News & Observer / The Sacramento Bee, December 18, 2013

Ordinarily, the sight of a hypodermic needle might leave Shane Tilstra flat on his back, floored by wooziness from his fear of needles. But on a recent night at the Gender Health Center, Tilstra, 25, was able to sit upright in a straight-backed chair as he persuaded a physician's assistant to use the tiniest needle possible to draw his blood. The ability to be a partner in his care at the center, where staff is "like family," helps Tilstra continue on a journey toward his chosen gender. For more than a year now, the Arden-Arcade, Calif., artist has been physically transitioning from being a woman to being a man.

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