On her bedside table, Karen Parker has a treasured photo of her daughter, Lauren.
An adorable smiley toddler, Lauren is dressed for a Christmas party in sparkly tights and a pretty dress.
It’s the last thing Karen sees before she goes to sleep and a poignant reminder of the little girl she has lost.
Lauren, pictured left, age three, and, right, as a schoolgirl, became a young man called Lucas
For Lauren has gone for good. In her place instead is a young man called Lucas, complete with buzz cut, stubble, a deep voice and impressive pectoral muscles.
Three years ago, at the age of 18, Lucas revealed to his mum he felt he had been trapped in the wrong body and would henceforth be living as a man.
It was the starting point of a journey which, via hormone treatment, culminated eight months ago in Lucas having his breasts surgically removed.
It is a dramatic choice which has proved emotional and on occasions harrowing for both mother and son.
It has been particularly hard for Karen, 52, who has had to navigate the grief she has felt — and continues to feel — for the daughter she has lost while supporting the son he has become.
‘Everyone in the family has struggled to get used to it and we still have slip-ups. Everyone has had to deal with it in their own way,’ she says now.
‘I’m grieving for a daughter but welcoming a new son. It’s not always been easy but at the end of the day it’s about love — Lucas is my child. I’d never abandon him.’
Karen and Lucas are one of several stories featured in a compelling new documentary series in which, over the course of a year, cameras were given unprecedented access to a private London clinic which specialises in helping those who believe they have been born in the wrong body.
Lucas, 20, told his mother Karen, pictured, that he felt he had been living in the wrong body and underwent surgery
It’s a growing industry. Whether on the NHS or privately, the number of adults seeking to change their gender has more than doubled in the past five years. Today it’s estimated that across Britain 130,000 people are united by this need and desire.
And with waiting times for transgender surgery of up to 2½ years on the NHS, many are choosing to undergo treatment privately at one of the number of clinics that have sprung up in recent years.
Among them is London Transgender Surgery near London’s Harley Street, the focus of ITV’s documentary.
Founded ten years ago by plastic surgeon Christopher Inglefield, one of the country’s leading transgender specialists and a member of the Royal College of Surgeons, the clinic offers surgical procedures along with hormone treatment, voice coaching and even make-up lessons.
Over the years, people from all walks of life have entered his clinic, from firemen and soldiers to shop assistants and office workers.
‘Patients come to us having made a conscious decision to change their identity and that is a huge decision,’ says Inglefield.
Karen, pictured with Lucas, says she has had to navigate the grief she felt for losing her daughter while welcoming and supporting her son
‘It’s a huge responsibility because it’s our job to give our patients the life that they have chosen.’
This is a life which can involve multiple treatments and surgeries over many months, from breast augmentation and breast removal through to full male to female gender confirmation surgery, in which male genitalia are removed.
The clinic performs around 12 such operations each year at a cost of more than £20,000 a time, although it does not offer the more complex multiple stage female to male surgery, referring patients instead back to the NHS.
Facial feminisation surgery meanwhile — rarely available on the NHS and in which features like noses and chins are tweaked and smoothed to be rendered less masculine at a cost of between £6,000 and £20,000 — is among the most popular procedure requested by male to female patients.
‘We’re not just changing a face,’ says Inglefield. ‘It’s about empowering people to live as you or I want to live.’
It’s a sentiment which underpins the three-part series, which reveals the poignant and sometimes dramatic struggles many of the patients have endured.
Among them is Emma, a 52-year-old shop assistant who has lived as a woman for seven years and attends for breast augmentation.
Having lived in denial of her feelings for most of her life, she reveals that she has never had a relationship and remains a virgin. ‘It is not an existence,’ she says simply.
It’s a feeling 50-year-old Stephy recognises all too well. Today she’s an attractive bobbed blonde, but until three years ago she was a grey-haired firefighter called Mark, married for 22 years with two grown-up sons.
Yet throughout it all, she had also battled with the belief that she was really a woman.
Only a recent nervous breakdown led Stephy to acknowledge that she had to transition, a decision that led to the loss not only of her wife and her home but her two sons who broke off contact.
Stephy is attending the clinic to undergo facial surgery, and weeps when she describes the heavy price she has paid to become what she believes is her real self.
‘You have to understand that I didn’t chose this,’ she says through floods of tears. ‘If there was a choice involved I’d be back home, but sometimes we don’t get a choice in life.’
Also attending the clinic for facial feminisation surgery is former Marine commando Danny, who wants to look more feminine before transitioning publicly as a woman, a lifelong desire.
Danny is accompanied by Sue, to whom these feelings were revealed only four months after their 2015 wedding.
Sue says: ‘I had a few weeks of shock where I didn’t feel anything. I was numb. And then I had anger . . . when Danny said: ‘I have to do this for me, even if that means losing you.’ I had to weigh things up. But I was too much in love.’
Sadly, by the time of 34-year- old Danny’s surgery, the couple had separated.
Firefighter Mark, pictured left, was married for 22 years and became Stephy, pictured on the right
Also at the clinic for facial feminisation surgery is Juno, who until 2014 was a successful children’s author called James Dawson. Juno knows she is lucky.
Her family has supported her decision; her father even helped fund the surgery. ‘Not all transgender people are so lucky,’ she says.
At his mum’s home in Bognor Regis, West Sussex, Lucas, now 21, is the first to acknowledge he is among the fortunate ones, too.
Today his relationship with Mum Karen remains close — his father died some years ago — with both of them able to tease the other about the extraordinary events of recent years.
‘I wouldn’t be here it wasn’t for her — she just baked me wrong in the oven,’ Lucas says. ‘I guess you could say I got the recipe wrong,’ Karen smiles.
Yet both acknowledge that their closeness has been hard-fought, and on occasions remains so.
‘It’s not a secret that I still find it hard. I will never be the mother of the bride, I will never experience the special bond you have with a daughter having her first child. That’s all been taken away,’ Karen admits.
‘Silly things can set you off. Last year there was a TV advert with a dad walking a daughter up the aisle and the mother dabbing her eyes and it made me cry.’
She recalls how her daughter started rejecting ‘anything girlie’ when she was at primary school
‘I would put her in a summer dress and by the time she came out she would always be in her PE kit, claiming she had spilled paint on it or some other excuse.
‘I remember buying her a Barbie doll and she threw it to one side, saying she wanted an Action Man.
‘Everyone said she was such a tomboy, and I thought it was a phase she would grow out of.’
She didn’t. At the age of 13, Lauren announced she was a lesbian. ‘It was the only language I had at the time,’ Lucas recalls now.
‘I knew I wasn’t interested in boys, so being a lesbian was a category that seemed to make what I felt acceptable to everyone else.’
Even that did little to combat what Lucas now calls the ‘nightmare’ of the onset of puberty.
Former Marine Danny, pictured left, underwent facial feminisation surgery in order to live as Ezri, pictured right
‘Growing breasts felt like a prison sentence,’ he says. ‘I remember mum giving me a training bra and hurling it back at her. I even tried to bind them to pretend they weren’t there.’
Only after moving away from home aged 17 and meeting a transgender male at a party, however, did Lucas find what he calls ‘the key to the puzzle’.
‘He showed me there was another path.’ He knew it would be a terrible blow to his mother, who had been accepting of his sexuality, but could never have envisaged this.
‘I was terrified as the last thing I wanted to do was lose my mum —she’s absolutely everything to me.
‘At the same time I had to do it, to tell her I was a man in a girl’s body and I knew she’d need time. At first she couldn’t even look at me.’
‘I cried,’ Karen remembers. ‘He asked me to help chose his new name from a list and I told him I couldn’t, I had chosen his name all those years ago.’
It would take many months from that first conversation for Karen and Lucas’s brothers, who are in their 30s, to adjust.
‘We all had to find our own ways of dealing with it, but it came down to the fact that we loved him and if this is what he needs to do to be happy, then we have to accept and support that. We have taken it one step at a time.’
One of those steps came 18 months ago when Lucas confided in Karen that he wanted to have his breasts removed.
‘He told me that they made him desperately unhappy and that he could not be himself while they were there,’ she says.
‘In some ways I had known this for a long time although it was still a shock to think about him undergoing surgery.’
While Lucas had been referred by his GP to an NHS Gender Identity clinic, he was facing a two-year wait for surgery.
The realisation led him to London Transgender Surgery where, after counselling and assessments, he started on a course of testosterone prior to the surgery six months later.
Costing upwards of £10,000, it was funded by family and friends.
The documentary charts an emotional Karen as over the course of a few months Lucas’s voice deepens and he develops facial hair enabling him to shave for the first time.
‘Little by little Lauren is disappearing,’ she says through tears.
And never more so than the day in May last year when Lucas was due to undergo his breast surgery.
‘We were staying in a hotel and I remember waking up on the day of his surgery and looking over at him while he was sleeping and thinking that another part of Lauren was going,’ Karen recalls now.
‘I had to force my brain not to dwell on it as I had to be strong for him, but it was so hard.’
And equally so for Lucas. ‘Saying goodbye to Mum as I was walking into the theatre was the hardest thing I have had to do as I knew she was saying goodbye to Lauren for good,’ says Lucas.
‘I wrote her a card to read while I was in surgery telling her how proud I was of her. It’s amazing to have a mum who is so accepting — I knew there were people out there in the waiting room who were very alone.’
Nine months on, and Lucas — who is in a relationship with a woman — says that not only are there no regrets but he is happier than he has ever been.
The next step is to decide whether to undergo gender confirmation surgery, in which he has male genitalia constructed.
It is a complex affair and Lucas is in no rush. ‘I had already accepted myself but when I had breasts my issue was how other people saw me. Now I don’t worry about that. So for now I am fine.’
It is a reminder for Karen, however, that her son faces an ongoing battle. ‘It doesn’t end with surgery, he will face challenges throughout his life,’ she says.
‘Watching Lucas go through this makes it clear how strongly you have to feel. I’m proud of his courage.’
She will not, though, put that photograph of Lauren away.
‘Lucas always asks me to but I won’t,’ she says. ‘It’s my reminder of my little girl.’
Transformation Street starts on ITV, Thursday, at 9pm.