When you fill out a demographic form, there are generally two little boxes to check—male or female.

What if your birth certificate indicates that you are one, but everything in your heart, body and mind screams that you are the other?

Further, what if society tells you that wanting to claim your true identity makes you, at best, odd and, at worst, a misfit who can’t seem to find your rightful place in the world and are in danger of harassment, discrimination or violence?

Such is the case of Nicole Bray who at birth was designated male and bestowed with a boy’s name. At the age of four, “he” knew that there was indeed a disconnect between the image in the mirror and that which “she” held in her soul.

Throughout childhood and into adolescence, confusion deepened and by the time adulthood was reached, Nicole knew that cognitive dissonance was no longer an option, since while attempting to hide her true identity, she was risking her life. Suicidal thoughts came to call more often.

Nicole explains:

“It is worth noting that 41% of transgender people attempt suicide. I must admit that I fit into the 41% and actually have attempted suicide multiple times throughout my life and have thought about suicide more times than I can count.”

Fast forward and Nicole (still physiologically male) marries her sweetheart Lori. Throughout their marriage, they lived for all intents and purposes as a heterosexual couple.

When Nicole informed Lori of her Gender Dysphoria, she remained her most ardent advocate and to this day, unlike 80% of partners of transgender people who end up splitting, they are committed to staying together. Not only is the support coming from Lori and her family, but Nicole’s family as well.

I met Nicole recently and must admit, she is more fastidious about her appearance than I am. Had I not known she was in process, I would never have suspected that she was not born female. We laughed over lunch as she explained that she needed to learn how to speak, cough and sneeze like a woman would.

She reports, “Up until now, I have undergone seven rounds of full facial electrolysis, 1 ½ years of Hormone Replacement Therapy, four months of voice therapy, Facial Feminization Surgery (hairline advancement, eyebrow lift, forehead/orbital rim contouring, rhinoplasty, cheek implants, chin implant, and a tracheal shave), and three rounds of genital electrolysis.

Facial Feminization Surgery is necessary for many male-to-female transgender individuals as it allows them to more easily fit into female culture. There are structural bone differences in the faces of males and females. People notice these differences and assign a gender to a person because of the structure. Therefore, male-to-female individuals with masculine bone structures often require Facial Feminization Surgery to make it easier to blend into society.

All of these procedures have taken place in addition to two years of counseling, legal name and gender marker change, coming out to family, friends, healthcare professionals and colleagues, not to mention acquiring an entirely new wardrobe including items that most women accumulate over a lifetime and I needed to accumulate these items over the course of two years. Two years is about the fastest one can transition according to the standards of care set forth by the World Professional Association for Transgender Health. My Gender Dysphoria is significantly severe pushing me to take the ‘fast track’ to transition.”

Depression remains a frequent companion.

“I wish I could say that I have more good days than bad days. Unfortunately, every day is a struggle for me to find a reason to live. I am immensely grateful for the love, support and acceptance I have from family and friends and that I’ve come this far with my transition. But there are a number of roadblocks preventing me from becoming my authentic self.

The first roadblock is the refusal of most insurance companies to pay for any transition-related costs. Up to this point, my wife and I paid out $60,000 for medically necessary procedures and surgeries and insurance has paid about $500. Our insurance company deems these surgeries as ‘elective and cosmetic’ despite the American Medical Association, American Psychological Association, American Psychiatric Association, and the World Professional Association for Transgender Health’s statements that it is ‘medically necessary’ for Transgender people to have these surgeries.

In fact, these professional organizations have found that being Transgender is a biological, medical condition that is present even before birth. Nevertheless, the insurance company refused coverage of the medically necessary procedures, and, as a result, the majority of the expenses were paid for in cash. Few people have that kind of money lying around and we are no different. In fact, we have exhausted any and all funds we ever had in order to get this far through transition.

The second roadblock is that there is still a negative stigma about transgender people. Much of society regards transgender people as being ‘mentally ill’ or ‘crazy.’ Therefore, the commonly-held belief is that these surgeries are ‘wanted’ instead of ‘needed.’ As a result, the general public often has difficulty backing a surgery they believe to be a choice.”

“The third roadblock is the expense of these procedures and surgeries. On average, a full transition from male-to-female costs approximately $100,000. We’ve managed to pay for more than half and launched a crowdfunding campaign on www.indiegogo.com to raise money for the final surgery.”

Enter Untitled Documentary-Nicole’s Story, which will have a more definitive title further in the production process.

“The documentary that I am hoping to develop will address all of these issues as they are common roadblocks for most transgender people. These are just some of the reasons why the suicidal thought rate (80%) and suicide attempt rate (41%) is so high for transgender people compared with the general population (1.6% for attempts). These factors need to be addressed and resolved and I believe that my documentary will bring more attention and awareness to these issues.

I am proud to be transgender. At the same time, I would never wish being Transgender on anyone and I do wish that I was born with a match between my brain and body. Since that is not the case, I embrace being transgender and I desire to help others achieve the same mindset. I hope to be a role model and an advocate within the transgender community through development of my documentary and through giving presentations across the country.

The back and forth travel is simply exhausting. Unfortunately, there is a paucity of providers available for the necessary procedures and surgeries. This means that the majority of transgender people have to travel extensively in order to take the steps through transition. For example, I will travel from my home state of Michigan to Chicago, Illinois every 10-12 weeks for approximately two years, will travel to New Hope, Pennsylvania every four weeks for half a year, and already traveled to Boston, Massachusetts for a consultation and surgery. This is just a small portion of the traveling I have done over the past 1 ½ years. You can only imagine the expense associated with these travels. Keep in mind that travel costs are not included in the estimated expense of transition from male-to-female.

“The physical pain associated with the procedures and surgeries is beyond words. That’s why it amazes me when some people say, ‘Why would someone choose to be transgender?’ Nobody would choose to be transgender or to undergo these procedures and surgeries if they didn’t have to. For at least half of the procedures, you are awake and can feel everything that is going on. For all of the surgeries, there is a significant recovery time and period of aftercare. Transition is quite the ordeal!”

I applaud the courage it takes for Nicole and Lori to move through it as they maintain a private life in the midst of what will become a very public experience once the film is released.

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Editor: Travis May

Photo Credit: Provided by author