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CLEVELAND -- By all appearances Zack Pichler is your typical guy. He's a sports fan and loves watching the Cleveland Gladiators. His dream hot rod of choice is a 1969 Chevy Camaro SS. And on weekends, Zack loves taking in the latest action flick. But that's where appearances end. A look into Zack's photo album reveals he started life as "Amanda," a girl.

But at a very young age, she already hated everything about being a girl.

At 17, Zack is making a permanent life-altering decision to look more like a man. He is going to have a double-mastectomy. He found a world renowned surgeon in his own backyard, Dr. Daniel Medalie at MetroHealth Medical Center.

Medalie specializes in female-to-male surgery. His ability to sculpt a masculine chest is in high demand.

"This has increased dramatically over the last 10 to 15 years, probably with the rise of the Internet and the rise of information," said Medalie.

The once taboo subject, turned more culturally acceptable for some, has patients travelling to Cleveland from as far away as Australia, Singapore, India, parts of Europe and Canada.

Medalie has also helped patients from parts of the Middle East, where being transgender is a crime.

Zack shows off a countdown on his phone. It is counting down second by second to his surgery.

"It's like when you are a kid and you're going to Disney World, but you have to wait a month. It's like that. It's my Disney World," Zack explained.

Zack is hoping that by looking more like a man, this will help others treat him the way he sees himself.

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