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Good question. They can't entirely, but surgeons and stem cell researchers think they're getting close.

Transsexual genitals are mostly superficial for now- you can't ever change sex and actually reproduce unless you stop transition.

Actually, what doctors do now is prescribe hormones and perform surgery. In the male-to-female (MtF) patient, estrogen causes breast growth - enough to where most patients don't need implant surgery. Then surgeons will remove their testes and invert the penis and scrotum to form the vagina and related structures.

In the FtM patient, testosterone causes body hair, deepening of the voice, increased upper body strength, mood changes, and may increase the size of the clitoris some. Menstruation stops. Then they will have their breasts and internal female organs removed. Some may eventually attempt to have a penis constructed, though that is generally an unsatisfactory series of surgeries. Some may opt for a simpler cosmetic fix where the labia is closed with fake testes added inside, and the suspensory ligaments to the clitoris are cut to make it protrude. So if the clitoris enlarged from hormones, it might look like a small penis.

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