Right? Damn I should tell them that I am really a horse and try to get a surgery if they say no ill say there are some king of phobic and sue them, Liberal nut job logic right there, it is a damn mental sickness ask any real doctor and they will tell you.

The majority of cases are entirely psychological. It used to be classified as such by the DSM as gender identity disorder. The times that it is actually a genetic mutation where their sexual characteristics are opposite their actual sex are the only people we should consider for reassignment surgery.