Ever thought about a gender reassignment where you substitued male for female characteristics or the opposite?
I haven't for myself, but I know people who have been in that situation.  I'm all for it.
Did your friend do hormone therapy?
He did, yeah.  Still going through it.  He was born a biological female, and for the longest time thought he was just a lesbian.  But something wasn't quite right still.  Admirable person.
Has there been surgery to modify some characteristics?
Not yet.  Not sure what he's considering, and it's kind of private, so I haven't asked.  What do you know about the subject?
I know that it can be a result of intersex at birth.