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They operate the same way in West Pedowood. They have a battery of shrinks and trans activist who love bomb potential new recruits to Cybele, they stick with the confused newcomers until their surgery is done after which they're on their own - and a high % take their own lives within a year.

Example:

LA TIMES sportswriter Mike Penner > "Christine Daniels"

https://en.wikipedia.org/wiki/Mike_Penner