I did a quick search and could not determine which ten states affirm that hormones and surgery do not really change one’s gender.
Does anybody know which states the author is referring to? (So maybe we can go live somewhere saner?)
Do not fall for the semantic tricks "they" play on us.
"Gender" is a social/psychological construct. You can change your "gender" faster than you can change your socks.
"Sex", OTOH, is biological and inherent. No matter how hard you try, you cannot change your sex.
If everyone simply insisted on using the correct words, much of the incredible "confusion" that this topic produces would be eliminated. "They" use "sex" and "gender" interchangeably, in order to make rational discussion impossible. Don't fall for "their" tricks.