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- Franken Fran has a double example. Possibly justified by Fran quite frankly being crazy enough to do it, especially since she performs any surgery she thinks is warranted regardless of later psychological issues and believes "alive but in unimaginable, incurable psychological torment" to be preferable to "dead". Oddly enough, it's one of the few "happy" endings (though the couple in question is later revealed to have broken up after cheating on each other).
- Wandering Son, which treats these types of issue more seriously in general, averts this. At one point, Transgender Cool Big Sis Yuki confides to Yoshino that her mother can't forgive her because she wanted to be a girl, "wanted it so bad." Which can imply that Yuki went through all the proper processes. It's also showing signs with the protagonists, who are slowly transitioning (well, as much as teenagers with parents who aren't letting them go to therapists can).
- Averted in Pretty Face: Dr. Manabe insists on giving Rando a sex change (since he has a girl's face), and acts like this trope is real. Rando, on the other hand, knows better and beats up Manabe whenever he brings it up.
- Semi-averted in The Day of Revolution: Kei/Megumi's gender reassignment goes fairly easily since she's already genetically female and physically intersexed. However, everyone agreed to go through with it far too quickly and for fairly dubious reasons.
- In He's Dedicated to Roses, the main heroine briefly (but seriously) contemplates getting a sex change operation seeing how her crush is in love with her crossdressing alter-ego and she doesn't want to hurt him by letting him know she's actually a girl. This idea is quickly shot down and isn't brought up again.
- In The Vision of Escaflowne, it is revealed that Dilandau used to be an innocent little girl, and Allen Schezar's little sister at that. Although it's implied that there was a long, drawn-out process of some type required involving Emperor Dornkirk's "Fate Changing" experiments, which possibly involved some kind of probability-manipulating, extra-dimensional/quantum physics weirdness, but at the end, Dilandau reverts back to Celina and it's implied that she stays that way. This is not addressed in either the OVA or the manga; in the OVA, Dilandau is biologically male the entire time, and in the manga, the character is female and stays that way the whole time.
- Marika from Bokura no Hentai averts this. She spends a while dressing up in private but eventually comes out to her mom after some friends tell her she should see a doctor. She spends a few weeks out of school, going to therapy and such, but ends up going to school as a girl.
- Averted in Yuureitou. Tetsuo still looks feminine, in a bishonen way, despite being on testosterone for a while. He casually implies once he wants surgery but doesn't have the money.
- Subverted in Kyou Kara Yonshimai. Kashiwa comes back from college specifically to save money on dorming due to her transitioning. One of her sisters even elaborates how expensive it is. Kashiwa's sisters at first think she had already gotten "the surgery" but she tells them she wouldn't do that without coming out to them first.
- Averted in The Sandman story "A Game of You"; Wanda lives as a woman and appears to be taking hormones but won't get "the operation" because she's terrified of surgery. It later comes out that she was rejected and despised by her entire family, who all want to pretend that the whole "wanting to be a girl thing" never happened. Gender change appears to have been very hard for Wanda so trying to live as a man must have been even harder. After her death, she's shown as a happy, beautiful woman in the afterlife.
- Discussed and averted in a The Penguins of Madagascar fic entitled "Princess"; Kowalski, the resident Mad Scientist, quite easily could give Julien male anatomy, but they decide it's a bad idea because it would raise uncomfortable questions from the humans and because Kowalski's inventions have a tendency to go horribly wrong.
- In This World and the Next: gender reassignment surgery is performed on an unconscious Ron without his knowledge and he wakes up a woman.
- In this Linkin Park fanfiction, "Chessi" Bennoda becomes a completely passing young woman with the help of a makeover in one day. The fic is loaded with pretty offensive misconceptions about being transgender. Hilariously enough, the writer is a trans man that wrote it before he identified as such.
- Averted in The Silence of the Lambs, when Hannibal says that the Serial Killer Buffalo Bill will probably be found to have been rejected by multiple sex reassignment clinics because he thinks he is a trans woman when he really just hates himself.
Lecter: Our Billy hates his own identity, you see. He always has, and he thinks that makes him a transsexual. But his pathology is a thousand times more savage and more terrifying. He wants to be reborn, you see.
- Ironically, despite the film going out of its way to point out that Buffalo Bill is not transgender and merely thinks he is, the film was attacked upon release by people who thought that transgender people were being unfairly demonized in the film.
- A subversion of this trope is central to the premise of the off-Broadway play and movie Hedwig and the Angry Inch. Hedwig's surgery is done with little preparation by a shady East German doctor, leaving Hedwig with the "Angry Inch" of the title.
- Invoked in the Adam Sandler version of The Longest Yard. Adam's team, the underdogs of the movie, replace someone on the guards' team's steroids with female hormone pills. Not more than two days later, said guy is bawling and weeping, supposedly acting feminine because of the hormone. To make a long story short, hormones do not work that way. A more likely outcome from suddenly taking a huge dose of estrogen would simply be getting very sick, in various "normal" ways (headache, nausea, etc.) Emotional side effects are possible, but would probably require testosterone-blocking medication to be taken at the same time.
- In Myra Breckinridge, the character Myron Breckinridge has a sex reassignment surgery that works so well that his new persona as Myra completely convinces everyone that she's been female all along...which she should, being played by Raquel Welch (with Rex Reed as Myron who tags along as Myra's more-or-less imaginary friend). Justified, as it turns out the whole movie is a dream the closeted Myron is having.
- While not as "easy" for the patient as most examples, a dark take in The Skin I Live In is similarly unrealistic, as a surgeon does an involuntary sex change on the guy who raped his daughter. He also keeps him/her in isolation and uses him/her as a guinea pig for developing artificial skin.
- Subverted in Bad Education. Ignacio is prevented from having one because he doesn't have enough money. All he manages to get are breast implants, and he still looks like a man in spite of that.
- Members of The Culture can change sex at will, although it does take several months for the changes to gradually take place. Justified because they're ridiculously advanced transhuman post-scarcity beings who can also (for example) produce a variety of drugs and chemicals from specially-tailored glands within their bodies simply by choosing to do so.
- Fairly easy sex changes (taking several months) are available to anyone who wants them in Walter Jon Williams' Aristoi, using a "nanologic" package. Another nanotech procedure allows men to experience pregnancy.
- Tanith Lee's Biting the Sun books describe an ultra-futuristic society with very easy sex and body changes. Officially, you are only supposed to change bodies once per month, but everybody flouts this rule all the time.
- In John Varley's Eight Worlds series, sex changes are so commonplace that anyone who spends their life as just one is considered a little weird, and population control laws are: "one person, one child."
- In the books Accelerando and Glass House by Charles Stross, people living in post-Acceleration times have completely mutable bodies: They can get a new body of either sex (or both, or neither) in as little as a kilosec (just under 17 minutes) - the time it takes an A-Gate to build it for them. This leads to phrases such as "I found myself in a female orthohuman body...".
- Within Lois McMaster Bujold's Vorkosigan Saga, the saga of Lady Donna’s sex change to Lord Dono shows that sex changes are relatively easy and painless with futuristic genetic technology, although Lord Dono comments that it does take time and his guy parts are still growing in. No mention of therapy is made although the character did go to a planet known for pervasive (sex) therapy, and in fact Dono's stated reason for the change (Loophole Abuse in highly patriarchal Barrayar's inheritance laws) is at best highly dubious. It's possible that Dono deliberately avoids mentioning any mandatory therapy since a) he is seeking public office, b) his family is not known for their mental stability, and c) on Barrayar, therapy carries a stigma of presumed violent insanity. The process is also apparently quite possible to reverse, which would lead to some relaxation of the rules.
- The book Trans-Sister Radio has Dana (MtF), a college professor, get his surgery done to become a her over the summer so that she can come back in the fall as female. (One is supposed to live as the other gender for a year before surgery even gets done, which Dana doesn't do.) The author seems to have sped up the process for drama, especially since Dana's girlfriend is a public school teacher and thus everyone in town objects to them. At one point in the book this trope is played straight, as a doctor discusses another MtF sex change (that he didn't perform) where the man's wife decided she was a lesbian so he had a sex change to stay with her, only to be then dumped because the wife decided she wasn't a lesbian after all.
- George Alec Effinger's Marid Audran series takes place in the Budayeen, a Red Light District of a 23rd century Cyberpunk Muslim/Arab city. In this setting, sex changes, while expensive, are still easy and commonplace. Also quite effective, though not quite to the point of being a true Gender Bender treatment. Attractive Bent-Gender is the norm, not the exception.
- Neil Gaiman's short story Changes features a pill (originally created as a cancer cure) that has the "side effect" of causing a painless, perfect, permanent yet easily reversible (just pop another one) sex change over night. The story follows the way society changes following that discovery, and towards its end years later, the very concept of gender has become completely ambiguous and the words used to describe it considered strange and outdated.
- This happens to Mina Rush in "Deep in the Depths of Acme Warehouse". However, it was probably magic, as the object that caused the change was dildo modelled after the plaster cast of Jimi Hendrix's penis found in the said Acme Warehouse.
Live Action TV
- Invoked in an episode of The Love Boat where a woman assumes that a man on the cruise is traveling for a sex change operation because he has a dress in his room (among other misunderstandings) because obviously he would be traveling and living as a man right up until he gets the operation and jumps into womanhood all at once.
- Wonder Showzen: Mother Nature cuts off her own lady parts with a knife, then puts them in a bucket. She dies as a result of attempting surgery on herself. Then another puppet has sex with the bucket of bloody lady parts. It's just that kind of show.
- Nip/Tuck had an episode with a MTF transperson becoming male again after realizing she really felt more comfortable being a gay male. Christian Troy does the surgery ASAP, without any of the prerequisites. Even assuming that Troy is an unscrupulous and unethical doctor, sexual reassignment surgery still doesn't work that way.
- The Psych episode "Who Ya Gonna Call" had a man with three alternate personalities: a woman who wanted to have SRS, a confused normal guy, and a psychopath who had murdered the doctor to prevent his imminent surgery, although he wasn't taking hormones or undergoing any other precursors to SRS. Somewhat averted in that there was a psychologist involved, but the SRS process as presented was heavily compressed.
- Averted in CSI in one episode, where they investigate the death of a woman and discover that she is a transwoman in the midst of transitioning to female, and has not yet had any genital surgery. They also meet a well-intentioned back alley doctor who explains how this trope is nowhere close to true in real life, and how the length of the process (both from a medical and bureaucratic standpoint) makes people turn to people like him even though it puts them in danger.
- The sitcom Soap had almost the perfect example of this trope. In an early story arc, Jodie (Billy Crystal) decides to have a sex change to please his boyfriend. Despite no real life experience (aside from a bit of crossdressing), no hormonal therapy, no psych evaluation, still looking like what he is (a man), he gets admitted to a hospital to have his outie turned into an innie, and they're apparently quite willing to do it. He does not go through with it.
- In the "Nobody's Perfect" episode of Karen Sisco, Karen hunts fugitive Louis DiNardo. Eventually, it turns out that Louis has had surgery to become "Lois". The timeline is a little vague, but certainly not enough time has elapsed for the requirements of ethical SRS medical treatment. While easy, the surgery is also thorough (Lois specifically mentions that she no longer has a penis, and that she "doesn't miss it"), and quite successful. While Louis is played by a male actor, Lois is played by Alexandra Billings, an attractive female actress — albeit one who once was a male herself.
- Degrassi set themselves up to sidestep this whole part of the issue by putting Adam in Grade 11 at age fifteen, meaning he's on schedule to graduate from High School and therefore the show before he turns 18 and can begin physical transitioning. He was was retconned into a sophomore in the second half of Season 10 and then killed off while he was still pre-hormones.
- Addressed (and averted) in an episode of Private Practice, where a patient is told that their procedure will have to be delayed because Sheldon suspects that although the desire for the operation is genuine, there are psychological issues that need to be addressed to ensure everything goes smoothly. He turns out to be right when the patient attempts suicide upon being given this news, and offers to help them get through these issues so she can complete the process of becoming a woman.
- In the much-derided Star Trek: Deep Space Nine episode "Profit and Lace", Quark is forced to pretend to be a woman and conduct a meeting with an important Ferengi businessman (on the subject of women's rights on Ferenginar) while his mother is out of commission. Apparently, 24th-Century technology allows them to perform a complete sex change operation on him in just a few hours, and then change him back to a man the following day (presumably they kept his... male parts in bio-stasis or something). Granted, this is Star Trek, where plastic surgery to make someone look like a different species is apparently an outpatient procedure.
- In the Torchwood episode "Greeks Bearing Gifts", Jack claims that he started paying closer attention to his co-workers after a male colleague began "acting strange" right before going on several weeks leave and returning as a woman named Vanessa. Since Jack only mentions this in passing, it's possible that sex changes are handled differently in the 51st century, and it's always possible that Jack is just that oblivious.
- Partly averted for comedy effect in The League of Gentlemen, where Barbara of Babs' Cabs is a transwoman who is some years into the process ("I've only been on the hormone treatments eighteen months. Me nipples are like bullets.") and dresses and presents as a woman, and is referred to and treated as a woman by all the other inhabitants of Royston Vasey, but still speaks with a deep, growly voice and has excessively hairy arms is to all intents and purposes clearly still physically very much a man. She describes in some wince-inducing detail the surgery she's going to be getting. Later events put Babs clearly in the realm of this trope, however, when she gets pregnant and delivers twins.
- In Mendol Ikemen, the manager Saeko apparently had one. But the characters keep referring to her as a man after The Reveal, suggesting she's merely a Creepy Crossdresser (or, perhaps, that the characters are just really insensitive?)
- Averted in the Picket Fences episode "Pageantry". A schoolteacher is found to be transgender which causes problems with the townsfolk. Jill Brock defends the transgender individual's credibility by explaining that undergoing such a process involves a number of steps and is not something done on a whim.
- Averted in The L Word with the character introduced initially as Moira, but is soon known as female-to-male transsexual (FTM) Max. The characterization was generally pretty awful, and much of the actual science was off - being on testosterone for as long as he'd been, it would be damn near impossible to get pregnant, even with no birth control methods being used; also, "roid rage" is a myth, and as such couldn't possibly be exacerbated by testosterone obtained illegally. Non-prescribed testosterone's risks are vastly associated with the substance either being doctored or effectively "overdosing" - after a certain point, testosterone reaches maximum saturation in the body and the remainder is converted into estrogen, which is why non-trans bodybuilders using it can experience shrinking of testicles and breast growth. But he did hold a benefit to pay for his chest surgery (breast reduction/chest masculinization), which meant he couldn't afford even the more basic and less expensive of the "sex change" surgeries. Just FTM chest surgery ranges runs about $8k in reality, not including travel, time off work, etc.
- The Alex-to-Alexis transition in Ugly Betty took quite a long time and involved several episodes featuring Alexis wrapped up in bandages while recovering from the surgery. On the other hand, she did come out looking like Rebecca Romijin, so....
- Nao from Kinpachi-sensei averts this. He wants surgery now but is told by a doctor it's a long process. He's only fifteen and won't be allowed to go on hormones until age twenty, age eighteen with parental consent. It would take two to three years of hormones until he can get any surgery and even then he'd need a lot of therapy beforehand. Nao's understandably distraught.
- Played with in the NOFX song "My Vagina", which is sung from the perspective of a male-to-female transsexual who went through an operation. The singer complains about remembering to put the seat down when she uses the toilet and having to be more thorough in cleaning herself, but considers it worth it to be able to hang out with lesbians.
- Transhuman Space includes this as part of the general high-biotech transhumanist style of the setting, and quite a lot of people are said to change, permanently or temporarily. However, it doesn't seem to come up much in the game beyond this mention.
- In Eclipse Phase a sex change requires nothing more than twelve hours in a Healing Vat. There's also a fairly inexpensive Sex Switch biomod that allows one to change sexes at will, though it takes a week, but at least you're out and about during the change.
- Shadowrun: Due to advances in cybertech, biotech, and genetech, sex changes have become relatively cheap, easy to perform procedures. To the point that notable runner Plan 9 has apparently had so many sex change operations that they can't remember which sex they started out as, over the course of just a few years.
- In BioShock it is stated in an audio log by Dr. Steinman that Adam makes this easy.
- Circuits Edge, the 1989 CRPG based on George Alec Effinger's Marid Audran series (see Literature, above), likewise features several characters who have had Easy Sex Changes (though it's not an in-game option for the player/Audran himself.)
- With tongue firmly in cheek, one of the fake radio ads in Grand Theft Auto: San Andreas advertises this sort of thing.
- Adventure in The Sleazy Back Alley of Kingdom of Loathing, and you may run into a clinic where you can get a sex change for 500 Meat and 1 Adventure, and be on your way the same day. Do it often enough, and you become eligible for a trophy. What's the meat for? You don't want to know. note
- In Saints Row 2, 3 and 4, you can get a sex change for just five hundred dollars at the plastic surgeon. And not only is it cheap, it's instantaneous! (You can also go from white to black, or black to Hispanic, or white to Asian, green or blue, change from being skinny as a nail to morbidly obese, or anything else you can think of.) In the third game, this is necessary if you play as a female Boss since one mission requires you to get plastic surgery to become Cyrus Temple and infiltrate a ship.
- Discussed in Dragon Age: Inquisition. Apparently magic makes it fairly easy to physically transform one's sex. The problem is that magic is heavily stigmatized in non-Tevinter nations throughout Thedas, and even many Tevinter citizens are still incredibly wary of magic. Case in point: transgender character Krem (who is Tevinter) admits that he would never let magic go near his body to change "all the way".
- Xenoblade Chronicles X allows you to change your character's gender once you complete a side mission. Since your body isn't human but rather a mimeosome, Yardley's machine is easily capable of changing every appearance, including gender.
- Ballerina Mafia has a sex change performed overnight as an April fools joke.
- A Running Gag in College Roomies from Hell!!! is the horrifying side businesses of the Hot Dog Man, which include "quick and effective sex-change surgery".
- Aversion in High Maintenance, a comic centering on a transgender vigilante and her transitioning friend/sidekick. It might help that the writer is transgender.
- In the Jet Dream Remix Comic, NATO scientists have re-engineered the bioweapon Virus-X into a viable Gender Bender. Unable to replicate the Western effort, Soviet scientists perfected the Easy Sex Change. While considered quite inferior and much more painful, this surgical process is much more widely available, and a powerful tool for the Reds in the "Cool War" to win over the world's teens.
- Averted and pointed out in Khaos Komix, and the author would know, from personal experience. Though the pre-transition was unusually easy, and they pass very well.
- One of the many possible modifications offered by GavCorps Diversity Engineering division in Schlock Mercenary. Somewhat justified given the already established medical technology in the 31st century (quite a few characters have had new & different bodies regrown from just their severed heads).
- Comes up a lot, sometimes subverted, sometimes played straight, in Unicorn Jelly and other works by Jennifer Diane Reitz, who is herself transsexual. Played straight in To Save Her, thanks to Kaye's Mover containing incredibly advanced medical technology. For a machine that can grant immortality and resurrect a dead human-crystal hybrid after an explosion tore her to pieces, something like a sex change is piece of cake.
- Presented mostly realistic for Venus Envy (also by a real life transsexual). Though Zoe has been on hormone treatment for months she has yet to develop any substantial breasts, and wears a padded bra instead. Plus the rest of her "equipment" is still intact, which occasionally causes problems...
- In Umlaut House Rick invented a gender bender ray that changes someone's sex instantly and implied to be completely, judging by his "28 days" comment when Voltair accidentally used it. It's later shown that he made it to help his "colleague" Dr. Peggy Seus (born as "James")
- Ted from El Goonish Shive long ago invented a device that allows him to change a person's biological sex (and other features) essentially at will. In fact, his obsession with transforming himself and his friends into the opposite sex could have been seen as somewhat creepy... until it's revealed that he's gender fluid, and was using the tech to help him wrestle with his own gender identity.
- He actually used the change ray to walk around school as a girl for several days, but he was already so effeminate as a guy that no one noticed.
- The round robin story H! Flash had this very heavily implied to have happened to a character at the end of one of the chapters. The next writer, however, hated this trope and had "the operation" turn out to simply be exploratory surgery in preparation for the theoretically more realistic reassignment surgery to follow. The author of the previous chapter was not well pleased.
- Averted in The Salvation War series. The character 'kitten' (small K not a typo; it's complicated) is partly inspired by someone known to the author who went through the same process herself.
- In their crossover review of Myra Breckinridge, The Cinema Snob and Diamanda Hagan discuss the sex change with (unhappy to be cameoing) trans activist Zinnia Jones, who notes that a) telling Myron right before the surgery that once the penis is gone it's gone for good is rather late to be mentioning that, and b) given that Myron's still presenting as a man (complete with facial stubble) she would have thought Myron was FTM rather than MTF.
- The South Park episode "Mr. Garrison's Fancy New Vagina" (Although, as you might expect from an overnight sex change, Garrison never really looked like a woman, let alone a supermodel.)
- In the Futurama episode "Bend Her", Bender becomes a woman to cheat at the Olympics. The procedure involves changing out his male oil for female oil and snipping off his antenna. The operation also involves hitting his body with a hammer until it looks vaguely feminine. To be fair, Professor Farnsworth does give Bender some disclosure, about the danger of Bender's being "trapped forever between the already ill-defined robot sexes." Plus, y'know, he's a robot.
- Aqua Teen Hunger Force
- In Aqua Teen Hunger Force Colon Movie Film For Theaters, this happened with Frylock. The fact that he clearly identified as a guy before the movie.
- Frylock also performed a sex-change operation on Carl (against his will) to prevent him from getting his dick cut off. It Seemed Like a Good Idea at the Time. Or rather, it didn't. The exact line was something like, "I have an idea, but it's not very good." Ripped off. Ouch. It also hurts for Carl.
- In The Venture Bros., Colonel Hunter Gathers' operation is remarkably superficial - he gains large breasts and (apparently) a vagina, but remains the same in every other way. The easiness of sex changes on this show is primarily demonstrated by the fact that Hunter gets a second one, revealing both to be part of a long plan.
- A flashback in the Superjail! episode "Jailbot 2.0" shows that Alice underwent a rather quick hormonal transition to try to become an attractive woman, in hopes of finally getting to date her old warden. However, she then found out that he was a gay man, and once he discovers she changed, he fired her. Subverted a bit in that Alice is still visibly brawny, deep-voiced, and hasn't "gotten it removed" (as she states in the season 2 finale).
- Family Guy: In "Quagmire's Dad", the titular character goes in for surgery, and comes out a few (onscreen) minutes later looking like a mannish woman. No time needed to heal, and ready to have sex with an unknowing Brian right away!
- Ugly Americans:
- Callie get a sex change to get a job as New York Ambassador to Atlantis. At the end of the episode, just as suddenly as she changed into a man, she's mostly back to normal, but, in bed, Mark mentions her needing "a few more surgeries." From then on out, though, she's back to normal.
- An older episode had Mark himself transformed into looking like his roommate's ex-girlfriend, hoping to help him get over her. Unfortunately for Mark, seeing how his change was a curse that made him rapidly age until he had sex with a man, he didn't turn back so easily. The initial easiness is explained by Leonard Did It.