But after years of struggle, Alex, an aspiring pop singer, hopes her journey to self-acceptance inspires others.
”I Always Knew Something Was Different”
Born in Lima, Peru, in 1992, Alex was adopted when she was just 16 days old by John and Julie Jinkinson, who brought her home to the U.S. to raise her in their small town of Sheldon, Iowa.
While they raised Alex as the little boy they’d always wanted, over time they found she preferred Barbies to Tonka trucks, related more to girls and displayed mannerisms unlike her male peers.
“She always had a towel on her head,” remembers Julie. “She thought it was her hair – she wanted long hair.”
Adds Alex: “I always knew something was different.”
A Diagnosis That Offered More Questions Than Answers
In elementary school, the family got some answers when Alex was diagnosed with partial androgen insensitivity syndrome, a rare genetic condition where “the male hormones … do not have the full capacity to [develop a masculine] body,” says Dr. Eric Vilain, professor of human genetics, pediatrics and urology at the UCLA school of medicine.
PAIS is just one of many conditions classified as intersex, which – unlike transgender people, whose internal gender identity does not match the sex they were assigned at birth – is when a person’s external or internal sexual organs do not physically fit the typical definition of male or female and “are caused by genetic factors such as mutations in genes that are important to make a fetus develop in the male or female direction,” Dr. Vilain adds.
For Alex, this meant she was born without internal sex organs and ambiguous genitalia; extra skin made her female parts appear male, and the male hormones responsible for having caused her genitalia to appear male also made her overall appearance more masculine.
“Being categorized as a gender that I wasn’t was so confusing,” says Alex.
And it was confusing for her parents, too.
“I was very, very dumb when it came to thinking that this is the way it is,” says Julie.
Adds John: “I never thought anything was different. ‘[Male]’ was on her birth certificate, so it sounded good to me.”
Despite the diagnosis, Alex still struggled with her identity and her inability to fit societal gender norms, especially in a small (population: 5,188), conservative town.
“I felt like I was in a weird psychological thriller,” says Alex, who started to wear her hair longer and sported bright, androgynous clothes in high school. “I was half living in a world that wasn’t a reality to me.”
Between facing bullying in school, where she felt alienated, and her struggle to discover her true self, Alex found herself depressed and in 2011 attempted suicide.
“It was the darkest time I’ll ever have in my life,” she says, adding that professional help and starting to open up about her situation to others helped her get “my spark back,” adding she realized: “You need to live 100 percent as who you are or you’ll never be happy.”
A Look to Match How She Felt Inside
In 2012, Alex began living publicly as a woman and sharing her condition with others.
“It wasn’t a thing of ‘coming out,’ but I realized if I didn’t explain how I was medically different, I wouldn’t be able to live in a way that was true,” she says.
Then last year, she took steps to overcome her physical insecurities. In the spring, she flew to Los Angeles for an appointment with Dr. Toby Mayer, the renowned surgeon at the Beverly Hills Institute of Aesthetics & Reconstructive Surgery.
After their initial meeting, Dr. Mayer performed Alex’s facial feminization procedures: a nose revision to make it more narrow, liposuction on the chin, upper and lower lip augmentations, then a forehead lift, hairline lowering, flattening the bone above her brow and raising the brow for a softer, more feminine look.
Dr. Mayer has been working with transgender and intergender patients (like Alex) for more than 35 and says doing feminization procedures “is very satisfying.”
“It’s one of the most gratifying surgeries that I do,” says Dr. Mayer. “They feel like they’re a woman inside: You’re trying to make the outside of the body match the inside of the person. I can give them what they need.”
When Dr. Mayer started doing these procedures in 1977, he performed “two or three” that year. Now, it’s at least one a week.
“It’s what they feel inside, and we’re able to help them,” adds Dr. Mayer. “Just like regular doctors, we’re trying to eliminate pain and suffering.”
Claiming Her New Identity
In addition to her facial feminization at the Beverly Hills Institute, Alex got a breast augmentation and genital surgery – and now she feels “at peace.”
“Everything’s normal now,” she says. “I don’t have to look at myself and wonder why I look so different. It helped me grow more confident and become the person that I am. I’m the same person, it’s just my outside appearance is matching the inside. I fought for so long, I can finally live. And I feel more alive than ever.”
Still living in Sheldon, Jinkinson is pursuing her passion for entertainment, has been recording in Los Angeles and Chicago and plans to release new music later this spring under the name Ali J.
Her hope is that her experience will inspire others to live their authentic lives.
“I viewed my situation as a curse. Now I look at it as something that made me stronger. It’s liberating,” she says. “You’ve got to be proud of who you are and your journey.”