She sold the salon a few years ago because of financial and health troubles.
In 1986, Ms. Santiago married a man from Santo Domingo, in the Dominican Republic, Héctor Mejía Santana, and used her birth certificate to petition immigration services to allow him to take up residence with her in Puerto Rico. Some officials questioned whether someone who was legally born male should be allowed to sponsor another man’s immigration application, but she won that battle, too.
The marriage ended in divorce a few years later.
In 2008, Ms. Santiago ran unsuccessfully for a Municipal Assembly seat in Carolina as a member of the pro-statehood New Progressive Party, becoming the first openly trans person to run for office on the island.
She published her memoir, “Hand Made: Gender Dysphoria, Soraya,” in 2014, attended international conferences and gave television interviews about gender dysphoria, which she described in medical terms that many people in the transgender community considered archaic.
“My throat has gotten dry from trying to explain that the only difference between a woman and me, is that one comes straight from the factory and mine was made by hand in the United States of America,” she wrote in her book.
She was featured in the documentary “Mala Mala,” which was directed by Antonio Santini and Dan Sickles and had its premiere at the Tribeca Film Festival in New York in 2014. Mr. Santini said that when the film played in Puerto Rico, Ms. Santiago would stand outside the theater with a bag of books to sign and sell.
In the film, she and Ivana Fred, a transgender activist, debate what it means to be trans. Ms. Santiago disliked the emphasis transgender women often put on good looks. “Being a woman is something you carry in your heart and soul,” she said.
She asserted that some transgender women give up living as females once they gain weight, get old and “are no longer the Barbie they aspired to be.”