The drive back to Luke’s apartment was awkwardly quiet, Luke driving, Tom staring at his big hands wrapped around the steering wheel, trying desperately not to think about what Luke thought of him. Every once in a while Luke would make a passing remark or ask a question, but he kept his thoughts focused on anything other than himself. It felt like an awkward first date, though both thought the other was straight.

There are multiple ways to approach gender reassignment surgery, all procedures are viable, and each has their own set of complications, which depending on the patient's particular medical history can make one method preferable over the other. The most common is through a method known as penile inversion vaginoplasty (PIV), which basically means cutting open the penis and turning it inside out. This procedure removes the erectile tissue, testicles and much of the scrotum, but preserves the glans, penile skin and urethra to fashion the clitoris and vaginal cavity.