Not recently (um, 19 years?), but it probably hasn't changed much. There was a DMV form I had to get signed by my therapist, and then they took a new picture and reissued my license. (Which, of course, this being California, got lost in the mail so they had to do it again.)

That was enough to get my Social Security card changed, along with my bank account, credit card, and so on.

Two gotchas, however. First, to get my New York state birth certificate changed, I actually had to go to court and do that whole name change dance, well after surgery and all. There were some confused spectators. Second, the Social Security people didn't fix my gender, so for my most recent job, I got a confused call from HR and had to go down and show them a bunch of paperwork to get things sorted. I don't know whether that was a mistake (deliberate or genuine) on the part of the people I originally spoke to, or just a thing they don't do to trip you up later on.

(In fact, I'm now wondering whether that was a factor in my previous job's end... Hmm.)