A transgender operation involves changing the physical sex of a person. It may involve removing a males penis and creating a vagina and feminising the male or vice versa to change a female to a male. These operations may be done in adulthood because an individual feels that they have been born into the wrong body; while they appear to be one sex they feel strongly that they are the other. The operation may also be conducted on children in cases of indeterminate sex or hermaphroditism, where a child is born with sex organs that are unrecognisable as one sex or the other or where complete sex organs of both sexes are present. In this case parents make the decision over which sex the child should be raised as and the sex organs are ‘created’ accordingly. In cases where an adult patient requests surgery, ethical issues are of less significance as the patient can be briefed about the effects and make an informed decision about whether to have the operation. In the case of children however, some argue that there are serious ethical questions that should be addressed. Case of David Reimer
The decision to raise Bruce as a girl after his botched circumcision did not prove to be a good decision, as Bruce always felt more like a male and this affected his self-esteem growing up. Other cases of males raised as females
Reiner and Gaerhart studied 16 genetic males born without (or with a very small) penis, but normal testes and XY chromosome, 14 of whom were raised as girls after surgery. The majority of those raised as girls still felt as if they were male which raises some ethical questions about whether the parents should have had the power to make that decision.