I was born and currently live in Texas. I don't currently feel like I need surgery, cannot imagine being able to afford it, and would only want to have any kind of medical procedure if it was medical necessary. Texas requires surgery for a birth certificate change. Is there any way out of this, such as getting an out of state court order? Or am I screwed until Texas changes this barbaric rule, or it's determined that I actually need surgery, and that i acquire the means to undergo it? If I can't get my birth certificate changed, am I therefore unable to change my DL? The info on this site says that Texas requries a BC or court order for the DL change. Do I need surgery for that court order, too? You'd think that as as culture that prides small government and wants the government out of peoples lives, they'd be all for removing unnecessary burdensome restrictions on stuff like that.
You should see if there's an LGBT advocacy group in your current state, and ask them about it. If you're low-income, I'd also suggest looking into a pro bono program to see if you'd qualify for counsel just in case it gets complicated.
You may want to see this thread, apparently even with a court order it can be hard: https://www.susans.org/forums/index.php?topic=141497.0
edit: I misread your initial post, and thought you currently lived out of state. Generally, under the Doctrine of something or another (I forget the name) courts from one jurisdiction need to respect judgments/order from other jurisdictions, so you may possibly be successful getting a change with a judgment from another place, though TX may still want their surgery-only laws followed.
However, since you live and reside in TX, you wouldn't have standing to file a suit in another state. You'd have to move and meet their residency requirement, or somehow get it waived.
I live in Texas currently and apparently much of gaining the court order to change your DL (I don't have my changed birth cert back from my birth state yet) depends mostly on which judge you see. My advice is to higher a transfer friendly lawyer to use them for their connections to the judges. Lawyers know which judges to see to get a court order signed. I did have surgery however (only top). I'd say look for a local support group in your county and ask around.
All my documents are changed btw, far more easily than I imagined frankly after hearing all the stories about Texas. Maybe it was easier since I wasn't born here?