In New Zealand there are around 400 people on the waiting list for gender affirmation surgery and only nine of the genital surgeries were performed last year.
There is only one surgeon in Aotearoa who can perform genital gender affirmation operations: Dr Rita Yang.
As vicious rhetoric rages around the world over the transgender 'debate', Dr Yang has never spoken publicly about her work - until this week.
She appeared on Wednesday night's episode of Paddy Gower Has Issues, where Gower said it had taken "a lot" to get her to agree to the interview.
Dr Yang acknowledged it was difficult, before explaining why it was time for her to "step up".
"I'm doing this because I have come to the realisation that no matter how transformational reconstructive surgeries are, the biggest factor for my patients' wellbeing lies in society's acceptance," Dr Yang said.
"Reconstructive surgery is just one small piece of what provides my patients with their overall wellbeing. I think as a clinician who practises in this field, it's important for me to step up and raise some public awareness about the positive impact gender affirmation care has for my patients.
"Ultimately it's acceptance, compassion and support from society that makes my patients' journey whole."
Dr Yang said the surgeries she performs result in "pure joy and relief".
"It's overwhelmingly humbling for me and our team of doctors and nurses," she told Gower of her patient's reactions.
"They are so relieved at not having to hide their body and just being able to get on with their lives. For a young trans guy, you know, it means not having to shy away from your mates when you're out, or in changing rooms.
"It's just a sheer joy of finally having this last piece of the puzzle fall into place for them. We're not unfamiliar in this hospital with witnessing tears of joy."
Dr Yang said she can't help but be "very moved" as her postoperative patients are able to simply get on with normal life and be seen by society as more than just their gender identity.
When asked if patients are absolutely ready for the surgery when they come to have it done, she emphatically said they are.
"All of the patients who come through this door to see me have already been through a very long journey," Dr Yang said.
"They've been through a very long and comprehensive assessment process. And because of the hormone treatment that they have already had for years, they have already lived in their gender identity and been accepted in gender identity by the time they present to a reconstructive surgeon's office.
"It's very crystal clear. You know, for a trans man, what they really, really want is to be able to go out there and enjoy next summer by the beach without having to hide their body and wear binders and things like that.
"For a trans woman, sometimes a one hour operation to shave down their Adam's apple just means they no longer have to hide behind scarves and things like that. So it does provide the next level of ease, comfort and freedom of living that I think all of us deserve."
Dr Yang works at multiple clinics in Auckland and Wellington. She said the number of people in New Zealand requiring gender affirmation genital surgeries is growing and more surgeons are needed.
