Adam and John discussed trans gendering surgery needing to include two spirit, etc. Remember there are dozens of genders so we really need to include those. And gender is fluid so perhaps we need swappable parts as necessary. And what about those 'like me' who might identify as a different species. Personally I might want to identify as a donkey. (I have often been mis-identified as a jackass.)
Discussion
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If you identify as a horse, do you get a mane implant?