When Angel Simone was 33 years old, she underwent gender reassignment surgery so that she could experience life as a woman.

“The surgeries themselves are pretty complicated and very invasive,” Simone told The Dallas Express. “I have had both top surgery and bottom surgery already. I have not done facial feminization surgery. I’ve considered it but I’m not sure at this point in my life if I do want that or not.”

It’s been six years since Simone had a vaginoplasty, referred to as bottom surgery and breast augmentation, known as top surgery.

“I’m much happier,” she said. “Had I transitioned at a younger age, as far as my overall outward appearance, it would have been more beneficial, but it definitely takes a lot of growth, both mentally and emotionally, to make sure that a person is actually ready for it.”

Originally from Dallas, Simone is a professional make-up artist who currently lives in Flower Mound and also works at American Airlines in Fort Worth.

“They are very, very pro-LGBTQA++ and they do cover my estrogen and progesterone pills; however, most insurance companies do not cover injectables,” she said. “I usually get a three-month supply of my injectables from my doctor, and I probably spend close to $100 out of pocket every time I refill that.”

Simone uses injectables to keep a certain level of estrogen flowing in her body.

“I self-inject intramuscularly into my buttocks usually,” she said. “Estrogen being the primary female hormone, as opposed to the male hormone testosterone, keeps my body progressing as a female instead of regressing back to male in any manner or form.”

“Gender reassignment is the biggest decision that anyone is going to make in their whole lives,” said Dr. Miriam Grossman, a child-adolescent psychiatrist. “We’re talking about irreversible physical changes like infertility and all sorts of secondary sex characteristics, such as voice lowering, which is permanent.”

It was widely reported that Attorney General Ken Paxton issued an opinion establishing that the state had a duty to protect children’s biological reproductive organs and capability —and not doing so is child abuse. Gov. Greg Abbott ordered the state’s Department of Family and Protective Services to investigate parents and doctors who promote and perform such procedures for children.

However, an opinion is not enough, according to Jeff Younger, a Texas House candidate who advanced out of the Republican primaries on March 1 and will compete in a run-off on May 24.

“We got the attorney general’s opinion letter, which classifies all this stuff as child abuse – chemical castration of kids as child abuse and sex change surgeries as child abuse –  which binds all the government agencies in the state,” he said. “So, that’s a huge deal, but that doesn’t bind the courts. The courts are only bound by the laws. We still need a law.”

As previously reported in The Dallas Express, Younger was thrust into the national media spotlight last year after losing partial custody of his son, James, during a divorce from his ex-wife, Dr. Anne Georgulas, who works as a pediatrician. He objected to Georgulas administering transgender hormone usage on their 9-year-old.

Younger told The Dallas Express. “A child is not capable of making these decisions, and they have to wait until they’re 18 to do it, just like smoking, drinking, or having a handgun.”

When reached on her cellphone, Georgulas declined to comment.

As someone who has experienced gender reassignment surgery, Simone understands the pros and cons of transitioning at a younger age.

“Had I transitioned before puberty with [transgender hormones], and then, at the onset of puberty, began female hormones, I probably would have developed breasts on my own and would not have needed breast augmentation surgery,” she said.

However, Simone added that transgender hormones prevent male genitalia from growing to their full size.

“When it comes to having a vaginoplasty, not having your genitalia grow that well can present more complications because you don’t necessarily have enough tissue to create the vaginal canal without having follow up surgeries,” she said.

Some 13.1% of currently identified transgender people have reverted back to their gender of origin at some point in their lives, according to media reports.

Luckily, Simone’s experience living as a transgender individual has been largely supportive.

“My mom has responded very well,” she said. “My transition from everything has been relatively easier for her than my dad. My parents divorced when I was a teenager. My dad and I always had a very topsy turvy relationship as it is, and I never got the opportunity to physically talk to him about it because he passed away in 2018.”

About 0.6% of the adult U.S. population or 1.4 million are trans adults, according to a Williams Institute at UCLA Law study. 

“The process of de-transitioning depends on how far a person went,” Grossman added. “For people who had surgery, you can’t get back your breasts or genitalia. You can’t get back your uterus.”

The Williams Institute at UCLA Law study also found that 55% of trans adults “identify” as white, 16% African-American or black, 21% Latino or hispanic, and 8% another race or ethnicity.”

Grossman attributes the current transgender trend to peer pressure.

“We hear so much about those that have privilege, those that are oppressed, those that are minorities and marginalized, and the kids are being made to feel guilty about being middle class, being white and some of them might feel like the only thing they can do to show solidarity to the oppressed and marginalized population is to actually join them,” she said. “This is the door that’s open to them.”

But Simone, who is Caucasian, has always been attracted to men, even while attending L.O Donald Elementary School in Dallas ISD, which is predominantly made up of black and Latino students.

“I’ve always been a minority,” she said. “When I was 18, I came out as a ‘gay’ male, and then I came out again as a drag queen, cross-dresser. Now, of course, I’ve come out as a transgender female, so I’ve been a minority technically for 20 plus years and I’m pretty sure I’m not transitioning now just to feel closer to racial minorities.”