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> why is it necessary to implement significant physical alterations via medications and surgery to "fit" into a role that feels right?

Good question, there's three answers here:

1) It's not necessary. Many trans people do not want or do not get bottom surgery. It's an incredibly difficult surgery, and many folks also believe it's unnecessary to be trans.

2) The cultural group that the trans person belongs to will only accept them if they have the surgery, so the trans person must perform it to be recognized.

3) Some trans folks experience sexual dysphoria, seeing one's birth genitals causes anxiety, discomfort, and depression.



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