Yes Steve, this topic as well many others has not a unique aspects.
The aspects I can see are: Karmic assignment of sex, possibility to overrule karmic assignment and related problems; legitimacy to overrule karmic assignment if mentally miserable; legitimacy to provide for sex change when serious cases of mental instability are know to have ensued; legitimacy not to provide sex change when mental instability present because of refusal; compassion for those who are in such a difficult karmic plight; necessity of society to avoid doing more harm then good,..... surely more are present.
I see in this conversation some concepts above that relate to our previous conversation on ‘spheres of thought’ and that…
“Two spheres could even overlap, so as to share common elements with each other. This could be seen for example in Schopenhauer's philosophy, who takes over certain basic elements of his predecessor, Kant's philosophy. Conversely, we could unite two formerly antagonistic views in a higher synthetic sphere, by sublating (in Hegel's terms) both views in a higher synthesis.”