“I’ve told you before, yes, I feel like a woman,” he said with an apologetic look.

And so the time when I “need to” had arrived. We were at the hospital for facial feminization surgery, a not uncommon procedure in male-to-female transitions, in which a surgeon carves out a more femininely proportioned version of a male face. In my husband’s case, this meant higher eyebrows, a smaller nose and a more pronounced chin. A few months later, his Adam’s apple would be shaved down and he would receive breast implants. Genital surgery would follow.

Already, estrogen had narrowed and softened his face, and the alterations would be slight, the surgeon said. His wide blue eyes would not change, nor would his high-enough cheekbones or soft lips.