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Under good medical supervision. The transgendered (transsexual) patient has to meet all the above requirements and must get two recommendations from psychiatrists. Even after the surgery, they cannot change their gender on any legal document. In 1990, the court rejected a male-to-female transsexual‚s petition stating, ‚Because the plastic surgery only made anatomical structures that look like those of the female artificially so that it does not change the chromosomal structure, he cannot be accepted as a female from our society‚s common sense and value. ‚ [ Comment 2003 : Added to that, the court ruled that ‚he cannot legally change his gender because he has no internal parts of the female body which are very important to the woman‚s role of giving birth.

Dated June 6, 2005, Judge Sarah Vance. of the United States District Court for. the Eastern District of Louisiana found. sufficient evidence to uphold all.]