Dr. Stuart Fischer, a top New York City physician who has not treated Caitlyn, described gender reassignment surgery as “extremely complex” and “challenging,” especially in male-to-female cases. “It’s still a relative rarity, possibly due to the extremely complex surgery and prolonged course of hormones, not to mention the cost,” Dr. Fischer told The ENQUIRER. “Turning the patient’s penis inside out to create an artificial vagina is a challenging task. Recuperating from
the extensive surgery is difficult enough, but dealing with the hormonal treatments has its own risks.”