Emeri Burks is a 20-year-old university student. If she does not have genital reassignment surgery before she graduates, it will not be covered by her mother's health insurer. However, because of a risk factor, the surgery must be postponed. Donna Richards is a 52-year-old trans woman who is preparing for genital reassignment surgery. With her is Dave, her partner of five years. She came out at work in 2002, and began to transition soon after.

Bree Miller, age 40, was born in a small town in Tennessee. She has tried to begin transition more than once, but stopped because of the hostility she encountered. She started hormone replacement therapy (HRT) in 2006, and is now preparing for genital reassignment surgery. Her therapist (Saroj Chand, LPC-MHSP) arrives separately to observe the surgery in a professional capacity. Charlie Snook is a trans man who started HRT about five years ago, at age 46. He is in Trinidad for a vaginectomy, metoidioplasty, and testicular implants. He is accompanied by a friend who is eager to meet Dr. Bowers.

45-year-old Lisa Scott started transition one year ago, and has had little support. She is about to have genital reassignment surgery and breast augmentation. Jackie Feakins, age 53, postponed transition until after her children graduated high school and she retired from her job as an air traffic controller. She has come to the hospital for male-to-female genital reassignment; two of her sons are with her.

After Malinda Chadwick (54) started living as a woman, her wife of 28 years left, and their son cut Malinda out. Malinda was heartbroken. Gena, an online friend, gave her support, and their friendship developed into a relationship. They work together as bounty hunters. After surgery, bounty hunting seems too aggressive for Malinda, and the couple turns their attention to gold mining. Alaina Hardy is a 35-year-old patient who is about to have genital reassignment surgery. She comes to Trinidad with her partner and her best friend Krista.

Stephanie Battaglino (age 47) works as a marketing director. She has come to Dr. Bowers for genital reassignment surgery. With Stephanie is her best friend, Diana (74), whose presence is essential to her. They keep Stephanie's sister and son up-to-date on her progress. Ryan Brown is a 40-year-old trans man from South Dakota. Last year he came to Mt. San Rafael for an hysterectomy, metoidioplasty, and testicular implants. One of the implants is causing him pain, and Dr. Bowers decides to replace it. For him and his wife, Kim, the surgeries are extremely important, but the expense is so great it has bankrupted them.

Vicki Estrada is a 54-year-old trans woman who has come to Mt. San Rafael for genital reassignment surgery. She is accompanied by her girlfriend Cristina and father Steven, both of whom are very supportive. Cristina describes how Vicki's transition has prompted her own introspection, and says that she has become a better person for it. Jim Howley is a 33-year-old trans man from Hilliard, Ohio. After years of unhappiness, substance abuse, and suicide attempts, Jim has the full of support of his parents, who are relieved that Jim has a path toward wellness. He is at Mt. San Rafael for a hysterectomy.