This is part one of a two part long-form series, which will be available at theprospectordaily.com.

Read part two here.

Adriano Kristian Perez always felt different. Growing up in a religious Mexican family and attending an all-girl high school, he attributed his discomfort with his body to the societal norms of puberty.

It wasn’t until he started attending classes at UTEP, and had a conversation with another student that he realized that not everyone else felt as uncomfortable as he did.

“I heard him talk about his experience as a transgender man and how he knew he wanted to transition, and I was like, ‘oh, wait, that’s me.’ It clicked,” Perez said. “I couldn’t do anything for a while, but I finally started to transition. I struggled with it for a year, though, the consequences of my transition and what that would mean in my life—if I was comfortable with that challenge, primarily for my family and my safety.”

Before this, Perez, senior biology major, had already been binding his chest for three years, before he knew he wanted to transition from a woman to a man. 

“Binders are like a really tight tank top with two layers of tight-ass material. It hinders your breathing so I had to wear that all of the time to keep my chest down. That’s also really dangerous because it can cause breast cancer,” Perez said.

He then had a top-surgery, which is a double mastectomy for transgender people, to remove his breasts.

When Perez first told his mother, he told her he was going to New York since he had been in a long-distance relationship at the time.

“I told her I was going to New York to see a doctor over there to start hormones and she couldn’t do anything about it,” he said. “I was gone for a month, so when I came back she missed me so much that it was rather insignificant.”

After his visit to New York, Perez was able to find a doctor in Las Cruces, N.M. Since January 2014, he has been driving there and back to receive hormone treatments that have gradually changed his voice and added more body hair.

“The most noticeable thing for me was my voice, then it was body hair, then muscle mass happens. I got a ton of body hair—I have hair on my thighs now, my stomach, my back, which is great,” Perez said. “Your voice gets deeper and you get acne, since you’re going through puberty. I had perfect flawless skin before this.”

After the first year, Perez’s voice settled, but he still can’t sing like he used to.

“I don’t have as wide of a vocal range because my voice will just crack. In a couple of years, I’ll be able to hit those higher notes,” he said. “Hopefully, I get facial hair one day. I’m just fuzzy.”

Perez said that transitioning costs a lot of money, and those who want to transition have to have a doctor who will treat and see them as a transgender person who is sane.

Texas still considers transitioning to a different sex as psychological. Those who want to transition must go through three months of psychological therapy first to prove that they are a transgender person. Only then can hormone treatment be started.

Once a willing therapist is found, the transgender person has to find a willing endocrinologist to administer the hormone treatments and begin treatment.

“My family struggled with it, but I think they would have struggled with it more if I had been younger,” Perez said. “The changes have been gradual enough that my family was able to get used to it, like my voice being different.”

During Christmas, his family wrote Adriano on his gifts.

“When my mom yells at me, she’ll call me Adriano, so that’s cool,” Perez said. “You’re mad at me, but I’m so happy that you’re using the right name.”

Perez changed his name last summer, keeping his initials the same and using his mother’s maiden name as his last name.

“My mom’s middle name is Kristina so I made mine Kristian, and I tell her, ‘see, you can’t be mad at me because I changed my name to yours,’” he said. 

Dr. Oralia Loza, assistant professor of public health sciences, recently finished a study that focused on transgender women in the El Paso/Juárez, Mexico region, specifically what their health needs were and where they access services.

“They had never been interviewed for a health needs assessment before, and we didn’t know what the resources were in the community,” Loza said.

The study is now under revision and Loza is working on publishing the findings.

“What we found is that at the time of the interview, there were no services in El Paso for transgender women in 2012-2013. We asked for any other resources, and we didn’t identify any from the participants, so that was alarming,” she said.

Since the interviews, however, Loza has been working with community partners, including the Department of Public Health and two physicians in endocrinology and pediatrics—including Dr. Hector Granados—from Texas Tech University Health Science Center in El Paso, the Office of Diversity Affairs at Texas Tech, International AIDS Empowerment and The M Factor, to create a professional network that will work toward improving health services for lesbian, gays, bisexual and transgender persons living in El Paso.

“Services have emerged and people have come forward. Centers that didn’t exist have returned with a different name, like OUTright Community Center, an LGBT youth center,” Loza said. “That didn’t exist five years ago, so I guess some agencies have come back under a new name, design, management, etc.”

The two physicians are trained in transgender health. They built a complete clinic within Texas Tech for transgender children to receive the care they need in all areas, such as mental health assessment, hormone treatment and puberty blockers.

The pediatric clinic also serves adults because of the need in the region, Loza said. Now, the network is working on finding a mental health provider who can provide the portion of care that transgender people need.

“People here are not willing to do that, or they’re not ready. They don’t feel comfortable for whatever reason,” she said. “If they’re here, they’re hard to find. We have a network with professionals from different sectors of the community, including HIV care and LGBT outreach from the new center. If we can’t find them as professionals, how is somebody who feels uncomfortable stepping forward and coming out going to find them?”

The community partners who were brought on board to serve the transgender population took pledges, promising to be sensitive to LGBT patients.

“So instead of saying, ‘is that your wife or girlfriend?’ they will say, ‘is that your partner?’ They welcome other scenarios that are non-traditional or not being assessed on the forms,” Loza said. “Those are small changes that are occurring in health care.”

Loza and her partners want to launch a study where all health care and social services providers in the region are interviewed on how willing they are to serve the LGBT community, particularly transgender people.

That information will go on a resource page that will be posted on the city’s website.

“This has been a huge effort. It has brought a lot of people together who care about the community, and have realized that there is nothing here for them. We want to change that,” Loza said.

Loza said that when people talk about health in the LGBT community, specifically transgender women, they are always talking about HIV.

“They are a human body that has other organs, and engages in other behaviors besides sex,” she said. “So we need to address that, and remove the stigma of only focusing on HIV. There are disparities in other things.”

Perez said that he knows transgender people who turn to sex work to survive because they cannot get hired in a typical setting—whether the transgender person feels uncomfortable or the employer doesn’t respect them.

“To each his own in sex work, I’m not shaming anyone, but when you’re forced into that situation, that’s a problem. A lot of people have trans fantasies—wanting to sleep with a trans man or trans woman—too, and dealing with those kind of people is dangerous,” Perez said. “They’re not in the right state of mind, they’re not people who will respect you or be safe and clean. That’s why HIV and AIDS, STIs in general, are more prevalent in the trans community. I’ve been fortunate enough not to do that. I’m privileged.”

Lorain Ambrocio may be reached at [email protected].