Two years ago, Kavitha Sivasamy, an articulate, elegant Canberra lawyer, began to face her fears about undergoing gender-affirming surgery. “It’s really scary to go through something so invasive,” she says. Gender dysphoria had been causing “a lot of distress” in Sivasamy’s day-to-day life. “It can prevent you getting out the door, having and keeping a job, sustaining healthy relationships,” the 27-year-old says. “The list goes on.” She embarked on a course of hormone replacement therapy, and she liked the physical changes she was seeing, but this meant her “genital dysphoria became more salient”. There was a disconnect between her aspirations for her body and how it looked in the moment.