This was not well received by his family, and according to Angel, "They were going to put me in a mental institution." Unaware of the existence of treatments for gender dysphoria such as hormone replacement therapy, he lived for years as female, during which time he took drugs and drank alcohol.
Eventually, he was taking 1-cc doses of testosterone every 10 days.
Afterward, Angel began focusing on his physical appearance and searched for a surgeon that dealt with upper-body modifications, to remove his breasts.
He is the founder of Buck Angel Entertainment, a media production company.
A trans man, he received the 2007 AVN Award as Transsexual Performer of the Year; he now works as an advocate, educator, lecturer, and writer.
Angel gradually concluded that he did not need a penis because it is not what defined him as a man.
He learned to love his body, and he came to be satisfied with what he was given.
The numerous psychiatric therapies that followed his fall eventually brought him back into society after encountering the first therapist, out of many, that stated he was a man.
This concurrence was one of the first discussions that didn’t ostracize and generalize him as being a “gay woman.” Rather, he was embraced by his therapist, who shared the same view point of him identifying as a male.
This was because Angel was one of the earliest—but more modern—cases of female-to-male patients, because there was limited data on prior cases like his.