Instruct: Given a question, retrieve relevant documents that can help answer the question.
Query: Where was the first sex change operation performed?
Lili Elbe was the first known recipient of male-to-female sex reassignment surgery, in Germany in 1930. She was the subject of four surgeries: one for orchiectomy, one to transplant an ovary, one for penectomy, and one for vaginoplasty and a uterus transplant. However, she died three months after her last operation.
Following the widespread newspaper reports of the successful sex change operations of Christine Jorgensen in December 1952 and Roberta Cowell in March 1954, the first reported case of an Australian undertaking a sex change operation was an ex-RAAF Staff Sergeant Robert James Brooks in February 1956.
In 2012, the Community of Christ held national conferences in Canada and Australia both of which recommended to church leadership to change standing policies regarding ordination to include those in same-sex marriage (Canada) and in marriage-like same-sex committed relationships (Australia), and in Canada to extend the sacrament of marriage to same-sex couples. Official policy changes for these nations have since been released that follow the recommendations of these conferences. The Community of Christ's 2013 USA National Conference like those in Canada and Australia recommended changes. Those changes were recommended for the extension of the sacrament of marriage to same-sex couples in states where same-sex marriages are legal, the extension of covenant commitment services for same-sex couples in states where same-sex marriages are not yet legal, and extending eligibility for the priesthood call sacrament to all church members regardless of sexual orientation or open same-sex relationship. As a result of these recommendations, church leadership released in March 2014 policy embracing the recommendations for the church in the United States. Ireland and Great Britain held a special multi-nation conference in 2013 which also recommended changes to policy similar to those of Canada, Australia, and the United States. The changes have yet to be approved by the First Presidency and Council of Twelve for Ireland and Great Britain, with the likely timeframe to "develop, approve, and implement interim policies" being up to one year after the 2013 Conferences.
The hospital's sex-change surgery service led to Trinidad being named the "sex-change capital of the world." Resident surgeon Dr. Stanley Biber performed the hospital's first sex-change operation in 1969, and thousands of additional sex-change operations were performed there until Biber's successor left following a dispute in 2010.
In 1988, Tantawy issued a fatwa regarding the sex reassignment surgery of Egyptian woman Sally Mursi. The statement summary is translated: "It is permissible to perform the operation in order to reveal what was hidden of male or female organs. Indeed, it is obligatory to do so on the grounds that it must be considered a treatment, when a trustworthy doctor advises it. It is, however, not permissible to do it at the mere wish to change sex from woman to man, or vice versa." The fatwa has been interpreted both as in favor and also in rejection of sex reassignment operations.
An account by the transsexual, April Ashley (the first British citizen to have had a sex-change operation performed, albeit in Casablanca) describes the Astor in the early 1960s as having been "black tie and full of tarts".
As a transgender spokesperson and public figure, Jorgensen influenced other transgender people to change their sex on birth certificates and to change their names. Jorgensen's case was also significant because, for the first time, it led to complications over sex and science and the changing definition of sexuality. Gender was thought of as a set binary (where one could only be male or female) that was permanent, but Jorgensen's case questioned that stability. Gender was not the set binary as people once thought of it, and doctors were redefining gender with the term "psychological sex". This new "psychological sex" showed that psychologically, one might not relate to one's biological sex.
In Romania it is legal for transgender people to change their first name to reflect their gender identity based on personal choice. Since 1996, it has been possible for someone who has gone through genital reassignment surgery to change their legal gender in order to reflect their post-operative sex. Transgender people then have the right to marry in accordance with their post-operative sex.
The first case to deal with legal recognition of transgender identity in the United States was "In re Anonymous v. Weiner" in 1966. A post-operative male-to-female trans woman applied for a change of sex on her birth certificate through the Bureau of Vital Statistics in the New York City Health Department. The Bureau turned to the Board of Health who then called on a committee on public health of the New York Academy of Medicine to make a recommendation. The application was ultimately denied and the Board of Health stated that "an individual born one sex cannot be changed for the reasons proposed by the request which was made to us. Sex can be changed where there is an error, of course, but not when there is a later attempt to change psychological orientation of the patient and including such surgery as goes with it."
In 2007, the Thai National Assembly debated allowing transgender people to legally change their names after having a sex change operation, but as of 2014 this change had not been passed. Post-operation male-to-female transgender government employees are not granted the right to wear female uniforms at work, and are still expected to perform military service. Specific cases of inequality include a hospital which refused to allow a transgender woman to stay in a woman's ward, even though she had undergone sex reassignment surgery.
Carlotta was born in Balmain, New South Wales, in 1943. As a child, she was taught song-and-dance routines by her mother. Neither her mother nor her stepfather approved of her subsequent transgender performing career. She had a sex change operation in the early 1970s which, though not the first such procedure in Australia, was the first to receive publicity.
In Saba (as in Bonaire and Sint Eustatius), marriage is open to same sex and opposite sex couples following the entering in force of a law enabling same-sex couples to marry on 10 October 2012. The first same-sex marriage was performed on Saba on 4 December 2012 between a Dutch and a Venezuelan man, both residing in Aruba, where same-sex marriage is not performed.
Sex reassignment therapy is a controversial ethical subject. Notably, the Roman Catholic church, according to an unpublished Vatican document, holds that changing sex is not possible and, while in some cases treatment might be necessary, it does not change the person's sex in the eyes of the church. Some Catholic ethicists go further, proclaiming that a "sex change operation" is "mutilation" and therefore immoral.
At first, Westerners may find the Iranian state's support of sex change operations contradictory in light of their views on homosexuality. However, "Be Like Others" reveals the reasoning behind this apparent disagreement: while homosexuality is considered a shameful choice, transsexuality is thought of as a curable mental illness. Dr. Bahram Mir-Jalali, performs more sex-change operations in a year than the entire country of France does in 10 years. Iranian President Mahmoud Ahmadinejad has notoriously proclaimed that there are no homosexuals in Iran, as it is clear that homosexuality has become interchangeable with transsexuality due to fear and repression. The film walks us through the lives of individuals undergoing this procedure and gives us a look into what life is like afterwards.
In 1983, the Malaysian Conference of Rulers issued a "fatwa" which ruled that sex reassignment surgery should be forbidden to all except intersex people, on the basis that any other surgery was against Islam, as Islam only permits "khunsa" (intersex people) to undergo a sex change operation. Sunni Islam forbids males from cross-dressing, wearing make-up, injecting hormones to enlarge their breasts, and undergoing sex change operations. Research shows that 78% of "mak nyahs" would prefer to have a sex change operation if their religion permits them to do so.
People have started accepting acts of sex reassignment surgery to change their sex as a norm either compelled by gender dysphoria. There are situations where such cases have come into the limelight. A 2008 ruling at Pakistan's Lahore High Court gave permission to Naureen, 28, to have a sex change operation, although the decision was applicable only towards people suffering from gender dysphoria.
Celebrity Cruises announced on October 11, 2017, that it will perform legal same-sex marriages on its ships while in international waters following the legalization of same-sex marriage in Malta, where most of the Celebrity fleet is registered. The company already hosted same-sex marriages while docked in jurisdictions where they are legal, but the change in Maltese law allowed the company's captains to perform legally recognized marriages while in international waters.
Independent phone sex operators engage in self-promotion. This self-promotion can involve a personalized website where the phone sex performer lists their specialties and services, engaging prospects in social media, various methods of advertising (via the traditional methods listed below, or on organized third-party network sites that provide a basic level of privacy for performer and client alike) and/or surfing of sexually themed chat rooms for interested clients.
When McLeod first went to Denmark to receive plastic surgery there was a law that stated they could only perform the operation on Scandonavians. However, McLeod still underwent a sex change surgery that was performed by professors and surgeons free of charge. McLeod's surgery was cited as being rather dangerous and unconventional. However, McLeod's intentions to return home a woman did not falter: “The thought of having come all this way in vain and of return as the Charlie I hated was unbearable. So I managed to have the first operation made unofficially. It happened on a kitchen table at midnight and that’s all I want to say about that, but the operation almost killed me.” 
Trans culture is very prevalent in Thailand due to extensive medical research done and sex-change surgeries. The first documented sex change in Thailand was in 1975, and attitudes and surgical techniques have improved much since then. On 25 November 2009, the Thailand Medical Council released a policy that was titled "Criteria for the treatment of sex change, Census 2009". Since this policy change, ninety percent of those who received a sex change operation are foreigners to Thailand. With this much tourism based solely off of sex reassignment surgery, Thailand's transgender community has not only grown, but trans individuals in Thai society are accepted on a much larger scale and will continue to be so in the future if the trend continues.
In 1987, Estelle Asmodelle became possibly Australia's first legally recognized post operative transgender person with the Births, Deaths and Marriages Department of New South Wales, and her transition helped gain recognition for transgender people in Australia. This was the first time in Australian legal history that a transgender Australian was permitted to change their birth certificate to a different sex. Soon afterwards the passport laws also changed to allow the sex on passports to be changed
North Dakota permits transgender people to change their legal gender. Doing so requires undergoing sex reassignment surgery. The North Dakota Health Department will issue an amended birth certificate on receipt of a written request of "the person who has undergone the operation", an affidavit by a physician stating "that the physician has performed an operation on the person, and that by reason of the operation, the sex designation of such person's birth record should be changed", a court order for legal name change, and payment of the associated fees.
People have started accepting acts of sex reassignment surgery to change their sex as a norm either compelled by gender dysphoria or just for the sake of it. There are situations where such cases have come into the limelight. A 2008 ruling at Pakistan's Lahore High Court gave permission to Naureen, 28, to have a sex change operation, although the decision was applicable only towards people suffering from gender dysphoria.
Trinidad was dubbed the "Sex Change Capital of the World", because a local doctor had an international reputation for performing sex reassignment surgery. In the 1960s, Dr. Stanley Biber, a veteran surgeon returning from Korea, decided to move to Trinidad because he had heard that the town needed a surgeon. In 1969, a local social worker asked him if he would perform the surgery for her, which he learned by consulting diagrams and a New York surgeon. Biber attained a reputation as a good surgeon at a time when very few doctors were performing sex-change operations. At his peak, Biber was performing roughly four sex-change operations a day, and the term "taking a trip to Trinidad" became a euphemism for some seeking the procedures he offered. Biber was featured in an episode of "South Park", in which elementary school teacher Mr. Garrison undergoes a sex-change operation. Biber's surgical practice was taken over in 2003 by Marci Bowers. Dr. Bowers has since moved the practice to San Mateo, California. The 2008 documentary "Trinidad" focuses on Marci Bowers and two of her patients.
Biber performed his first sex reassignment surgery in 1969 after a trans woman asked him if he would be willing and able to do so. At first, he did not know how, but he learned by studying diagrams from Johns Hopkins Hospital. He kept his first few surgeries secret from the Catholic nuns who operated the hospital, due to concerns that they would react negatively. Trinidad became known as the "Sex Change Capital of the World" because of his renown.