The surgery hardly changed anything for Alexis, and fans and family were completely unsurprised. The film roles continued, and Alexis later said of her change that "'Gender is bullshit. Putting on a dress doesn't biologically change anything. Nor does a sex-change. Sex-reassignment is physically impossible. All you can do is adopt these superficial characteristics but the biology will never change."
This was later on, when her long-running battle with HIV was drawing to a terrible close. She had contracted it at the age of 18, although it wasn't a secret, her struggles were well hidden. At the age of 47, she had gone back to living as a man for three years and had given up the fight. On September 11, 2016, Alexis Arquette was placed in a medically induced coma and soon died of a heart attack. The world had lost a leading lady.