AbstractSex‐change procedures, better described as gender‐change procedures, involve preparing patients psychologically and surgically for gender transition to treat their gender dysphoria. Physical treatment might include hysterectomy for female to male transition, and post‐castration fashioning of an artificial vagina for male to female transition. Conservative opposition to accommodating and recognizing such procedures remains in some countries, and where treated, transgender individuals might face social hostility and oppression. However, human rights laws increasingly provide for transgender non‐discrimination and government re‐issue of official documents such as birth certificates and social insurance cards in the changed gender. A UK legal decision required a transgendered male who retained his ovaries and uterus to be registered as mother on the birth certificate of the child he bore. Most challenging are decisions on adolescents’ requests for gender transition, especially over parents’ objections. Laws increasingly recognize that legal minors with sufficiently evolved intellectual and emotional capacity can make decisions for themselves.