I am planning to accompany a friend on an overseas trip, where my friend will be undertaking several medical procedures to finish transitioning gender. These procedures include the actual gender reassignment surgery, and some plastic surgery.
His passport currently says his name is "John" and he is male. After the procedure, my friend's name will legally still be 'John', but her gender will be female, and her physical appear will also change. (Here I am using the word "gender" to refer to external genitalia, body shape, etc.)
Should we apply for an emergency travel document in order to return home, after the procedures are completed, given the discrepancy in appearance and gender with the official passport? Or will it still be possible to return on the original passport, post-operation, if my friend carries extensive documentation about the procedures performed?
(Both of us will be travelling on US passports.)