My one small addition is that the temporary or permanent nature of a
biological change should not be read as an indication of the seriousness
of that decision for the person involved. The very notion of choice,
of making an active decision about one's own biology or sex role,
challenges the base power structures of human society. Taking on those
encoded norms by refusing to stay in one gender, however it is done--
through semipermanent hormones, permanent surgery, or temporary
cosmetic alteration--carries the same societal consequences for the
individual. The medical profession carries a vested interest in
preserving the binary sex system and, therefore, in its role as
gatekeeper will try to weed out those who would practice some
flexibility.
Sin,
Kathryn Aegis