Yiliam Gonzalez, left, speaks with her mother, Janeth Anchia, as they clean dishes in a friend's home in Havana on March 5. Gonzalez is one of eight transsexuals to undergo a sex change, paid for by Cuba's universal health care system.

Yiliam Gonzalez has her hair done by a stylist in Havana on March 5. She has said that before getting the controversial operation, she hated looking at her own reflection.

Janeth Anchia watches her daughter Yiliam Gonzalez get her hair done in Havana. Gonzalez is living proof of a remarkable change taking place in Cuba, a country where, in the 1960s, homosexuals would often be fired from state jobs -- or even imprisoned.

Yiliam Gonzalez plays the piano at a neighbors home in Havana. Gonzalez, a 28-year-old wedding pianist, underwent the sex change procedure in 2008.

Yiliam Gonzalez attends a ceremony at the Russian Orthodox cathedral in Havana. She was one of eight Cubans to undergo the sex-change operation under a program begun in 1988 — then suspended for two decades, after many complained the communist government had better ways to spend its scarce resources.

Yiliam Gonzalez shows her ID showing her former name, William, in Havana. She is currently waiting for permission to legally change her name to Yiliam.

Yiliam Gonzalez, second from right, and her mother Janeth Anchia, left, visit with neighbors in Havana. Mariela Castro, Cuba's top gay-rights activist, said recently, "There has been a lot of resistance because homophobia remains strong in our culture."