When she was in her teens, Yumiko Higuchi was suicidal.

The Niigata native says she was always loath to put on the traditional sailor-style school uniform for girls. Tormented by a growing sense of gender discomfort, the teenager had a morbid tendency to slit her wrists and overdose on drugs.

The former troubled schoolgirl is now Kazuki Osawa, a 26-year-old civil servant in Tokyo who still remains legally, and physically, female but looks and sounds male due to twice-monthly hormone injections.