I am afraid, this is still an open question. It appears, lawmakers in many Western countries have not really addressed this issue.
Most people and commons sense most likely agree that when an adult personally declares one day to be of the other sex/gender is not enough. Further, there is probably also a broad agreement that some adults have a substantial urge or need or seriously prefer to live of the other gender as best as possible.
So what could be the legal criteria to make a transgender adult legitimate?
How about double mastectomy + penis or castration as a minimum? Seems extreme or too narrowly focused on physical appearance? Any better suggestions?
Just some food for thought.
P.S. Juveniles and transgender is a another subject.
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