilization and 8-16 cell stage. This process is not necessarily complete. What determines the male is testicular formation NOT penile formation. The genes that regulate testicular formation are on the Y chromosome--the 1-2 genes that are actually on the piece of DNA that are functional... Penile formation occurs on autosome(s), not sex chromosomes... So, it is possible that a genetic female (XX) has a penis--albeit not functional if she has some uterus and reminants of ovaries. More likely, she is not born with female parts, but a gapping hole.
Now these things constitute birth defects and are treated as such. Waiting for the baby to grow up and decide usually is painful that is why the doctors make the surgical decision based on the parents wishes at that time. And infant healing is relatively rapid.
However, loss of hormonal development at puberty is what is at stake. Girls who do not have somekind of menstruation at 10/11 till 14 years old are ostracized. Boys generally start their maturation and fighting at 9-13 years old as dictated by testosterone production.
So, if a PNM has a question regarding their gender identification, that is when I would ask her to see some kind of therapist. The issue for the organization is will programs be best served by this kind person if extended membership? That is not discrimination if they cannot fullfill the basic housing requirement.
A little science...
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