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In Japan, the path to such surgery is often governed by specific standards, which may include psychological evaluation and a period of living in the desired gender role. For an adult film performer like Miran, the decision to undergo, or not undergo, these procedures is a deeply personal one that can significantly impact her career and public persona.

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Waheed Miran, Wenyuan Huang, Xizi Long, Gaku Imamura, and Akihiro Okamoto. Abstract Summary: In Japan, the path to such surgery is

Transgender women of color experience disproportionately high rates of violence. the decision to undergo