American prisons have the best healthcare system in the world. I would probably go ahead and get the operation, and after that, I would probably be placed with the women. However, my motive would be largely based on the fact that it's free, and I kind of want to get the operation, anyhow.
Then again, I'm not sure how I feel about the idea of women's housing...if they are in there for violent crimes, I have a feeling that I would not benefit very well from the switch. I know how to deal with guys. Most of the time, physical aggression is just how they make friends with you, and they really don't mean any harm. I've gotten worse injuries from handling grain-crazed thoroughbreds if I am honest, and that's when they were in a good mood: they'll bite you black-and-blue just to flirt. I honestly am not afraid of men, even violent ones. I'm not as sure about the psychology of cis-women, though, especially ones that have gone down a bad path. If I had had the operation, I would probably be expected to move into women's housing, but I am not entirely sure if I would actually be safer or happier.
On the other hand, I do not really have any knowledge regarding prison administration. I know what I can deal with, but how do you make those kinds of decisions for other people? I would want whoever has the authority to make administrative decisions at a prison to act with the best interests of the people that have to live there. Regardless of what those people have done, all of those people are somebody's sons and daughters. I would not want to keep the system going unless I would be able to sleep with my own kid living in there. If that's not how the prison administrator thinks, then shut the whole system down, and let them all go. I would never want to have to make those kinds of decisions. They are hard decisions to make, and each way you roll, you are gambling with people's lives.
Therefore, I am not sure how to answer that question, and I would not want to be in charge of it.