On March 15, the day of the Los Angeles Marathon and myriad street closures, Bruce Jenner left his bunker-style home above Decker Canyon in Malibu at 4:15 in the morning to avoid any possibility of being late. Detection seemed unlikely this early in the day; even the paparazzi go back to their wormholes for a few hours’ sleep before the body count begins again.

But anything could happen, as it had in January of 2014 in the space of roughly five feet from the back door of a medical office to the car, with Jenner’s neck in a bandage from a tracheal shave, his picture snapped and disseminated into the Internet infinity of insatiable gossip at warp speed. So the more nondescript the car the better, which is why the black 2014 BMW sedan, in the conspicuous consumption of Los Angeles, was inconspicuous.

Jenner had already been taking hormones. The hair on his body and his facial hair had been removed. He had had his nose fixed twice and the tracheal shave. On this Sunday his destination was the office of a surgeon specializing in what is known as facial-feminization surgery. Pioneered in the 80s and 90s by San Francisco plastic surgeon Douglas Ousterhout, it can involve such procedures as hairline correction, forehead contouring, and jaw and chin contouring. There would also be a procedure to augment his breasts.

Photograph by Annie Leibovitz.

The car made its way to the surgical center in Beverly Hills without incident. Jenner was nervous. He knew there would be pain, and he hated taking any kind of drug to alleviate it because of the way it made him feel. But there was more than just physical dread. Several days earlier I had walked with him as he played golf at the exclusive Sherwood Country Club, in Thousand Oaks. He has been a member there for 15 years, ever since Kris Jenner, feeling generous toward her husband, paid the roughly $225,000 initiation fee. He played by himself because he almost always played by himself, a loner who said he wasn’t lonely, although it was hard to see the difference. He didn’t take his game very seriously: he could have been a scratch golfer if he had. He often played two balls at a time, voicing the usual golfer epithets of “Sit!” and “Get down!” He liked the peace of it, the Santa Monica Mountains safeguarding the holes like a cupped hand. It was perhaps the only open space he could go to without getting besieged by the paparazzi, not only with their cameras hanging from their necks like evil eyes but also with their questions: “Are you a woman yet?” “Do you still have a penis?”

“You wonder if you are making all the right decisions,” he said as he played in the anonymous uniform of blue sweater and gray slacks and hat and sneakers, parring the 517-yard par-five second hole because he, as usual, drove it at least 280 yards off the tee, being the kind of athlete who can pick up anything instantly. “I wish I were kind of normal. It would be so much more simple.

“The uncomfortableness of being me never leaves all day long,” he continued. “I’m not doing this to be interesting. I’m doing this to live.” Given his sense of humor, he couldn’t resist adding, “I’m not doing this so I can hit it off the women’s tee.”

After all the confusion and shame and self-conflict and dishonesty for virtually all of his 65 years, was this the right decision? Could he go on living as he had?

He was not having genital surgery. There are an estimated 700,000 transgender women and men in the United States; only about a quarter of transgender women have had genital surgery. There is a common misperception that such surgery is somehow “required” to be a transgender woman or man, akin to a certificate from the Transgender Licensing Board. The transgender community for years has been trying to get the public to understand that genitalia are not a determinant of gender: you can be born a woman with male genitalia, just as you can be born a man with female genitalia. In any case, under the World Professional Association for Transgender Health’s “Standards of Care,” formed by a consensus of leading psychologists and medical specialists, genital surgery is not advised for at least a year after transition.

Jenner had actually gone through various stages of transition once before, in the mid- and late 1980s. He took hormones that resulted in breast growth and had his beard removed through an incredibly painful two-year regimen of electrolysis that he withstood without any medication because “pain is kind of, for me, part of the pain for being me … this is what you get for being who you are. Just take the pain.”