The Health Commission Wales recently changed its policy on funding treatment for gender dysphoria - a condition where those affected feel trapped in the body and gender role of the wrong sex. Two people with the condition describe how they feel about the decision.
Miss Pearce, a social science student, has been living as a woman since 2005. It hasn't been easy. For one thing she has had to buy the hormone drugs she needs over the internet at a high cost.
"I've lost contact with my immediate family. My father refuses to acknowledge what I'm going through," said Miss Pearce, who withheld her first name.
"But it's what I was born with. I was confused, but now I'm not, and I want it sorted."
In December, she received a letter from her GP confirming referral to a psychiatrist - beginning the process of gender reassignment. Her first appointment is in July.
"I'm annoyed that it's taken so long, but hopeful I can get surgery soon," she said.
DISCRIMINATION IN WALES SURVEY
A survey about attitudes to discrimination in Wales found that prejudice is most stark towards transgender people - only a third of adults said they are happy for a relative to have a long-term relationship with a transgender person.
Source: Equality and Human Rights Commission (2008)
Dee Jenkins, 57, an office equipment engineer from Cardiff, began treatment privately while she "fought" the Health Commission Wales to fund her therapy.
"It was dragging me down. I couldn't concentrate on my job, I knew I had to take action," she said.
For some, surgery is an essential part of the transition from one gender to another.
Miss Jenkins thinks that men who transition into women "have to go the extra mile".
She said: "We have to look as female as possible not to draw the wrong sort of attention, sadly there still is a lot of bigotry out there."
"It's important for future relationships too," said Miss Pearce, "and everyday life. Let's just say I'm not about to go swimming before I have the operation, it would be too embarrassing. And uncomfortable for other women," she said.
A 2007 study commissioned by the Equality Review found that 73% of trans people in the UK had experienced verbal harassment, threatening behaviour, or, physical, verbal or sexual abuse in public spaces.
Miss Pearce, who now lives in Llanelli, Carmarthenshire, said she had experienced "odd stares" and "shouts" on the street.
"I've deliberately avoided situations where I think I would face discrimination - so I stay in a lot," she said.
Miss Jenkins said she feels "luckier" than many other trans people she knows.
As a self-employed engineer she said it was important to be open and honest with her customers. And all but one has supported her decision.
Her six children, from two previous marriages, are also adjusting, and now mostly call her Dee.
Last Christmas, Miss Jenkins's father, who is 84 years old, bought her two skirts and blouses for work.
"He's accepted me as a daughter. For me that means the world," she said.
Gender reassignment surgery would "complete the transition" Miss Jenkins began in 2007.
She said: "I want to be as complete a woman as I can."