Emmie Smith has documented herself undergoing gender reassignment surgery on film.
She invited National Geographic photographer Lynn Johnson in the room to capture the procedure in order to help others understand what the surgery involves.
The magazine has released a video detailing the experience, including interviews with Emmie, her identical twin brother Caleb, her mum, and her plastic surgeon.
Speaking in the video Emmie says: “The thing I really remember about coming out, was I was in a play. I went to rehearsal, and they were getting my pronouns right, they were using my name.
“It was just a totally different world. It was incredible. If I was not out, I’m not sure I’d be alive right now.”
Despite knowing she wanted to be a girl, Emmie wasn’t always sure she actually wanted to take surgical steps to change her body.
“When I thought about why I eventually wanted to get this surgery, because I really didn’t at first, I think the reason that I ended up really wanting it to happen, started being something more out of convenience,” she explains.
“As it started to get more real and I got the surgery date and all that, I found a million reasons why I wanted it to happen.”
Emmie’s mother, Kate Malin, a reverend in the family’s Episcopal church, has been very supportive of her daughter.
“I was the one in the know, and all of a sudden I didn’t know anything and it was frightening and it was other and I didn’t want my child to hurt or be hurt or be judged.”
On August 30, 2016, Emmie, formerly Walker, went under the knife for her surgery.
As the camera rolls a surgeon explains: “The glans penis becomes the clitoris, the skin of the penis becomes the labia minora and part of the opening of the vagina.
“The scrotal skin is taken off and used as a skin graft … That’s going to be the lining of the vagina.”
Emmie is now fully recovered and looking forward to the future as she prepares herself for college in September.