Dr. Jeffrey Spiegel, a Boston facial plastic surgeon, performs about 1,200 surgical procedures a year—but that’s not what sets him apart from other top doctors. He’s been making masculine faces look more feminine for 20 years, and sees more than 30 transgender women a week for consultations or procedures. One of these women is Valerie, who considers Dr. Spiegel one of the best surgeons in the country for the procedure that, for most of her life, she doubted she’d ever have.

“As early as age 8,” Valerie says, “I remember feeling profoundly distressed that my male body wasn’t the right body. That feeling never changed, though I remained in the closet for most of my life. I’m 66 now, and I’ve just recently come out.

“Before I transitioned, I thought the choice was fairly stark: Either I’d continue to live as a man, which meant continuing to live a lie—or I’d come out and blow up our lives. I met my wife when I was 18 and she was 17, and we’ve been together ever since. I’m an attorney and had a fairly high- profile career before I retired. I was afraid that if I came out, I’d lose my friends, my business associates, and maybe some of my family. Those kinds of thoughts are very heavy to carry around.”

To learn more about facial feminization and Valerie’s story read the full Realself article here