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Sidney Leister felt content in most aspects of his life. He’d married his beloved Brenda in 2014. He was nearing retirement from a fulfilling career in hospital customer service and looked forward to adding a puppy to the family and traveling more. Still, he felt incomplete. The final step of his transition to a transgender man, which he began more than a decade earlier, lay out of reach — at least it seemed that way to the Hilliard resident. In his 60s, he thought he was too old to have transmasculine "bottom" surgery. He’d already paid $5,000 for reconstructive surgery on his chest at the Cleveland Clinic in 2010. Traveling out of town for a more complicated surgery that would alter the genital region and require weeks of recovery in a strange city was daunting.