Hayley Anthony, a 30-year-old marketing consultant, has become one of the first people in the world to have a piece of tissue taken from the cavity of her abdomen and turned into a vagina. It was her own idea and it caused a revolution in gender reassignment surgery because nobody has ever done it before. In autumn 2015, after talking it through with her therapist, Hayley was preparing to undergo the standard procedure for trans bottom surgery. Her doctor, Jess Ting, the director of surgery at the Centre for Transgender Medicine and Surgery at Mount Sinai, would cut open the penis and remove most of the insides. He would then fold the penile skin into the space between the urethra and the rectum. In this procedure, the outside of the penis becomes the inside of the vagina. The patient understood everything and had her eyes wide opened, some compromises were necessary but she accepted them. Hayley found a paper describing doctors in India who performed surgeries on women whose vaginas had grown abnormally or not at all.They started from scratch, using tissue from the peritoneum – loose tissue which surrounds the inside of your abdomen. Dr Ting had been trying to come up with an alternative for years. “I kept thinking, there’s got to be something better,” he said, “But where were we going to find a large amount of pink, hairless, inner skin that secretes fluid?” Then Hayley showed him the paper. “At first he was like: ‘What is this girl doing?’” she laughed. “I have no medical training. I’m not a scientist. But then he looked at it and said: ‘Oh, there might be something here.’” The New York City doctor spent the next two years developing and honing a procedure which he has now performed on 22 trans women.