Like a crucifixion, Bianca's arms are strapped to a crude plank of wood as she lies on her back on an operating table at Pratunam Polyclinic, Thailand. One nurse snaps instructions at her in broken English while another drags a crumpled pink towel across the floor using her foot, soaking up fluids from the operation before.

This clinic, located in the heart of Bangkok, offers gender confirming surgery (GCS) at an unbeatable price. While most patients can pay upwards of $20,000 USD for Thailand’s top surgeons, trans women from poor socio-economic backgrounds can receive the same operation from Dr. Thep Vejvisith for just $2,100 USD. But for Bianca, who has been dreaming of GCS since childhood, this clinic is a far cry from the hospital where she had breast augmentation back home in the Philippines. In the pocket of a hospital gown, she has snuck a rosary given by her mother as a goodbye gift upon leaving her small rural village in Mindanao. As Dr Thep starts injecting her with large syringes of liquid, it dawns on her that she’s about to do the 2.5 hour-long reconstructive operation on local anesthesia. She begins to pray.

This story unveils the lived experiences of trans women like Bianca for whom Dr Thep's low price point offers a rare lifeline. But it also describes what realities they are faced with once they arrive.

Video, photo and written reporting for CNN. This story is part of a long-term personal project investigating transgender healthcare in Asia, previously featured in Longreads and republished by the South China Morning Post.