Those who are transgender go through struggles that cisgender people could not imagine. From an early age, gender dysphoria consumes their every thought, and they are faced with the arduous decision of whether or not to live their life as their authentic selves.

Thanks to modern medicine, it is now possible for transgender people to align their physicality with their gender. The first sex change took place in the 1930s, but it was unsuccessful, and it wasn’t until the 1960s that the procedure became commonplace.

After living a lie for 40 years, 56-year-old Fulvia Pellegrino finally decided to transition into a woman. Fulvia first realized that she had been born into the wrong body when she was just 15, but because she had a religious family, she kept her gender a secret.

“I was living with my family who were very narrow-minded and very religious. I never manifested my will because it was impossible with my dad. He had three sons and he wanted three sons only,” Fulvia, who had previously been known as Fulvio, said.

The turning point in Fulvia’s life came when she met her future wife Marisa. After the two married, she started to visit gay bars and began experimenting with cross dressing in private. These steps towards living as a woman, however, caused Fulvia much distress.

To cover up her gender, Fulvia began to outwardly present herself as a hypermasculine man, buying firearms and cars. But 16 years into her marriage, she couldn’t live a lie any longer, and finally confessed to Marisa that she was a transgender woman.

“Obviously Marisa lost if for a moment, it is not something that is easy to accept,” she said. “Today Marisa and I are nothing more than two sisters. We live together, we argue like two normal people but not like husband and wife.”

Now Fulvia has spent in excess of $76,000 in a bid to obtain the “perfect” female body.