Thomas was thirty-two years old when he finally decided to come out. The momentous day was the 21th of January 2017. Until this point he had only told two other people of his feelings, his partner of six years did not know. Although he had spoken, jokingly, on numerous occasions about what would it be like to have a sex change operation. It took Thomas two years to pluck up the courage to finally come out. Retrospectively, Thomas recalled that he had felt since early childhood that things were not right, being in the wrong body. Finally, Thomas had the realisation that what he needed was clarity, that his mind and body were as one. It was hard to give up a loving relationship of six years with his partner, love and devotion did not survive. His parents were firstly shocked by his revelation, his mother was distressed on losing a son but both parents have supported his every wish. Thomas changed his name by deed poll to Gemima. Following research, mostly on American websites, he began to realise what a complicated process a gender change was. There are no clinics dealing with Gender Dysphoria in Wales, a referral to a clinic in the Hammersmith Hospital in London has been made. She is now six months away from that initial consultation. The waiting list has been for two years. During this period Gem has tried to change her body shape by exercise, impersonating female traits and making a conscious attempt to feminise her voice. Growing her hair, using makeup and wearing female clothing every day. She also follows a five-week cycle of hairdressing and waxing. Gem has a full-time job and wears female clothing to work. On a number of occasions, she has been on the receiving end of abuse and discrimination within the workplace and outside of work. This is only the start of the Gender Realignment process. She will have to live a female life for two years before hormone therapy. Hormone therapy will have a non-reversible impact on her body. Following hormone therapy, the final stage is Male to Female Sex Reassignment Surgery (SRS) and Vaginoplasty. Throughout my contact with Gem, I have come to respect her and I am totally in awe of how brave she and her family are. This is a lonely path and she should be admired for her decision, and commitment. She has now commissioned me to follow her throughout the whole process.