When being

For transgender people, daily hormone injections can be a matter of life and death. But many medical aids still see gender-affirming treatment as a choice rather than a necessity

It’s 4am and Cammi Morris, 47, is stretched out on a floral Chinese rug. She prefers this to a yoga mat when she does yoga or Pilates because it gives her a better grip. But this morning she’s not practising famous yoga poses such as the downward facing dog or folding her legs into the lotus position.

She’s stretching her vagina. Morris, who asked for her real surname not to be used, is a transwoman and one of many who has had gender-affirming surgery to align the way she looks with who she really is.

These kinds of surgeries can include removing breasts, testicles or penises. Some people also have follow-up reconstructive plastic surgery procedures such as breast implants or creating a vagina from a patient’s penis.

Morris had her vagina constructed in August 2017. To maintain her vagina’s elasticity, she must use a penis-shaped stent to stretch it periodically.

But the journey in Morris’ quest to be her true self doesn’t end there.

For some transgender people, including Morris, hormone replacement therapy (HRT) is a crucial part of finally feeling like themselves. As part of this, people take either the hormone oestrogen or testosterone along with other drugs to help them attain the physical characteristics that society normally ascribes to the gender they identify with.

Oestrogen, for example, helps transgender women to develop breasts, Maddie Deutsch explains on the University of California at San Francisco’s website. Deutsch is the director of clinical services at the university’s Centre of Excellence for Transgender Health.

People on the hormone will also notice fat redistributing around their hips and thighs and their faces take on “a more female appearance” as fatty tissue changes there too, she says.

Transgender men, on the other hand, can take testosterone to achieve the opposite effect: fat begins to move towards the gut, the arms become more muscular and the face becomes more angular.

Because transgender men’s bodies won’t ever produce testosterone naturally — and vice versa for transgender women — HRT is a lifelong treatment.

After her morning exercise session, Morris usually takes out her favourite mug and makes herself black coffee with a sweetener. She says she’s trying to cut down her sugar intake. After coffee follows breakfast — almost always a Granny Smith apple. But before she takes a bite, she pops two tablets into her mouth — one blue, one white.