Alright, I know that it's very unlikely that he'll ever have it done, but 41% of transgendered Americans attempt suicide. Furthermore, Phil is already prone to suicidal ideations, and let's be frank, he has very few prospects in life unless he seriously turns himself around. So given all of this, I believe that the biggest threat to his life, after his poor hygiene and his tendency to spout off to complete strangers is actually getting his surgery.