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The public declaration in which the female becomes a man happens on one of three occasions: At her birth (if the family has no male heir and knows they never will), at the death of the family's only male (often at war), or at her refusal to marry the man her family wish her to accept as a husband.

For those experiencing discrimination or very high costs for sex change surgery, Thailand can be an attractive option.

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So, depending on the country, or regulations of its medical profession, an individual seeking a sex change may be required to have psychiatric or psychological assessment.

He or she may also be required to live for a period of time as a member of the opposite sex before being approved for surgery. and other countries do not recognize a person who has had sexual change surgery done in a foreign country as being the new sex.

The practice was born from traditional, northern Albanian law, the Kanun of Lek Dukagjin, which believed that women belonged to their fathers until marriage, and then became the property of their husbands.

Becoming a 'sworn virgin' did allow women to escape from unwanted arranged marriages.

Then a penis is created for her from either her vaginal tissue, or extra intestinal tissue in a procedure called penectomy.

Usually the patient receives hormone therapy for a period of time, both before the operation and afterward.One in 500,000 males and one in 2 million females have sought sex change surgery, according to a research paper, On the Calculation of the Prevalence of Transsexualism, by Femke Oyslager and Lynn Conway, presented to the World Professional Association for Transgender Health (WPATH) in Chicago.Other researchers estimate that this number is increasing by 14 percent every year.The pros: This is similar to laws in many Western countries. Consult the Thai embassy or consulate in your area, for a full understanding of all the legal requirements and implications.Legal advice for what is accepted in your jurisdiction is highly advised.My husband is working later than usual and I lay down in bed and close my eyes.