But they see themselves as women who are interested in men. They are not men interested in other men. After their surgery, they can have a perfectly normal relationship with a man.

Some people decide never to have surgery to save a marriage or a career. They try to live with it in subtle ways: Wearing women's underwear, using clear nail polish or colorless lip gloss.

You can tell a difference in them from the very first month. Once they have been given permission to be a woman, the depression lifts.