Rose became the first openly transgender wrestler to sign with a major American professional wrestling promotion when she signed with All Elite Wrestling (AEW) in February 2019. Rose made her AEW debut at the promotion's inaugural event, Double or Nothing. Her scheduled triple threat match against Dr. Britt Baker, D.M.D. and Kylie Rae was turned into a fatal four-way match with the surprise addition of Awesome Kong. Rose was not involved in the decision, after spearing Kong into the ring steps shortly before Baker pinned Rae.