One of the world’s leading centres for sex assignment surgery is, in fact, in the Arab region. The Center for Gender Determination and Correction is a bustling department in the main university hospital in Jeddah, Saudi Arabia. When I visited in 2010, the place was packed. Demand for its services is high: the centre is handling around than 60 patients a year from across the Arab world, and has a three-year waiting list; the majority of its cases are crossing over from male to female. The Center’s director, Dr Yassir Jamal, has over 400 such surgeries under his belt. He’s proud of the centre’s niche reputation, but he has clear rules on eligibility; the centre will only change, or rather “correct”, those who are intersex—that is, possess some physical attribute of the other sex, such as ambiguous genitalia or chromosomes. “People of transsex—physically they are normal, but it’s here,” said Jamal, pointing to his head. “They feel they are the other sex. No, religiously it’s not allowed.” Although there are medical experts in Saudi Arabia who argue the contrary, the government has ruled out any other grounds for surgery.