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Published: 19:47 GMT, 5 January 2017 | Updated: 19:47 GMT, 5 January 2017
Choosing to undergo gender reassignment surgery is an intensely personal and monumental decision — one that, understandably, many trans people choose not to reveal much about.
But one brave teenager named Emmie Smith is not only speaking out about her surgery— the 18-year-old allowed a National Geographic photographer, Lynn Johnson, to come along for the procedure and film her and her Massachusetts-based family through the process.
The magazine has since released a nine-minute video documenting the experience, including interviews with Emmie, her identical twin brother Caleb, her mom, and her plastic surgeon.
Big change: Emmie Smith, 18, was born Walker but transitioned from male to female as a teen
Brave: She let National Geographic's cameras come along for the momentous occasion
Love: Her mother Kate (left), an Episcopal reverend, has been very supportive and was at the hospital for the surgery
Emmie is lucky in that her parents and twin have been very supportive throughout her transitional process, even if it was a shock to come to terms with.
'When I first learned that my child was transgender, I couldn't speak the word, I was so — I didn't know, I didn't know anything about it,' her mother Kate Malin, a reverend at an Episcopal church, says in the video, stuttering out her thoughts.
'Here I was, this "good mother" that researched everything before we, you know, bought a diaper. I was the one in the know, and all of a sudden I didn't know anything and it was frightening and it was other and I didn't want my child to hurt or be hurt or be judged.'
Emmie, formerly Walker, found that she's mostly received a positive and nonjudgmental response to her news.
Kate said finding out about Emmie was a shock because she knew nothing about being trans
Unique: Emmie has an identical twin brother, Caleb, making them one of a very small number of identical twins of different sexes
Family: Caleb is proud of that fact and has been supportive of his sister
'Being closeted was one of the worst parts of my life. Being out, it's not so much a personal change, it's a social change,' she said.
She shared the news publicly for the first time on Facebook two years ago, and her social circle seemed to adapt quickly.
'The thing I really remember about coming out, was I was in a play. I went to rehearsal, and they were getting my pronouns right, they were using my name,' she recalls. 'It was just a totally different world. It was incredible.'
'If I was not out, I'm not sure I'd be alive right now,' she adds.
Her brother Caleb, too, has taken the news well. He notes, 'I kind of taking pride in being one of the few identical twin pairs that are boy and girl.'
Important: Emmie said that if she wasn't out, she might not be alive
Unsure: Emmie was hesitant about undergoing the surgery at first, but now says that she has a 'million' reasons for having wanted the change and is happy with the decision
Perfect: She was 'giddy' and 'nervous' on the big day but the surgery was a success
Despite knowing she wanted to be a girl, though, Emmie wasn't always convinced she actually wanted to take surgical steps to change her body.
'When I thought about why I eventually wanted to get this surgery, because I really didn't at first, I think the reason that I ended up really wanting it to happen, started being something more out of convenience,' she explains.
'As it started to get more real and I got the surgery date and all that, I found a million reasons why I wanted it to happen.'
So, on August 30, 2016, she went under the knife, having a surgeon change her penis into a vagina.
National Geographic was there on the big day, as Kate said she felt 'honored' to accompany her daughter on this journey — adding that they were both 'giddy' and 'nervous'.
In position: Emmie's legs were held in place with the help of two braces
Detail: The video goes into great detail about how the procedure is carried out, with Emime's surgeon explaining each step of the operation
Transformation: The penis is used to create a vagina
Complicated: Emmie hopes that by documenting the procedure, she will help to bring new awareness about transgender people
'I think people are fascinated by gender reassignment surgery. They also don't know how to have a conversation about,' Emmie said of her decision to let the cameras in.
Before heading into the operating room, Kate and Emmie are seen waiting and praying together. Kate looks like she is holding back tears as she asks God to lead Emmie through.
The surgeon, Dr. Christine McGinn, then explains exactly what happens once the anesthesia kicks in.
'The glans penis becomes the clitoris, the skin of the penis becomes the labia minora and part of the opening of the vagina,' she says.
'The scrotal skin is taken off and used as a skin graft, it's rolled up into a tube, and that's placed in a space that we make at the base of the scrotum... and that's going to be the lining of the vagina.'
All the details: Her surgeon explained on camera what the procedure entailed; her penis became the clitoris and labia while the scrotal skin became the inside of the vagina
It's all good: Kate cried and smiled as she called family members to tell them that the surgery went well
'The testicles are removed, and the urethra is actually saved, and the flap of the urethra is used to make a hood for the clitoris.'
After all of that happens, Dr. McGinn wakes up a groggy Emmie, telling her the surgery is over.
The doctor explains in a voice-over that though Emmie looked scared, she knows she will be fine — particularly because her family is there for her.
'When people don't do well, after their transition, it's because they have absolutely no support system. Their support system is their families putting on a game face, but they're scared as hell too... She's got everything going for her,' she says.
Outside the operating room, Kate can be seen crying and smiling as she calls family members to tell them the surgery went well.
'I feel like I haven't taken a deep breath in two days,' she says before visiting Emmie and reading her the supportive messages sent by her other family members.
Kate and her husband know this was the best decision and see Emmie is happy
Strong: Emmie's doctor said she would be fine since she has such a great support system
Getting acquainted: Emmie checks out her new equipment after surgery
'What my husband and I keep remarking on to each other is this just feels so right, it's so her, it's so the child we've always known and loved, even thought a few years ago we wouldn't have necessarily anticipated this step,' says Kate.
'And that's where I think, again, transition is problematic. Because it presupposes an end point, where at some point you have transitioned. Whereas every single one of us is in constant development. This is obviously a huge, huge moment in Emmie's life, but it by no means the end point. In some ways it's just the beginning.'
Emmie took nine weeks to recover, and is now working at an art museum and taking a gap year before starting college in the fall.
She hopes to study acting and is working with her brother on a musical, and wants her story to help educate others.
'If you’re not living freely that’s time wasted, and I felt my time was wasted pretending to be a boy.
'[Transitioning] was the best decision in my life,' she said. 'It’s not science fiction or mythology. It's what happens to women just trying to be at peace with themselves and their bodies.'
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The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
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Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group
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Published: 00:00 BST, 23 July 2013 | Updated: 10:59 BST, 10 January 2014
Teenagers Arin Andrews and Katie Hill look like any normal young couple posing in their swimwear.
It is hard to believe that just two years ago Arin was a girl called Emerald, and Katie was a boy called Luke.
Arin, 17, and Katie, 19, from Tulsa, Oklahoma, have both undergone surgeries to change their gender and now are enjoying being in their bodies they always wished for.
Young and in love: Transgender teens Arin Andrews, 17, seen posing for a picture with sweetheart Katie Hill, 19, at the Oologah Lake in Tulsa, Oklahoma
Living life to the fullest: The teenage couple have been bullied and lost friends but have been able to support each other through their gender treatment
Just over a year ago Katie, a university student, had gender reassignment surgery, thanks to an amazing $35,000 donation from an anonymous donor who read her story in a local newspaper.
Now, Arin, who is still at school, has undergone an operation to remove both of his breasts, and is proudly showing off his new male physique.
For the last year, Arin has been binding up his chest to try to hide his female body, but can now go topless for the first time after his surgery in Cleveland, Ohio, in June.
He said: 'Now I can wear a tank top, which I couldn't before, I can go swimming shirtless, I can walk outside, I can just be a regular guy now.
'I hated my breasts, I always felt like they didn't belong - now I can finally be comfortable in my own body.'
He added: 'Now when I'm out in a public pool, or lifting weights, no-one raises an eyebrow, they just think I'm a guy - just a skinny dude in the gym trying to build some muscle.
Enjoying life: The teenagers say that they are now both comfortable in their own bodies
Defining themselves: Last year Katie had a $35,000 sex change surgery to turn her into a woman - and now Arin has followed his dream to have a flat, male chest following an operation
'My family have really surprised me with how supportive they have been throughout the surgery. I'm so lucky to have them and Katie to rely on.'
Katie and Arin met nearly two years ago at a support group for transgender teenagers and bonded through their shared experiences.
Katie said: 'To me, Arin's just my Arin, he's always looked manly to me. But now he's had the surgery he's much more confident and comfortable with himself.'
But now that the teens' physical appearance matches their gender, both of them are excited to be able to go swimming, boating and sunbathe like other couples.
Katie added: 'Being transgender myself, I understand Arin probably better than anybody else, how good he feels and how complete he feels.'
True love: The couple have been able to rely on each other through their transformation
Happy and healthy: Arin and Katie pose in their swimwear at the lake and later looking casual at home
Light at the end of the tunnel: The couple were both bullied and lost friends who could not cope with their changes
In the future, Arin might consider having genital surgery, but this can be complicated, and for now he's delighted with his new body.
Both the couple's families are supportive of their relationship and say the way the way the teenagers have supported each other has helped in their transition.
Arin's mum Denise Andrews said: 'Seeing Katie go through her surgery was helpful to Arin.
'It was being around it and seeing her getting to transform. And being a couple at the time was I think just the cherry on the cake.
Changed lives: Emerald Andrews, before she became Arin, at the age of five in Tulsa, Oklahoma (left) and Luke Hill (right), before he became Katie, aged seven
'Every transgender person would love to have the transformation physically because it just completes them as a person.'
The last two years have been very difficult for the teenagers.
Katie was bullied at school, and Arin had to change to a different high school when he revealed he was transgender, and has lost friends in the process.
'I lost one of my best friends through the transition,' said Arin. 'We used to go on vacations together and were like sisters.
Making a splash: The couple met at a group that supports transgender teens
'But I got the chance to open her eyes and show her I'm still a good person. I'm still the person I was, I just look different.
'She was gone for a while but then she came back.
'It taught me that the people who really love you need some time, but they'll always come back around.'
Happy: Arin had an operation to remove his breasts and is proud of his new physique
After he began dressing as a boy, Arin also lost a new male friend who learned about his past as a girl.
'He said: ''I pictured you as a girl, and I can't do it anymore,''' said Arin, adding: 'You can't just force people to be your friends.'
Katie started her degree course at an Oklahoma university last autumn but has struggled to make new friends because of prejudices against transgender people in the traditional Southern State.
She said: 'I had quite a lot of friends in college that were really close to me and then all of a sudden they just stopped talking to me.
'I think what happened is they found out I was trans through a story or word of mouth and they decided that was too much for them.'
The last two years have also been difficult for the teenager's families as they've come to terms with losing their son and daughter, and also some of their own friends.
Arin's mum Denise said: 'There are still a group of people we don't interact with any more. I know that they questioned me as a parent, they're not comfortable with it.'
But she added: 'A lot of people worry about losing the gender of their child. But as you look through albums and realise your babies are growing up, we also watched them grow up and turn into somebody different.
'Whether they stay the same gender or not, they become independent.'
Now their outward transformation is complete, the teenagers hope people will accept them as their new genders, and their difficulties will become a thing of the past.
Young romance: The couple have been together for two years
Carefree teens: Katie and Arin have both had the loving support of their families while they made the life-altering decision
The comments below have been moderated in advance.
The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
We are no longer accepting comments on this article.
Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group
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