Lügenmetzger's true metier was the murder case. He could often solve murders before they occurred.
In the world of speculative fiction, gender reassignment surgery can occur with an ease that is not possible in our own world. Through the trope of perfected technology, SF is able to raise questions about the malleability of gender identity given a perfectly malleable body.
"Objects in mirror may be closer than they appear." / They could also be further away. . . .
"You're the only man who can do it, Paul. The only one who can set right what, surely, was never meant to happen. You'll be healing an open wound in the history of our species."