From the files of the Lower Manhattan Gender Alteration Center:
Sal Constanza was four years old the first time he saw his father hit his mother. When he was eight he was raped by his older brother. When he was nine, his father sent his mother to the hospital. All of his uncles were abusive husbands, except for his uncle Albert, who was single. When Sal was 13, Albert was revealed to be a serial killer of young boys.
Although derided by his male relatives as a "sissy," Sal was sexually oriented towards women, and engaged in several relationships in college. His girlfriends described him as a "mostly fun guy, but with a dark side to his personality." He never hit them, but his rages were terrifying. He was profusely apologetic afterwards, but the relationships ended shortly thereafter, ended either by Sal himself or by the women in question. All agreed that he accepted the end of the relationship and did not become a stalker.
Sal was Catholic, and attended Mass weekly and confessed regularly. His confessions were increasingly characterized by his belief that the men in his family bore the "Mark of Cain"--a propensity towards violence, particularly aimed at women and children. He described his own life as a struggle with the Mark, a struggle he feared he was losing. His greatest fear was becoming a man like his father. He considered suicide, but knew it was considered a sin by the church. It also seemed to be giving in to his violent nature to be violent against himself.
Shortly after his 21st birthday and college graduation, Sal Costanza presented himself to the Lower Manhattan Gender Alteration Center. He wished to alter his body into that of a petite woman. He described this as the only way to defeat the mark short of suicide. After alteration into a 98 pound woman, Sal took the name Sally and moved to Montreal, fearing to be the target of violence from her male relatives if she stayed in New York.