Theresa Gaffney

ALT An excerpt from the story: “'In the case of an emerging field like this, where there weren’t a lot of road maps on how to do things and there was so much room for improvement, you have somehow to have a lot of creativity,' she recalled. Trinidad was a small 'Santa Fe Trail' type of town, Bowers said, where she and Biber were the only surgeons of any kind for miles. The people stepping off the Greyhound bus were almost always alone, Bowers remembers. They were usually older, retired, single or divorced, and had lived much of their lives in the closet. After finally coming out as trans, they were often estranged from their families. Insurance wouldn’t cover the procedure, so they always paid in cash. Afterward, they left town without knowing whether any other doctor might understand the procedure enough to be able to address potential future complications. They prepared for the long recovery alone."

ALT A 19-year-old patient wearing ripped jeans and loosely tied work boots sits in a chair in the doctor's office. One foot is propped up resting on his knee. He has a spiral notebook and mechanical pencil in his lap.