Monika: You’ve mentioned feeling euphoric about how feminine you look now. Can you tell us more about the role of self-image in your journey, and how it has impacted your overall sense of well-being?
Kizzy: I think one of the most interesting, and challenging, aspects of transition is how one’s self-image evolves over time.
Before I transitioned, decades of internalised transphobia and repressed dysphoria had led to self-hate and low self-esteem. I think this meant my self-image was pretty compromised, and I struggled to accept many of the positive things people said about me. I’d always been quietly driven in my professional life, focused on family in my personal life, and been lucky enough to achieve a lot by the time I was in my late thirties. I still felt like an imposter, though, as if it would all fall apart at some point when I was ‘found out’.
Monika: Was there a particular comment or moment that stuck with you as you began HRT?
Kizzy: In terms of my transition itself, whoooya, that’s been a journey. In the months before I started HRT, someone close to me questioned whether transition would ever be successful, with the simple statement, ‘but... just look at you’. I know it came from a place of love, with concern for my own wellbeing, but those five words cut to the core of many of my insecurities at that time. I was 190cm tall, six foot three, with broad shoulders, a deep voice and what I thought was a pretty masculine face, although I’ve since been told I had quite a few feminine features to start with.
I went into medical transition with a faint hope of looking like the woman I felt I was, but I had accepted that ‘looking like a woman’ wasn’t the goal. The goal was to stop living a life where I had to hide who I was, and I would do that no matter how I looked.
I think that was probably naivety, to have such a simple goal at the start, because as soon as I started HRT and began presenting feminine more often, the dysphoria over masculine features skyrocketed. It’s one of the slight paradoxes of transition, that dysphoria increases significantly once we start presenting as our lived gender, because the disparities between where we currently are and where we want to be are made all the more stark.
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“I do enjoy being told I look like a Valkyrie.” |
Monika: How do you feel about your height and those more traditionally masculine features now?
Kizzy: Over time, I’ve come to love my height and my broad shoulders, now viewing them as assets rather than features I should hide. That’s required quite a bit of work on my part, both in the gym and in self-reflection and therapy, but positive comments and encouragement from others have also helped a lot. I do enjoy being told I look like a Valkyrie, in my off-shoulder dress and five-inch heeled boots. To caveat the above, though, I’m sure a lot of my confidence has come from the benefits of private medical and surgical treatment, as my self-image has improved markedly from appropriate healthcare.
I do still struggle with dysphoria, particularly about my voice. There are still days when I hate what I see in the mirror, but I’m probably better at pulling myself out of the low points now. I’ve also got a wonderful group of trans friends who I can always talk to when the bad times hit, and their support has been life-changing.
Monika: How do you balance expressing your femininity with the expectations of your profession as a surgeon and educator?
Kizzy: I find the concept of ‘expressing femininity’ a bit contentious, even within the trans community. Transition doesn’t automatically undo the attitudes and assumptions we’ve absorbed throughout our lives, and some people still hold quite misogynistic views afterwards. I see this occasionally in videos aimed at early transitioners on ‘how to be feminine’, where the advice is just a list of outdated stereotypes.
As a surgeon, I often need to be decisive, assertive and confident, traits that are still sometimes coded as masculine, particularly given the familiar double standard in how assertive men versus assertive women are perceived. I’m fortunate to work alongside some outstanding women in orthopaedic surgery who demonstrate all of those qualities, probably much better than I do.
I think transition has allowed me to express myself authentically, whether those parts of me are traditionally labelled masculine, feminine or neither. I’ve always been a cheerful person in the operating theatre, and I’m often told I create quite a fun atmosphere while remaining professional and focused on the surgery. The word ‘boisterous’ has been used to describe my approach to teamwork in theatre, although a close friend who joined me in theatre one day aptly corrected this to ‘girlsterous’.
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| "I think transition has allowed me to express myself authentically." |
Monika: Do you think being visibly different, in how you present at work, changes how patients respond to you?
Kizzy: One thing I have become acutely aware of is how deeply our ideas of what it means to ‘look professional’ are rooted in outdated social norms, including cis- and heteronormativity, classism, racism and sexism. There is often a subtext to professional standards that suggests markers of queerness, such as different hair colours or styles, piercings and tattoos, are inherently unprofessional.
As a consultant, I’ve been able to express myself more freely than a resident doctor might, and I haven’t experienced much pushback from colleagues or patients. In fact, I’ve often experienced the opposite. A significant number of patients, including adults, young people and children who have attended my clinic, have told me that they felt incredibly safe with someone like me who is visibly queer, even when they aren’t queer themselves.
For me, that challenges the assumption underlying some traditional ideas of professionalism, that looking different somehow creates distance or undermines trust. Sometimes, being visibly different does precisely the opposite.
Also, having previously had zero interest in fashion, I now spend hours finding nice outfits for work, and get great joy when people compliment me on my dress at work.
Monika: What aspects of womanhood have brought you the most joy or satisfaction since your transition?
Kizzy: There’s an undeniable joy in just finally being who I think I always should have been. I don’t regret my life leading up to transition. I wouldn’t be where I am if it had been different, but I take great joy in the fact that I fought through the worst parts, the lowest lows I’ve ever experienced, and came out intact and thriving on the other side. I’ve mentioned privilege a lot here, but it’s worth stating again: I had the privilege of a happy childhood, a loving family and opportunities that others didn’t. My transition was possible because of all of that, and because I had the means to access the healthcare I needed in a timely manner.
I’ve always wanted to be a parent, from about as early an age as I can remember, and my kids are the single most important part of my life. I enjoyed fatherhood and still look back on the time I was ‘Daddy’ positively, but the gradual change to being a mum has been filled with immense joy. Do I parent any differently than I did pre-transition? I don’t think so, in any major way. It’s probably similar to my earlier comments about ‘femininity’, in that there are lots of traits labelled as ‘mothering’ or ‘fathering’, with a mix of positive and negative connotations. I’ve hopefully just picked the positive ones and continued much the same as I always did. There are undeniably some differences, though, particularly in how I’m perceived by others.
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“Sometimes, being visibly different does precisely the opposite.” |
I know there will be people who object to me saying I’m a mother, saying I didn’t give birth so couldn’t possibly understand. I’m just as much a mum as an adoptive mother, or a non-birthing mother in a same-sex couple, and if my kids call me their ‘tall mum’, then that’s all I care about.
Monika: Has transition changed the way you experience friendship?
Kizzy: Another aspect of transition that’s given me great joy is finding sisterhood with other trans girls. It seems to be a common phenomenon that trans girls have an immediate level of intimacy when they first meet, due to their shared experiences and challenges. That doesn’t mean trans people are a monolith who become best friends at first sight, but it does lead to some hilariously open discussions about the successes, challenges and traumas of transition, with people I’ve only met an hour or so earlier.
The friendships I’ve made since starting transition are often quite different to those from before, particularly with other women. We’re more likely to talk openly about emotions and be vulnerable, more likely to express explicit affection and give active support. I think I’m also much more of a tactile person now, and I absolutely love a cosy night with friends when we’re all cuddled together on a sofa, or in the back of a bar, just chatting and being close.
I have to say that I’m lucky in many of the male friendships I had pre-transition, which have mostly survived and evolved. During the pandemic, I spent a lot of time playing Xbox online with a couple of my friends, supporting each other through the isolation. They’ve always been emotionally mature guys without toxic masculinity: hugs and ‘love you, dude’ were big parts of our relationship. As some of the first people I came out to, they’ve been incredibly supportive throughout my journey.
Monika: As a surgeon, how did you handle the challenges of being a transgender woman in a traditionally male-dominated field? Were there any moments when you felt either supported or excluded?
Kizzy: I’ve talked about the support I received from my colleagues a bit earlier, and about how I’m protected from a lot of the potentially negative aspects by my status. I also think that being six foot three has helped to some degree, as being tall has its own benefits.
I do experience casual misogyny on occasion, like someone coming into a clinic room with me and a male registrar, only to ignore me and talk to ‘the man’. I’ve had patients ask me when the doctor is coming, or been surprised that I’m the one performing the surgery. That’s been quite eye-opening to see happen in front of me. It’s sometimes difficult to pick that apart from transphobia or queerphobia, though, as there’s often overlapping prejudice and intersectionality.
What I haven’t had is barriers placed in my way, either for being a trans person or a woman in surgery, but that’s because I was already past those barriers due to my presentation as a white, cis-het, middle-class man. Sexism and transphobia are still huge problems in medicine, along with other systemic prejudices like racism and ableism. I kind of think of myself as a bit of a Trojan horse, who got through the gate in a man-shaped disguise, only for a girl to jump out and hold it open for future trans people.
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| "I’ve always wanted to be a parent." |
Monika: How do you integrate your experiences as a transgender woman into your teaching and work as an educator? Do you share your personal story with your students or colleagues?
Kizzy: I think there are two types of useful representation that I can add as a trans woman in medicine and education.
The first is passive representation, of just being openly trans in a profession where gender diversity is under-represented. The average person will not have knowingly met a trans person, so I think seeing one doing a normal job, living a normal life, will help to humanise them and counter the bigotry of the national media. The downside is that there is pressure to be perfect, and a constant worry that the smallest slip-up will mean people point at me and say, ‘See! Trans people can’t be trusted in demanding jobs!’
The second, useful representation is active, by integrating my experiences of being trans into my teaching and sharing my story. I’m one of the first clinicians that medical students meet at my university, and I am quite open that I am trans, giving an early lecture about ‘what it means to be an orthopaedic surgeon’ that discusses how orthopaedics has evolved in its inclusivity over time. In later years, I lead the teaching on trans health and give an introductory lecture that includes my transition story. I think this adds to my earlier point about humanising trans people, particularly among future doctors. I often contrast my good experiences of healthcare with those of other trans people, showing how happy and straightforward it can be made with good funding and support, and how devastating poor care is to the individual. I’m genuinely confident that it makes a difference to how these students will treat their trans patients in future. I just wish that future could happen sooner.
Monika: Has your identity as a transgender woman impacted your interactions with patients or your approach to medicine in any way?
Kizzy: I think it’s a pretty rare thing for someone to have examined their inner self as much as a trans person, to have dived to the depths of their soul, torn it apart and rebuilt it into the person they know they should be. Personal identity is probably taken for granted by most people, particularly those who aren’t queer, and I think that can mean they have had less reason to interrogate assumptions about themselves or others.
I’m sure that has an unavoidable impact on how I interact with other people, including my patients, and I think it makes me a better doctor. I hope I’ve always been a fairly empathetic person, but I’m probably more so after understanding my own challenges, along with the experiences I’ve learned about from wider activism.
I’m also pretty sure that someone who is happier, has self-worth, and isn’t battling with suppressed dysphoria, is overall a better doctor.
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“If my kids call me their ‘tall mum’, that’s all I care about.” |
Monika: You’re an active social media creator and have shared your transition journey online. What inspired you to be so open about your experiences, and how has this affected your relationship with your followers?
Kizzy: When I started my transition, I had only peripheral ties to the queer community, and had no idea how to access support or advice. I’d never used Instagram before, but found my way onto it after interacting with a few trans-supportive subreddits, like r/translater. For me, it was a lifeline during an incredibly lonely, terrifying time. I found a community of people who were supportive and shared experiences and advice, as well as love and affirmation, at a time when I was probably at the lowest point in my life.
I’d previously tried out some local trans support groups and events, but found them skewed towards younger people, and although they were all lovely, I was at a different stage of life and had quite different concerns. I also found that I’d default to providing support, rather than receiving it, due to being that bit older and from a medical background.
END OF PART 2
All photos: courtesy of Kizzy B.
© 2026 - Monika Kowalska
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