Recently, during a radio show on which I appeared as a guest, a caller posed a question I frequently get asked: “Do the administration of cross-gender hormones and genital surgery change a boy into a girl or a girl into a boy?”

The answer is simple: biologically, not at all.

Underneath all the cosmetic procedures, vocal training, and hair growth or hair removal lies a physical reality. Biologically, the person has not changed from a man into a woman or vice versa.

Sex is an indelible fact of a person’s biology. Specifically, it describes one’s biological makeup with respect to its organization for reproduction. As Lawrence S. Mayer and Paul R. McHugh explain in The New Atlantis:

In biology, an organism is male or female if it is structured to perform one of the respective roles in reproduction. This definition does not require any arbitrary measurable or quantifiable physical characteristics or behaviors; it requires understanding the reproductive system and the reproduction process.

The authors go on to note that “[t]here is no other widely accepted biological classification for the sexes.” Sex pertains to the two different ways males and females are structured for reproduction, and these structures are permanently engrained in one’s biology. They cannot be chosen at will.

A man can mutilate his body, but he can never transform it to be organized as a female—and vice versa for the woman.

This makes sense of the head-snapping (and false) headline many of us saw about a man having a baby. The “man” featured in the story is simply a biological woman who kept her childbearing anatomy intact.

My Sex Change Fiction

My “sex change” surgery from male to female was performed by Dr. Stanley Biber in Trinidad, Colorado.

His unusual field of expertise drew clients from around the world and earned the small mountain town the nickname “Sex Change Capital of the World.” The surgeon estimated that he performed over 5,000 such surgeries during his career.

I lived legally and socially as a female for eight years, but I came to the realization that I wanted to go back to living as a man. To legally change my gender back to male, I needed to file a petition with the California Superior Court that verified I met certain criteria. (The process has since changed.)

My surgeon wrote a letter to the court stating that I met the medical criteria for the courts to legally change my birth certificate back to male. The very surgeon who earlier said that hormones and surgery had changed me to female, now admitted that it did not.

In the letter, he testified that the surgery and cross-gender hormones had the effect of neutering my external appearance and genitalia, but my internal biological structure and my genetics were still male.

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That’s the key to understand: Hormones and surgical changes can affect one’s external appearance, but no innate biological change of sex occurs.

This truth should seem obvious, but discontented trans women contact me who say they didn’t know that they could never become a “real” woman. They are unhappy and opting to go back to the gender of their birth.

False Hope Could Lead to More Suicide

A 2004 U.K. Guardian article, “Sex Changes Not Effective,” points out: “While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there’s still a large number of people who have the surgery but remain traumatized—often to the point of committing suicide.”

Too many post-surgical patients contact me to report they deeply regret the gender change surgery and that the false hope of surgical outcomes was a factor. For children, the focus on encouraging, assisting, and affirming them toward changing genders at earlier and earlier ages, with no research showing the outcomes, may lead to more suicides.

Others Advocate Less Surgery

A growing number of people like me, 50 years after the first surgery at Johns Hopkins University Gender Clinic in 1966, are advocating the scaling back of the radical, irreversible, often unnecessary genital mutilation surgeries.

Rene Jax, in his 2016 book, “DON’T Get on The Plane!” says, “Sex change surgery will ruin your life.”

Jax and I have had similar experiences. Both of us were approved for hormones and surgery to resolve our gender dysphoria, and after following the medically prescribed full regimen of hormones and genitalia surgery, and living as women, both of us came away with the same conclusions:

Gender change surgery was a destructive body mutilation and a waste of time and money.

After the medically-certified gender change, life didn’t improve.

Gender dysphoria, that feeling of unease with one’s gender, persisted, and was not relieved as promised.

Surgery as a Last Resort

Based on the emails I receive, I would urge the person who thinks that gender change is the answer in their situation to delay any surgical changes, or at the very least to restrict any physical changes to ones that are reversible.

This is especially important for younger people who may want to have children one day.

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Today in 10 states, only a verbal declaration and a doctor’s letter supporting the change are needed to legally change the gender on a birth certificate. Cross-gender hormones or surgery are not required. Only 10 states affirm that surgery and hormones do not change biology.

Studies show that two-thirds of people with gender dysphoria have co-existing disorders, such as depression and anxiety.

I’ve become an outspoken critic of gender reassignment surgeries because many people are not being treated for other co-existing problems first. Instead, they are quickly prescribed cross-gender hormones and shuttled on a path toward surgery.

But as noted earlier, this surgery cannot succeed in delivering what it promises. It will only mutilate the body, a far cry from the promised “sex change.”