Documents such as birth certificates should be changed when an affidavit exists regarding surgical intervention. In the instant case, it does not appear that such correction has taken place, albeit for other medical reasons. I have serious qualms about alterations of the sex designator simply by the stroke of a judge's pen and was not in support of such actions even back in the days when I was pre-op (and when such changes were not the subject of such scrutiny).
However, this becomes yet another instance where Rule #10 precludes my discussion of the matter in greater detail...