At the Trinidad Medical Center, Mr. Garrison is on the operating table getting a sex change operation from Dr. Biber. The good doctor makes sure to double-check with Garrison as to whether a "vaginaplasty" is really what he wants, and he confirms that it is. Delighted, Biber encourages Garrison to relax, telling him that he's convinced people would be far more accepting of sex change operations if only they could see how "natural" they are.
Allegedly to demonstrate this point, Biber carefully explains what he's doing to Garrison each step of the way, in clinically clean and yet fairly plainspoken vernacular. As he does so, we in the audience get to see brief live-action snippets from an actual sex change operation in full gory detail showing someone doing each of the things Biber says he is doing to Garrison. When he's finished, Garrison asks if he looks like a woman now, and Biber affirms that he does.
Meanwhile, over at the All Star Basketball tryouts, Kyle arrives at the stadium with the other boys in tow. Stan is trying to help him get over his anxiety about his pending tryout by pointing out he's the best basketball player in their school, while Eric (as usual) is opposed to the whole idea because he's certain that "Jews can't play basketball." Stung by this needling, Kyle reminds Eric that he certainly outplayed him at basketball, and boldly steps out onto the court to prove himself.
To absolutely no one's surprise, each top player from every single other school in the state is a tall black boy, making Kyle's comparative shortness (and whiteness) rather conspicuous. While no one calls any attention to this, Kyle soon demonstrates that he can't keep up with the other players no matter how hard he tries, since he can't run as fast or jump as high as they do. The coach presiding over the tryouts soon calls him off the court and disqualifies him, explaining that while he has the right attitude and skills, Kyle is clearly just not "physically built" right for the game because "Jews can't play basketball."
The heartbroken Kyle leans his head against the wall as Stan and Kenny each take a turn trying to comfort him, but to no avail. Being his usual obnoxious self, Eric taunts Kyle with the claim that his losing out proves that Jews really can't play basketball. Much to his dismay, Kyle agrees with him, leaving him with nothing to do but wander off grumbling about how Kyle just took all the fun out of tormenting him.
Meanwhile, down at Henry's Supermarket, the newly reassigned "Mrs." Garrison shocks everyone by showing off her new body. As everyone silently watches with a mixture of horror and fascination, she prances around the store cheerfully prattling about buying her first tampons and how she can't wait to get her period. Entering the ladies' bathroom for the first time, she creeps out all the women there with her overly ecstatic flaunting of her womanhood, and ends up driving them all out with her overly enthusiastic use of the facilities.
Somewhere not far away, Kyle emerges from a bus onto the sidewalk with his friends for the long and miserable walk home. Stan is still trying to cheer him up when Garrison suddenly arrives to show off her womanhood to them. They're all rather shocked and more than a little disquieted at this development, with Eric in particular noting that "Mr. Garrison has titties."
That evening at the dinner table, the understandably curious Kyle asks his parents about Garrison's sex change operation, which comes as rather disturbing news to them. His dad, who hadn't really planned to discuss such a mature topic with his boys so soon, starts panicking and saying he's going to pull them out of their school. His mother, insisting that such drastic measures are hardly necessary, approaches the subject with a somewhat more relaxed and conciliatory attitude.
She explains to Kyle that some people aren't comfortable with their bodies, feeling that these bodies don't reflect who they are inside. As such, for some who want to make their outside match who they feel they are inside, some new forms of surgeries are now available. Reflecting on how he (allegedly) lost out at the basketball tryout because he's short and Jewish, Kyle starts thinking that he might need one of these surgeries for himself to make him taller and blacker, in keeping with his inner passion for being a champion basketball player.
The next day, at the Trinidad Medical Center, Kyle and Stan pay Dr. Biber a visit. After Biber explains some of the surgeries he does (particularly Garrison's male-to-female sex change operation and its female-to-male inversion), Kyle then inquires as to whether Biber knows how to perform any kind of surgery that can make him taller and blacker so he can be a champion basketball player. Momentarily puzzled by this request, Biber then realizes what Kyle wants is a "negroplasty," which is an inversion of the "caucasiaplasty" he claims Michael Jackson had.
Drawing lines on Kyle with a marker as a visual aid, Biber explains all of the enhancements necessary, which add up to an operation taking seven hours and costing $3,000. Kyle is visibly eager to get this kind of surgery, but Stan wonders aloud whether this is really a good idea. The good doctor rather neutrally replies that if Kyle wants to be tall and black, it is; otherwise, not so much.
That evening, Mrs. Garrison arrives home to her live-in boyfriend Mr. Slave after shopping for some tampons and a slinky little dress. To her dismay, the glum Mr. Slave rebuffs her advances; since he's homosexual, he doesn't like vaginas, and is rather miffed that Garrison went off and had a sex change operation without asking him about his feelings on the matter. Their disagreement rapidly escalates into a full-blown lovers' quarrel, ending with Mr. Slave walking out and Mrs. Garrison angrily yelling after him that she doesn't need him anyway and calling him a fag.
The next day, Kyle eagerly tells his parents what Dr. Biber told him about a negroplasty, and asks them to get him one. His father scolds his mother that this kind of request is what her "trans-gender progressive thinking" gets her. His mother is no longer so relaxed and conciliatory about such drastically transformative surgery when it involves her son, and starts insisting to Kyle once she gets over her initial shock that he needs to be happy with his body the way it is.
Kyle insists that he really does identify as a tall black basketball player inside, citing the numerous things black people like that he likes, and explaining that he's tired of being short and Jewish because "Jews can't play basketball." Furious, his father chews him out for saying something so anti-Semitic, which results in Kyle asserting he'll never speak to either of his parents again as he bitterly storms off up the stairs to his room. Further infuriated, his father sets off for the Trinidad Medical Center to give Dr. Biber a piece of his mind.
When he arrives at the clinic, Kyle's father makes abundantly clear that he's planning on suing Dr. Biber into oblivion, but Biber isn't so easily rattled. Suddenly changing the subject, he deduces from the shirt Kyle's father is wearing that the man really likes dolphins, and offers to make him into one. Though initially dismissing this offer as crazy, Kyle's father does actually have a secret long-held desire to be a dolphin, and ends up letting Biber persuade him that "There's nothing crazy about a person wanting to look on the outside the way they feel on the inside."
Elsewhere, "Ms." Garrison interrupts a Girls Gone Wild shoot in a nightclub to show off her breasts, much to the disgust of just about everyone present. Subsequently bellying up to the bar among some of the women there, she then starts gossiping about Mr. Slave walking out on her and wondering why she hasn't gotten her period yet. When one of the women there mentions that when a woman misses her period, that's usually because she's pregnant, Garrison starts speculating that one of the truckers she's been banging (off-screen) must have knocked her up and ecstatically announces that now she can have an abortion!
Later that night, Kyle's father arrives home from his "dolphinoplasty" riding in on a wheeled walker. Kyle's mother is horrified, but his father insists that he's the happiest he's ever been, praising Dr. Biber as a miracle-worker. He explains that since Biber has helped him feel better about himself as a "trans-species" individual, he sees now that she and he were wrong to deny their "transracial" son surgery that will likewise make him feel better about himself, and is determined to get him the race change operation he wants.
Several days later, Kyle's friends are all astounded to meet the new tall, black Kyle; and even more astounded to see his father has been made up into a dolphin. Stan has no idea what to make of any of these events. Eric is not doing any better at making any sense of them either, though he finally settles on referring to Kyle's dolphinized Jewish father as a "Jewphin."
Down at the local Planned Parenthood, meanwhile, Ms. Garrison eagerly awaits her abortion. When called in for her appointment, she hops up on the operating seat and asks the perplexed abortionist whether he's going scramble the baby's brains or just vacuum it out. When he tells her she can't have an abortion, Garrison gets angry and starts going on a pro-abortion tirade about choice and a woman's body until the abortionist explains that he was speaking literally: Garrison can't have an abortion because she can't actually get pregnant; and she can't have periods either because she doesn't have ovaries or a womb or eggs to be fertilized, just a (fake) vagina.
Following the timid abortionist's premises to their logical end, Garrison comes to the rather discomforting conclusion that "she" is actually "just a guy with a mutilated penis." The abortionist has little choice but to agree with this conclusion. Feeling he's been had, Mr. Garrison leaves in high dudgeon and goes back to the Trinidad Medical Center to demand that his manly parts be restored.
Bursting in on Dr. Biber in the middle of a female-to-male sex change operation, Mr. Garrison starts raging at the good doctor for turning him into a "freak" instead of a real woman, and demands his genitals back. Unfortunately, Biber explains, that's much more easily said than done: he implanted Garrison's testicles in the knees of a certain boy he was giving a race change operation as part of extending his legs, and used the skin from his scrotum to make a dolphin fin for a certain man he was giving a species change operation. Furious, and well aware of who each of these patients were, Mr. Garrison drags Biber out with him to go retrieve the recycled parts.
Meanwhile, Kyle arrives at the first All Star Basketball playoff and easily convinces the presiding coach that he's now tall and black enough to play. On his way to suiting up, he yells this news up to his father, who's happy to hear about this. Then his father goes searching in vain for special seating for dolphins.
Elsewhere, meanwhile, the other boys are building a snowman when Garrison and Biber pull up in a car looking for Kyle. When Stan informs them that Kyle has gone to the stadium to play basketball, Dr. Biber is horrified: the race change surgery he gave Kyle doesn't actually give him the ability to play like a tall black basketball player, just to look like one. Should he attempt to make a high leap during the game, the testicles implanted in Kyle's knees are likely to explode on impact when he lands. The boys quickly join Garrison and the doctor in their car as they rush off to save Kyle.
At the game, meanwhile, Kyle's father is once again vainly looking around for a specialized bathroom for dolphins. A staffer he meets says that the stadium doesn't have any such bathrooms, whereupon Kyle's father flies into a rage. Telling them that he's a lawyer, he demands that the stadium staff make special arrangements to accomodate him. All the perplexed staffer can think to say is to ask him "You're a lawphin?"
At the entrance to the stadium, Mr. Garrison gets into an argument with the security staff at the door since neither he nor anyone in his party has any tickets for the game. Spotting Kyle's father, he punches his way through the gatekeepers to get to his scrotum (and Kyle's father), leaving them to raise the alarm over the breach in their perimeter security. As Garrison frantically explains the situation to Kyle's father and asks where his son is, a bunch of security guards arrive to take down the intruders.
When the men and boys flee from them, the guards draw their pistols and start firing, though none of them actually manage to hit anyone. The boys burst into the stands just as the announcer informs them that Kyle is being called onto the field. While Dr. Biber and Kyle's father desperately beat back the guards, Mr. Garrison tackles one of the players at random when he can't determine which one of them is Kyle, and Kyle's father flips over to tackle several more of them.
Unfortunately for everyone involved, all they've done is clear the court for Kyle, who goes for a slam dunk. His friends all cry out to him to stop, but he doesn't hear them. As the boys and men alike watch in helpless horror, Kyle seemingly flawlessly executes the slam dunk, only to have his knees explode the moment he lands; several players on the court and spectators in the stands are spattered with the blood and other tissues.
Soon afterward, as the paramedics carry Kyle out to their ambulance in front of a great many traumatized spectators, a police officer carefully reads back the whole long and incredibly absurd statement he took from Kyle's friends explaining what happened. Dr. Biber, for his part, apologizes to Kyle and his father for neglecting to tell them their surgery was purely cosmetic and wouldn't actually transform them into another race or species; and then he explains that he'll make amends by undoing the changes for merely a nominal fee. This leaves only one loose end to tie up: Mr. Garrison can't get his manly parts back.
Incredibly, after reflecting philosophically on his situation for a while, Mr. Garrison decides his situation isn't so bad after all. Even though he now knows he's not really a woman, he rather likes his new configuration. Loudly announcing to every male in range that he's decided to stay girly and keep his feminine parts, he cheerfully invites any of them who'll have him to gangbang him.
"Mr. Garrison's Fancy New Vagina" contains the following tropes:
- Acceptable Targets: You could say the episode makes fun of the people who undergo major transformative surgery like sex-change or species-change operations.
- Aluminum Christmas Trees: In the style of Older Than They Think. While calling the surgeries "species-change operations" is a relatively new feature, people who've wanted surgeries to change themselves into animals have been around since long before this episode first aired. The wealthy Jocelyn Wildenstein, for one, underwent a number of surgeries in an effort to make herself into a Real Life Cat Girl.
- An Aesop: Like all other cosmetic surgery, sex-change surgery can change how you look to match how you feel, but it can't change what you are. Your best bet is probably to come to terms with your body the way it is.
- Art Shift: Clips of an actual sex-change operation are intercut with the animated Mr. Garrison having his/hers.
- Black Is Bigger in Bed: One of the enhancements Dr. Biber mentions while explaining how "negroplasty" works involves enlarging Kyle's penis.
- Body Horror:
- Played Straight with both Kyle and Gerald's transracial and trans-species appearances with clear stitches and bruises in both them. And Sheila was horrific stock with the new appearance of two.
- Subverted with Garrison's trans woman appearance with no physical deformities and such.
- Comically Small Demand: The cops will shoot any trespassers into the basketball game who don't pay the $2 entry fee.
- Dead Baby Comedy: Garrison's extremely pro-abortion antics at Planned Parenthood. Not pro-choice but pro-abortion: he doesn't do any of the usual "I abhor abortion, but..." verbal gymnastics. He's genuinely enthusiastic about finally getting his chance to get knocked up so he can shred and queef out the unborn baby just like a woman.
- Didn't Think This Through: Mr./Mrs. Garrison should have realized that since Mr. Slave is a homosexual man, he probably wouldn't be attracted to Garrison's new configuration. As for Kyle's "Negroplasty", he should have realized that that the surgery was cosmetic only, something that Dr. Biber states word for word at the end of the episode, and that the changes to his body wouldn't actually let him be better at playing basketball, but would actually hurt himself while doing so.
- Disproportionate Retribution: The stadium guards shoot live ammunition at Garrison and company for not paying the two dollar entry fee.
- Easy Sex Change: While the time between Garrison's surgery and showing off "her" new configuration isn't specified, it can't have been very long, considering Mr. Slave's surprise and dismay that night when "she" gets home.
- Getting Crap Past the Radar: Yes, this is South Park, but one must wonder how Comedy Central got away with showing footage of an actual sex change, at least back in 2005, back when words like "shit" were still usually censored on the show.
- I Can Live With That: Pretty much Mr. Garrison's conclusion at the end.
- Imperial Stormtrooper Marksmanship Academy: As mentioned, the stadium guards' aim sucks. (No, they weren't deliberately pointing their guns away from any of their targets.)
- Incompatible Orientation: "Mrs." Garrison and Mr. Slave, since Mr. Slave doesn't like vaginas.
- Innocently Insensitive: While stated in a thoroughly needlessly offensive way, the basketbal coach is right to point out that Kyle is not a match against the other players. After all, Kyle wasn't exactly up to par compared to the other players.
- It Is Pronounced "Tro-PAY": Dr. Biber pronounces the "negro" in "negroplasty" "Nay-gro" the way Spanish speakers do. Kyle pronounces it "Nee-gro" the American way, which can raise a few eyebrows if you use that term around some black people.
- Let Me Get This Straight...: The officer taking the boys' statement at the end. To put it mildly, just about everything in their statement only Makes Sense In Context.
- Magic Plastic Surgery: Like Garrison's sex change, though the times aren't specified, it doesn't seem to have taken very long for Kyle or his father to recover enough from their surgeries to start showing off their new configurations. Also, come the next episode, they don't even have any scars from Dr. Biber's evidently making good on his promise to reverse their surgeries at the end of this episode.
- No Challenge Equals No Satisfaction: Certainly Eric Cartman's opinion when his taunting fails to stir up any disagreement from Kyle.
- N-Word Privileges: Garrison uses the word "fag" three times in this episode (none of them in a Having a Gay Old Time way), which he can get away with doing because he's a homosexual himself... at least from a certain perspective.
- Portmanteau: The "Jewphin" and "Lawphin" lines.
- Reasonable Authority Figure: Dr. Biber never exactly volunteers any information that might dissuade his customers, but he's quite possibly the world's least aggressive salesman ever. He certainly doesn't have to twist anyone's arm to sell his services in this episode.
- Status Quo Is God: For almost everyone; subverted by Mr. Garrison, however.
- Trans Equals Gay: Garrison's opinion, which doesn't really stand up to scrutiny very well, in view of Mr. Slave's reaction.
- Trans Nature: Black basketball player for Kyle, and dolphin for his father Gerald.
- Unusually Uninteresting Sight: Apparently, no one thinks it odd that every single one of the top basketball players from all the elementary schools in Colorado (except for Kyle) is a tall black kid. Only Kyle gets a second glance from the coach for being short and Jewish.
- Victory Is Boring: Having a Jew agree with his anti-Semitic claim that Jews can't play basketball really leaves Eric Cartman at a loss for anything more to say.