Bianca Balala sits inside her small, entirely pink house in Zamboanga del Sur, the Philippines.
Bianca points to an old photo of herself as a child. When Bianca was about three-years-old, she would wrap a handkerchief around her head to mimic long hair.
Bianca in the back of a car watches her home town of Zamboanga del Sur from the window.
The reception area of Pratunam Polyclinic where Dr Thep and a receptionist watch Thai soap operas on the television set, Bangkok, Thailand.
A consultation room at Pratunam Polyclinic where old newspaper clippings of past clients and before-and-after photos have been taped to the partition walls, Bangkok, Thailand.
Dr Thep Vechavisit in the operating room at Pratunam Polyclinc, Bangkok, Thailand
During a gender confirming vaginoplasty surgery, a member of Dr Thep’s staff scrolls through social media on her phone.
Dr Thep Vechavisit performs gender confirming vaginoplasty surgery at Pratunam Polyclinic supported by two nurses.
Dr Thep Vechavisit performs gender confirming vaginoplasty surgery at Pratunam Polyclinic.
A trans patient receives gender confirming breast augmentation surgery at Pratunam Polyclinic.
A patient is wheeled into the recovery ward on a steel table in Pratunam Polyclinic, Bangkok, Thailand.
A patient rests in the recovery ward at Pratunam Polyclinic, surrounded by Miss International Queen posters taped to the walls.
Medical trash accumulates in the room next to the patient waiting room at Pratunam Polyclinic, Bangkok, Thailand.
Bianca on her phone at Fukelya, an informal post-surgical hostel.
Bianca and a roommate who also had GCS at Pratunam Polyclinc lie in a dorm room at Fukelya, their catheters leading to a shared bucket on the floor between them.
Bianca outside her pink house in Zamboanga del Sur, the Philippines
Bianca in a moment of prayer outside her local church in Zamboanga del Sure, the Philippines. She was raised Roman Catholic.
Bianca Balala holds a pink plastic rosary, given to her by her mother on the morning that she left her hometown in Zamboanga del Sur to travel to Bangkok.
Bianca in her hometown in Zamboanga del Sur. “I wanted to have surgery not just to become a woman” she says. “The main goal is to be free. To free ourselves.”
Bianca applies lipstick in a mirror at a local beauty salon in her home town in Zamboanga del Sur.
One of Bianca’s cousins climbs up onto the parking lot roof to pick a soursop fruit from one of Bianca’s fruit trees, Zamboanga del Sur, the Philippines.
Bianca and her family enjoy a lechon lunch at home in Zamboanga del Sur, the Philippines.
Her gamble to feel at home in her body
Like a crucifixion, Bianca's arms are strapped to a crude plank of wood as she lies on her back on an operating table at Pratunam Polyclinic, Thailand. One nurse snaps instructions at her in broken English while another drags a crumpled pink towel across the floor using her foot, soaking up fluids from the operation before.
This clinic, located in the heart of Bangkok, offers gender confirming surgery (GCS) at an unbeatable price. While most patients can pay upwards of $20,000 USD for Thailand’s top surgeons, the same operation can be purchased from Dr. Thep Vejvisith for just $2,100 USD. But for Bianca, who has been dreaming of GCS since childhood, this clinic is a far cry from the hospital where she had breast augmentation back home in the Philippines. This story unveils the lived experiences of trans women like Bianca for whom Dr Thep's low price point offers a rare lifeline. But it also describes what realities they are faced with once they arrive.
Video, photo and written reporting for CNN. This story is the second part of a long-term investigation into transgender healthcare in Asia, featured in Longreads and republished by the South China Morning Post.