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In the series premiere, life coach and transman Tony Ferraiolo helps 23-year-old Elexis through the difficult process of deciding whether or not to live as a man. Later: Elexis considers permanent surgery and meets with a hormone replacement specialist before ultimately coming to a final decision about whether or not to transition to "Matthew."

Tony helps 23-year-old Robert, who is considering living as a woman. Later: Robert tries out wigs; meets with a gender therapist and faces going out as his female self "Echo" for the very first time in conservative Baytown, Texas before deciding whether or not to reveal his true self to his brother and religious mother and continue his transition to become "Echo" full-time.

Tony helps 20-year-old Aaron, who is considering living as a woman for the first time. Later: Aaron gets a makeover; goes out in a nearby town as a woman; and visits a plastic surgeon before deciding whether or not to come out as trans to his college friends and family and continue his transition to become "Erin" full-time.