Imagine looking in the mirror as a young child and having no connection to that face that stared back at you. Imagine feeling like you will never find your rightful place in this world. Imagine never being accepted for who you are on the inside because of how you look on the outside. This is the reality for Virginia prison system inmate Ophelia De’Lonta, and the estimated millions like her around the world who suffer from gender identity disorder (GID).

GID, or a conflict between physical and mental gender, is directly related to gender dysphoria, or being uncomfortable with one’s gender. De’Lonta, who won a court order that demands all prison personnel address her with female pronouns, has been battling GID since childhood. The 50 year-old has been in and out of prison because of her attempts at robbery, failed efforts, she says, to fund sex change surgery. “It’s like if this doesn’t exist, then I won’t have any more problems,” De’Lonta told the Associated Press referring to her male organs.

Like many who suffer from GID but don’t have the means to properly address the disorder, De’Lonta recently resorted to self-treatment. More than once she has attempted castration. The most recent attempt was nearly fatal and required 21 stitches to correct.

Currently, the few treatments for GID include hormone therapy and surgical correction of the sex organs. De’Lonta and with five other inmates in different correction facilities are approaching federal court, claiming the state of Virginia has failed to provide them with sufficient medical care.

Recently, GID has been in the news and a hot topic in popular culture. Talk show hostess Oprah Winfrey even dedicated a show to the subject in her final season by inviting international transgender supermodel Lea T for an interview.

“Medically, it’s a disorder…when you go to the doctors, they realize you don’t have any homosexuality, because your brain is like a woman’s brain,” Lea T said, as she clarified GID for the public.

Still, for those who can’t afford the procedures and hormones to help correct the disorder, GID can be as detrimental as any disease faced by majority of the population. De’Lonta is not giving in and has made it clear that she is not ruling out another effort at castration. Aware that she may not survive the next attempt, De’Lonta told the New York Daily News that “in the end I would have peace.”