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Angel gradually concluded that he did not need a penis because it is not what defined him as a man.He learned to love his body, and he came to be satisfied with what he was given.

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This was not well received by his family, and according to Angel, "They were going to put me in a mental institution." Unaware of the existence of treatments for gender dysphoria such as hormone replacement therapy, he lived for years as female, during which time he took drugs and drank alcohol.

Though he was employed as a female professional model, he was generally dissatisfied with his identity and existence, and "was not loving life".

Eventually, he was taking 1-cc doses of testosterone every 10 days.

Afterward, Angel began focusing on his physical appearance and searched for a surgeon that dealt with upper-body modifications, to remove his breasts.

He is the founder of Buck Angel Entertainment, a media production company.