I tried finding out on Google, but I failed. Tried "sexual reassignment surgery," "sexual reassignment surgery and youth," and "transgender youth" and get information overload. I haven't been able to locate the answer to the specific question.
Thanks in advance!
Edit: Can't really help on the setting. It takes place in an unspecified near future in an unspecified (and probably fictional) city. And I think it was taking place in Iowa, but I am not sure, and I might change it to Oregon.