Liana is troubled because Juan's final surgery will cause him to be excommunicated from the Mormon church, but she ultimately thinks that the sex change saved his life. "I'd rather have my twin around as a man than have to go visit him in the cemetery," she says. Oprah asks Liana if she still believes that Juan is condemned to hell for what he did to his body. "I'm leaving it in the Lord's hands," Liana answers. "I really don't know."

Juan says he no longer considers himself a Mormon. "I live a life that I think my heavenly father would be pleased with. I show my fellow man love and respect."

The rest of Juan's family still struggles with his decision. "When I told my mom that I started transition, she cried," Juan says. Liana says that their mother has been very upset, "Even angry. She's worried about Juan's eternal salvation." The twins' siblings also believe that Juan should have lived out his life as a woman. "I tried that for 32 years," Juan says. "I was miserable the whole time. Once I started the transition, I've never been happier."