Mr. Garrison is getting a vaginaplasty. He felt that he has been a woman trapped in a man's body and he feels that he will finally be happy when he gets the sex-change. Dr. Biber (the one doing the operation) thinks that if more people could see a sex-change operation, it would show how natural it is. After some real life footage of a sex-change, Mr. Garrison became Mrs. Garrison. Meanwhile at the Denver Convention Center, Kyle wants to try out for the All-State Basketball team. Stan wishes him good luck while Cartman thinks that he won't do well because he's Jewish. Kyle fails in comparison to the other children because all of them are tall and black. Kyle is devastated and Cartman tries to make fun of him. In town, everyone learns of Mr. Garrison's sex-change. Mrs. Garrison tries to act like a woman: She wants her first period; she pees sitting down; wants to know about tampons; and wants to go see a sad movie with other girls (however the other girls don't want to be with her).
The boys learn of Mr. Garrison's sex-change as well. Kyle asks his mother what that is. Gerald (Kyle's dad) wants to take Kyle & Ike out of that school. Sheila (Kyle's mom) says that he is acting very closed minded and she tells Kyle that some people's insides don't match their outsides so they change it. Kyle understands. He and Stan go to Dr. Biber and Kyle requests a negroplasty, to make him tall and black. At Mrs. Garrison's home, Mr. Slave is upset. He turns down sex because he is gay and does not like girls. Mr. Slave tells him that he did not think of others before the operation. Mrs. Garrison just tells him to act straight so Mr. Slave leaves her and Mrs. Garrison just calls him a 'fag'. Kyle asks his parents for $3000 for the negroplasty (Gerald is wearing a dolphin T-shirt). Kyle claims that all his life, he felt black but all his parents say in 'no". Gerald goes over to Dr. Biber's office to yell at him. When he gets there, Gerald tells him that he is a lawyer that is going to sue for malpractice and have the clinic shut down. Just then, Dr. Biber sees dolphins on Gerald's shirt and convinces him to have a dolphinoplasty. Mrs. Garrison goes in a Girls Gone Wild video. Later, she asks another woman why she did not have her period yet. She tells Mrs. Garrison that it usually means you are pregnant. Mrs. Garrison happily leaves for an abortion clinic. At his home, Gerald (who just had the operation to look like a dolphin) convinces Sheila to let Kyle have an operation too. After the negroplasty, all of Kyle's friends are amazed about how he changed. Now, Gerald is going to drive Kyle back to the all-star game to see if he can try out for the team again.
At the abortion clinic, Mrs. Garrison tells the doctors that she wants an abortion. The doctor tells him that he can't have an abortion because he is still physically incapable of getting pregnant. Mrs. Garrison learns that she just paid $5000 just for nothing. She rushes into Dr. Biber's clinic (while he's giving a peniplasty). He tells her that he can't change her back because he gave his balls to a boy wanting to be black (Kyle) and used his scrotum for a man wanting to be a dolphin (Gerald). Mrs. Garrison forces him to help search for those parts. They find Stan, Cartman, & Kenny and they tell him that Kyle is playing basketball. Biber tells them that when he plays the game, the balls in his knees will explode. The five of them rush to the game. At the game, Kyle is about to play. The group gets in without paying and recruits the help of Gerald to help. They are chased by the security but make it to the court. Unfortunately, the plan fails. Dr. Biber will change Gerald and Kyle back to normal for a nominal fee. As for Mrs. Garrison, she rather stay a woman who can't have periods than be a fag.