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.