A Denver man is facing felony charges for performing unlicensed gender confirmation surgery on a transgender woman. James Pennington was arrested last Thursday, one day after using a Army surgical kit to remove the testicles of a woman being identified as "Jane Doe," despite his not having a medical license.

He was charged with first-degree assault after confessing to using a scalpel and local anesthesia to perform the 90-minute procedure in Doe's apartment with her wife present. For post-op care, Pennington told them to call 911 if complications arose. Just a few hours later, when Doe's wife attempted to change the dressing, "a large amount of blood poured out of the incision," according to reports.

She waited several hours before contacting emergency services, by which time the testicles could not be re-attached.

In a letter obtained by KUSA, Doe insisted she was not Pennington's "victim."

"I am not a victim of 57 year old James Lowell Pennington who is the suspect in this case," she wrote. "I am a victim of a society and healthcare system that focuses on trying to demonize transgender people and prevent us from getting the medical transition we need instead of trying to do what is best for us. Arranging a back-alley surgery was out of pure desperation due to a system that failed me."

With trans people disproportionately uninsured and living in poverty—and most insurance plans not covering transition-related procedures—Jane Doe's experience is tragically not unique: In March, Oneal Ron Morris was sentenced to 10 years for injecting toxic substances—including tire sealant,Super Glue and cement—into trans women who couldn’t afford traditional cosmetic surgery.

"Until this system is fixed and transgender people are encouraged and able to get the care we need," Jane Doe concluded, "there will always be cases like me."