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.