What is the ruling on resorting to gender reassignment surgery, knowing that the reason for it is not desire, but rather a gender identity disorder since childhood, which has led to inner femininity and feminine physical manifestations, and the impossibility of living as a male? Is this permissible out of necessity?

Sex reassignment is not permissible in normal circumstances. However, if medical examinations reveal that a person's reproductive system is female, while outwardly appearing male, then there is no objection to performing the reassignment surgery. A medical examination must be conducted first, and then action should be taken based on what is confirmed.