London - Gray curls, lipstick, white blouse. At first sight, Ruth Rose looks like a typical elderly woman. But until three years ago, the 78-year-old British pensioner's name was James.
Ruth now wants to undergo a sex change, which would make her one of the oldest people ever to have the procedure.
Ruth is 1.83m tall, has broad shoulders and a deep voice. She was once an officer in the Royal Air Force. She has been a man all her life - at least biologically.
Already at the age of 9 years, the Briton from Sussex in southern England felt as if she were imprisoned inside the wrong body. In the 1970s, Ruth began to wear skirts and dresses - initially in secret.
Four months ago, she began hormone therapy. And now, she is waiting for the long desired, final step - the operation.
Whether Ruth in the end will really be a "complete" woman is still not 100% certain. In early August, she will have her second consultation at the Charing Cross Hospital in London.
Divorced after 42 years
"The first talk was very positive," Ruth says optimistically. "If it works, a long cherished wish will come true. If not, I won't have a hang-up. I am a strong character," she told dpa.
The switch from father and husband to "Ruth" was not easy for her wife and children to accept. The couple divorced in 2003 after 42 years of marriage. Ruth's relationship especially with the younger of her two daughters is difficult at the moment, as she regretfully admits.
"It's mainly because of media attention. The last months were quite hard for them," Ruth says.
Nevertheless, she does not want to stop talking in public about her situation as a transsexual. "I am the voice for other transgender people who experience the same, but feel awkward to talk about it," she says.
At the moment, Ruth Rose is especially happy about her growing breasts. "The doctor said they will progress up to one cup size smaller than my sister's breasts."
The operation is important for Ruth insofar as it would allow her to "clear things up". She is not seeking a sex life as a woman, and she does not have high expectations from an aesthetic standpoint.
"I'm not up for plastic surgery," she says. She also does not wear a wig. "I want to stay myself. I want to look as natural as I can."
If the sex change actually happens, Ruth Rose would be 80-years-old at the time of the operation. When asked if she was scared of the risks, she said: "They said I shouldn't put on weight and must take care of my blood pressure. But I'm in extremely good health."
The operation will cost £2 000, with the British national health system covering the costs.
Such operations are performed only after completing a long process of diagnoses and examinations by psychiatrists and other doctors, a spokesperson for the medical organisation in East Sussex told the BBC. No one can be discriminated against because of their age, the spokesperson added.
The possibility that the sex change operation of a 78-year-old transsexual will be financed by tax money has not been accepted by all the members of the British public.
"That's what I hear again and again," said Ruth. "But no one minds if chain smokers who have asthma and heart problems are treated, right?"
And there is a wonderful example of just how successful a sex change operation can be. Another Briton, the 18-year-old Jackie Green, has only been a woman for two years, and she has reached the semi-finals in the vote for Miss England.