If you take a look at teenage sweethearts Katie Hill and Arin Andrews, they would seem like any other young couple, but the truth is both were born the opposite sex.
The pair spent their childhoods trapped in the "wrong bodies" and battled years of bullying at school.
Andrews, 16, was born a girl named Emerald, a talented ballet dancer who was a champion at beauty pageants. Girlfriend Hill, 18, grew up as a boy called Luke who struggled for 15 years to accept her "boy body," the Mirror reported.
But the couple, from Tulsa, Oklahoma, met and fell in love after each discovered they were transgender and had begun the sex swap process.
High school graduate Hill has finished a course of female hormones, which has helped her to naturally develop breasts without the need for silicone implants.
"We're perfect for each other because we both had the same troubles growing up," she said.
"We look so convincing as a boy and a girl, nobody even notices now," she added.
Speaking of her years of torment at being born the wrong sex, Hill said: "Even from age three, I knew deep down I wanted to be a girl.
"All I wanted was to play with dolls. I hated my boy body and never felt right in it. I kept my feelings a total secret growing up and was petrified of what people in our tiny Christian town would say. Now Arin and I can share any problems we face together," she said.
Andrews said that he knew he was a boy inside from his first day at school, aged just five.
"Girly things didn't interest me, but I was worried what people would think if I said I wanted to be a boy, so I kept it secret," he said.