He started puberty blockers when he was 9. Just like Jazz Jennings. This means his penis stopped developing when he was 9. The normal procedure for alignment surgery can't take place. There isn't enough penile tissue to form a vagina. The solution for these type of surgeries is a bowel resection. To form the vaginal canal out of a piece of lower bowel. The healthy bacteria in a bowel is very much different than in a vagina. Jennings has had numerous infections and several surgeries. There is a strong odor of bowel. He will never achieve orgasm. Due to the early age of hormones, he reports no sexual attraction to either men or women. Not that the surgeries have improved the mental instability that caused Jennings to conclude he was a girl. Now an adult, Jazz Jennings doesn't feel like a woman or a man. He has gained well over 100 pounds putting the surgical sites at risk. He lives a life of depression, disappointment and unhappiness.
Knowing what I know, I would never allow a child to transition so early. Certainly no hormones or hormone blockers.
Eva looks like a boy in a dress. He is big, hulking, and a very masculine face. His parents did him no favors by feeding his delusion.