An Antrim woman who is currently transitioning has told how a near-death experience gave her the courage to stop living as a man and be herself.
Joni-Marie Augustine, a portrait artist and clerk at the Royal Victoria Hospital (RVH), always felt she had been born in the wrong body and her feminine mannerisms and appearance often led to her being bullied in her teens.
In an attempt to fit in, she over-compensated by going to the gym every day to bulk up and by adopting more masculine behaviour.
But the 38-year-old was struggling with depression and began to self-harm, leading to a breakdown and a spell in a psychiatric unit.
When a serious cardiac defect landed her in the RVH two years ago and resulted in her heart stopping twice, she decided the time had come to stop living a lie and to transition.
Currently on a lengthy waiting list for the gender identity clinic, Joni-Marie is now living her life as a woman and is happier and mentally healthier than ever before.
"For years I didn't know what was wrong with me. I just knew I was miserable, angry and frustrated and I tended to push people away. It was a very lonely existence," she says.
"As a teenager I felt different. I knew something wasn't right. I liked feminine things and my mannerisms weren't considered male, but I tried to be more masculine to fit in.
"Because I was feminine, I was picked on and bullied for being gay, but I wasn't gay. I was in the wrong body and it made me so unhappy. I had relationships with women who said they were attracted to my feminine side. They thought I was sensitive and felt comfortable with me. They told me I was different from other guys."
The confusion and uncertainty around her identity led Joni-Marie, whose previous name was Jonny, down a dark path of self-harm and suicidal thoughts. Feeling out of control, her life fell apart and she suffered a breakdown.
Joni-Marie was referred to a psychiatrist and slowly began to recover, deciding to refer to herself as non-binary, but even that was a lie.
A brush with death in 2018 was the game-changer that convinced her to let go of the past and finally be true to herself.
"I was working for a charity when I took ill. They knew I had mental health problems and thought I was having a panic attack. I was going in and out of consciousness and wasn't able to stand up, but nothing had been bothering me that day and I knew I wasn't panicking," she says.
"I was taken into hospital and they had to put me out and shock me. My heartbeat was 240 beats a minute. I have an electrical fault in my heart and twice in the hospital my heart actually stopped. When something surreal like that happens, it makes you re-evaluate your life."
Joni-Marie had a pacemaker and an cardioverter defibrillator fitted and spent a month and a half in hospital. Coincidentally, she now works on the same ward she was admitted to.
After she left hospital, she began to dress as a woman and attended her first post-discharge counselling appointment in a skirt and crop top. She also got herself referred to the gender identity clinic, which has a three-year waiting list for surgery and hormone treatment.
In the meantime, she has changed her name by deed poll, a process witnessed by American singer Amanda Palmer, for whom she had previously painted a portrait.
While waiting to be called to the clinic, Joni-Marie has been learning to feel comfortable in her new identity. She was delighted to gather up all her old 'Jonny' clothes and hand them into a charity shop. Since she can wear loose-fitting, vintage-style frocks, dressing isn't an issue.
A pre-lockdown appointment at a women-only hair salon - her first ever - was another moment of joy and she's become adept at applying her own make-up and contouring to disguise her jawline.
One area that has proved problematic, however - particularly during lockdown - is stubble. Regular shaving can't cover a five o'clock shadow and it's been getting Joni-Marie down.
However, Belfast's Beyond Skin clinic had been helping her out by providing laser hair removal treatments, though lockdown and the subsequent closure of salons and clinics put paid to that.
"I can shave as much as I want, but there's still that shadow and I've felt so self-conscious about that," explains Joni-Marie.
"Foundation hides it to a degree, but come the end of the day it's worn off and the stubble's coming through.
"In work I have been able to wear a mask but, still, seeing that (the stubble) has been distressing. I couldn't look at myself without seeing it coming through."
Joni-Marie has booked an appointment with Beyond Skin now that salons and clinics have reopened - and she can't wait to continue her transitioning process.
"It's hard when you know you're one thing but your body is telling you another," she says.
"I've got a few years to work on everything before I have my surgery and hormone treatment, but already everyone around me is seeing a difference - and I don't just mean physically. Mentally, all the issues I had have disappeared.
"My art has changed too. For a long time I projected my feelings into my paintings, so it was like a form of therapy. I got out my anger and aggression. Now it's something I enjoy doing.
"My work colleagues have been fantastic. It means so much to hear them referring to me as 'she'. They never knew Jonny, except the one whose heart stopped beating twice. That's not me anymore. That person is gone and I'm looking forward to the future as Joni-Marie."