is under the impression that he is a "woman trapped in a man's body" and decides to have a sex change, which is performed by Dr. Biber of the TrinidadMedical Center. He is later introduced as "Mrs. Garrison" at a supermarket. Meanwhile, Kyle is trying out for the all-state basketball team. However, Kyle's performance against his African American competitors is unimpressive, and the coach and Cartman tell him that "Jews can't play basketball". This depresses Kyle, and when he, Stan, Cartman and Kenny are walking home, Mrs. Garrison tells the boys of her surgery. Kyle asks his parents what a sex change is, and as she explains the term, his mother, Sheila Broflovski, insists on the legitimacy of cosmetic surgery as an important aid for people whose physical appearance contrasts with their self-image. However, in applauding Mr. Garrison's courage, she inadvertently implies that Kyle's own problems can be solved in a similar manner. Stan accompanies Kyle to Trinidad to see about the situation, and Dr. Biber suggests that Kyle should undergo a "negroplasty" to make him African-American. When Kyle returns home, his parents are outraged by the suggestion. His dad, Gerald Broflovski, travels to the Institute in order to confront Dr. Biber. However, Dr. Biber, spotting Gerald's dolphin shirt, appeals to his affinity for dolphins and convinces him to undergo "dolphinoplasty", surgically altering his appearance to resemble that of a dolphin. At Mrs. Garrison's home, she comes home and asks Mr. Slave to take her to bed, but Mr. Slave refuses, upset that he was never asked his feelings regarding the operation. He exclaims, "But I'm gay! I don't like vaginas!" when Mrs. Garrison tries to reason by explaining that she's the same person, only with a vagina instead of a penis. As he has now been persuaded to endorse cosmetic surgery, Gerald Broflovski allows his son to undergo the negroplasty. Meanwhile, Mrs. Garrison is puzzled by the absence of her period. Believing she is pregnant, she cheerfully decides to have an abortion. However, since she does not have ovaries and a uterus, she cannot menstruate, become pregnant, nor have an abortion. She requests Dr. Biber to change her sex back, but learns that the operation is irreversible, as her former testicles have been transplanted into Kyle's knees to make him taller, and her former scrotum had been fashioned into Mr. Broflovski's dorsal fin. At the all-state basketball game, Mrs. Garrison, Dr. Biber, Mr. Broflovski, and the other three boys are trying to stop Kyle from playing basketball, as any jumping could cause Mr. Garrison's testicles to explode. Unfortunately, in a dramatic climax, Kyle leaps into the air, causing his new "kneecaps" to explode as he lands. Faced with the loss of her testicles, Mrs. Garrison decides to accept her new gender. Dr. Biber then apologizes to Kyle and Gerald, saying he should have told them that the surgeries were cosmetic; he then decided to reverse the surgeries he performed on Kyle and his father for a nominal fee, in which they accept, as they are shown returned to normal in later episodes.
Production
According to the DVD commentary for "Mr. Garrison's Fancy New Vagina", Trey Parker and Matt Stone came into the season with "basically no ideas". "Mr. Garrison's Fancy New Vagina" and "Die Hippie, Die" were the first two episodes that were brainstormed just prior to the start of the production season. Parker said that they originally had an idea for an episode about hippies and an episode where Garrison undergoes a sex change but just "basically winged" the rest of the season's episodes. Parker stated that several days before this episode's air date, he was so stressed that he nearly "pulled a Dave Chappelle" and gave up. The scene in which Garrison undergoes his sex change originally featured over five minutes of real sex change footage because of the lack of ideas. Eventually, the sex change footage was trimmed to three brief one second shots after Comedy Central disapproved and after the idea of Gerald Broflovski's dolphin operation was brought up. The idea for Kyle wanting to play basketball came from Parker's desire to play for the Denver Broncos.
