Sex change is widespread among tropical marine fishes, many of which are targeted by fisheries. Conservation concerns have been raised that sex-changing species may be particularly prone to overexploitation by size-selective fishing. In the case of male-first sex-changers, populations may become egg limited if large females are disproportionately killed. However, if males reduce the size at which they change sex in response to higher female mortality, the population may still be sufficiently productive. We develop an age-based model to explore the effects of fishing on two types of male-first sex-changing fish: one with flexibility in size-at-sex-change and one without. These effects were compared with those of non-sex-changing populations with similar life-history and population characteristics. The model predicts that if male-first sex-changers cannot respond to elevated female mortality by adjusting their size-at-sex-change, the population will be more prone to recruitment limitation and extinction than non-sex-changers. These effects will be amplified as smaller individuals become susceptible to fishing mortality. However, if size-at-sex-change is flexible, sex-changers may be as resilient to fishing as non-sex-changers. Knowledge of a species' size-at-sex-change, and the mechanisms controlling it, should be fundamental to the selection of fisheries conservation strategies.