You bring up some things to think about , not that I really want to LOL --- I would figure , I am looking for that correct pronoun as to not offend , I am going to go with " they " , they wanted someone to pay for their sex change operation , but , insurance did not want to pay for it , so " they " initiated the preliminary procedure on " their " own , forcing the hand of the health care system , wonder which way the hospital would go ? Since it was already cut off , would they sew it back on or trash it --- truly it is a messed up world we live in >>> let me rephrase that , there are some messed up people in the world we live in