[5] She made her runway debut at New York Fashion Week Spring 2015, walking for both Hood By Air and Eckhaus Latta, and subsequently became the first openly transgender woman signed to IMG Models.

Gittel's character is a Pfefferman family ancestor who lived her life as a cross-dresser in Berlin, Germany during the Weimar Republic and eventually was murdered during the Holocaust.

[12] Creator Joey Soloway wrote the part for Nef after the two connected on social media and attended a PFLAG party together.

[17] In 2022, Nef starred in the comedy film 1Up, alongside Ruby Rose, Paris Berelc, Taylor Zakhar Perez, and Nicholas Coombe.

[19] Later that year, Nef returned to the stage and starred in Denis Johnson's play, Des Moines, at the Polonsky Shakespeare Center in Brooklyn.

[20] She performed in Thomas Bradshaw's debut of his adaptation of Anton Chekhov’s classic play, The Seagull, alongside Parker Posey, Patrick Foley, and Nat Wolff in spring 2023.

"[24][25] Nef wrote a regular sex advice and experience column for Sarah Nicole Prickett's Adult magazine.

[29] In 2015, she again walked shows during New York Fashion Week, including Adam Selman, VFiles, Vejas, Degen, and Eckhaus Latta once more.

[37] In January 2017, Nef starred in a television commercial for the L'Oréal Paris True Match line alongside Blake Lively, Lara Stone, and Xiao Wen Ju.