Courtney Penniman changed gender from female to male in February 2012 after accepting that his male gender identity is an integral part of who he was born to be. The decision to transition to male gender was made after a long process that included counseling, hormone therapy, medical intervention, and the support of the Phoenix gay community and other transsexuals. Mr. Penniman is comfortable as a male after years of experiencing discomfort and distress because there was a mismatch between his biological sex and gender identity (i.e., gender dysphoria).