recommending the removal of sex labels from birth certificates. Sexual identification, according to the AMA, is often arbitrarily assigned based on external genitalia, may have little to do with how someone feels about themselves and can lead to problems including stigmatization and discrimination.As a practicing psychologist, I've worked with nonbinary, including transgender, individuals.
About 10 years ago I had a patient who transitioned from female to male through hormonal treatments but without surgery. Slightly built, the only work he could find was in a warehouse, where he was routinely ridiculed, and finally forced to quit.