Transition is a change of identity for the person who goes through it, and also for all the people who surround that person. "I'm glad for my story to be a public narrative where things worked out," Jenny said. "You know, boy meets girl, boy is girl, girl meets girl, girl stays with girl. That age-old tale. The biggest change for me is not going from male to female: it's going from someone who has a secret to someone who doesn't really have secrets anymore. It's unimaginably difficult to know that other people consider your fondest of dreams and greatest of sorrows (a) incomprehensible and (b) hilarious. A double life is exhausting and ultimately tragic, because you can't ever be loved if you can never be known." People often question a trans person's authenticity in his or her affirmed gender. "I call myself a gender immigrant," Jenny said. "I'm a citizen of this land of women. But it is true that I was born somewhere else. I came here, and I got naturalized." Jenny laughed slyly. "Or unnaturalized, as the case may be."

In the summer of 2000, Jenny decided to tell her mother, who was then eighty-four years old. "I thought Mom was going to be resilient," Jenny said. "But resilient resilient means that someone snaps back after a blow, and I was aware that it was going to be a blow. She was bewildered, so I started to explain it, and I began to cry." I met Hildegarde Boylan when she was ninety-one, and as we all sat together, she said to Jenny, "You waited until five o'clock when we were having a gin and tonic. Then you just said, 'I always wanted to be a girl, and I didn't know how to tell you, because I didn't think you'd love me anymore.' Then I broke down and said, 'I'll always love you.'" Hildegarde experienced considerable difficulty at the beginning. "He'd led a perfectly normal life," she assured me. Jenny protested, "I was never perfectly normal." Hildegarde laughed. "I was a Cub Scout leader and he was a Cub Scout." It took Hildegarde some time to be ready to tell her friends, but about a year after that conversation she had a party to introduce her daughter. She turned to Jenny. "You were surprised when all of means that someone snaps back after a blow, and I was aware that it was going to be a blow. She was bewildered, so I started to explain it, and I began to cry." I met Hildegarde Boylan when she was ninety-one, and as we all sat together, she said to Jenny, "You waited until five o'clock when we were having a gin and tonic. Then you just said, 'I always wanted to be a girl, and I didn't know how to tell you, because I didn't think you'd love me anymore.' Then I broke down and said, 'I'll always love you.'" Hildegarde experienced considerable difficulty at the beginning. "He'd led a perfectly normal life," she assured me. Jenny protested, "I was never perfectly normal." Hildegarde laughed. "I was a Cub Scout leader and he was a Cub Scout." It took Hildegarde some time to be ready to tell her friends, but about a year after that conversation she had a party to introduce her daughter. She turned to Jenny. "You were surprised when all of your your close friends accepted it so readily. So I thought it worth trying close friends accepted it so readily. So I thought it worth trying my my friends. I hadn't even heard the word friends. I hadn't even heard the word transgender transgender so I just went with so I just went with Jenny Jenny. It's impossible to hate anyone whose story you know." Hildegarde leaned forward as if to tell me a great confidence and said the only thing she could never accept was Jenny's shoulder-length blonde hair. Turning to Jenny, she said, "If I tell you this, you'll cut your hair tonight when you go to bed: Ann Coulter has your hair." Jenny said indignantly, "So does Laura Dern, and she's a movie star!" impossible to hate anyone whose story you know." Hildegarde leaned forward as if to tell me a great confidence and said the only thing she could never accept was Jenny's shoulder-length blonde hair. Turning to Jenny, she said, "If I tell you this, you'll cut your hair tonight when you go to bed: Ann Coulter has your hair." Jenny said indignantly, "So does Laura Dern, and she's a movie star!"

Jenny had come out to her sister, who was living in England, six months after telling her mother. "She was the last major, important figure in my life that I came out to," Jenny said. "I mailed her this lengthy letter, and she wrote back basically, 'I don't want to get to know this Jennifer.' A year later I got a letter from her daughter Eliza, who's ten, saying, 'I don't understand this, I'm scared of this.' I wrote her back, 'I'm sorry you're scared. I know it's confusing. My love for you hasn't changed and I hope, in time, you'll get used to me.' My sister called a week later, furious. How dare I write her daughter a letter like that? Finally she said, 'What we would like is to be left alone.' I said, 'I'll always love you.' That was seven years ago now. I remember thinking, 'Well, now it's going to be as hard for Cindy as it used to be for me.' She and all the people I loved would have to go through years of learning how to talk about this. That fear I carried all those years-the shame, the secrecy, the inability to tell someone else-is what I gave to my mother and sister."

In her Jim days, Jenny had hoped that she could fall in love with a woman and learn to be happy being a man. "We are who we are as a result of who we love," Jenny said. She smiled her bright smile. "I'd always prayed for love to save me, and in a weird way, it was was love that saved me, although not in the way I expected. The love of Dede as well as the love of my family didn't keep me a boy, but it gave me the courage to know that if I did come out, it would be okay. Love didn't enable me to stay a man. It was love that enabled me finally to tell the truth." love that saved me, although not in the way I expected. The love of Dede as well as the love of my family didn't keep me a boy, but it gave me the courage to know that if I did come out, it would be okay. Love didn't enable me to stay a man. It was love that enabled me finally to tell the truth."

Responding to advocates for allowing children with persistent gender dysphoria to transition, the bioethicist Alice Domurat Dreger wrote, "Changing a kid's name and gender identification at the age of five or six? This approach takes gender claims of little children so seriously that it's actually beholden to a ridiculously strict notion of gender. The great majority of young children who declare they are a gender that doesn't match their birth sex grow out of the mismatch. Young girls who declare in word or behavior that they are boys end up all over the place, which at some level proves proves to me most really to me most really are are females. Sex-changing interventions are nontrivial. They involve substantial physical risk, including major risk to sexual sensation, and a lifelong females. Sex-changing interventions are nontrivial. They involve substantial physical risk, including major risk to sexual sensation, and a lifelong commitment to trying to manage hormone replacement. The problem is commitment to trying to manage hormone replacement. The problem is us us and the way we demand certainty from and the way we demand certainty from them, them, the way we insist on conformation to a two-sex model as early as possible." the way we insist on conformation to a two-sex model as early as possible."

Josie Romero and Tony Ferraiolo were adamant about who they were almost from infancy; Jenny Boylan knew but tried to repress the knowledge; but many others are deeply confused. Parents must determine whether such children are in a transient obsession or expressing a fundamental identity; they must guess what will make their child happy when he or she is grown, and how best to accomplish this. These balances are hard for parents to achieve: to supervise without presiding over, to caution but not demand, to impel but not insist, to protect but not throttle. Parents must take care not to squash their child's identity, nor to build it up so much that they create the truth to which they intend to respond. In Mom, I Need to Be a Girl, Mom, I Need to Be a Girl, Just Evelyn wrote of her child, "I knew his life would be difficult and sad. How could a mother help, and would a mother's love be enough?" Many parents are willing to do what it takes for their children to be happy, but it isn't always possible to know what it takes. Just Evelyn wrote of her child, "I knew his life would be difficult and sad. How could a mother help, and would a mother's love be enough?" Many parents are willing to do what it takes for their children to be happy, but it isn't always possible to know what it takes.

Abrupt, decisive transformation occurs regularly in fairy tales, fantasy literature, and comic books, but not in most real lives, where change tends to be gradual and incomplete. In her memoir The Woman I Was Born to Be The Woman I Was Born to Be, transwoman Aleshia Brevard writes, "I consciously tried to create a boy child who might be worthy of love. Painstakingly, I tried to mimic the acceptable traits of other males around me. I knew, and so did my daddy, that the mimicry was a sham." In her poignant book Transparent, Transparent, Cris Beam writes about a Latino transgirl who named herself Ariel after the heroine of Cris Beam writes about a Latino transgirl who named herself Ariel after the heroine of The Little Mermaid The Little Mermaid. "Ariel had to go talk to her father, who turned her into a human being for real," the girl explained. "I want to go through the story just the way Ariel did it, turning into a real girl and getting the guy." But struggling to become who you've always been and be loved anyway is a continuous process, usually marked with ambivalence.

Hendrik and Alexia Koos grew up in South Africa and emigrated to Canada shortly before the end of apartheid, choosing a fairly small community where Hendrik's abilities as a GP might prove valuable. Both parents knew that their eldest daughter, Sari, was unhappy; she'd been diagnosed with ADD, a learning disability, and an anxiety disorder. When she announced, at fourteen, that she had "the wrong body," Hendrik was terribly upset; it seemed like just another stab in the dark.

When we spoke, a little more than a year had passed since Sari had become Bill, and Hendrik seemed to be holding his feelings just in check. "We started reading, and we found out that there were guidelines and ages, and he was younger than these guidelines, and he was really pressuring us," Hendrik said. "I almost felt impotent as a parent. What was I supposed to do? I could say, 'You're a kid; you have to be patient.' Or I could listen to my child. I've never wanted to pressure my children; my best dream for them is to be themselves. But I was so worried, I was exhausted by it." Bill himself was anxious and ambivalent, and that made everything harder. I had become interested in interviewing Hendrik after hearing him question the adult trans people on a panel. "They were so self-confident, so full of 'I am who I am,'" he said to me. "People said, 'Once your child can be who he is, you'll see a new person.'" Hendrik laughed. "No. It was a few steps forward, a few back. Overall the steps forward are more, but it's an ongoing fight to gain good ground." become Bill, and Hendrik seemed to be holding his feelings just in check. "We started reading, and we found out that there were guidelines and ages, and he was younger than these guidelines, and he was really pressuring us," Hendrik said. "I almost felt impotent as a parent. What was I supposed to do? I could say, 'You're a kid; you have to be patient.' Or I could listen to my child. I've never wanted to pressure my children; my best dream for them is to be themselves. But I was so worried, I was exhausted by it." Bill himself was anxious and ambivalent, and that made everything harder. I had become interested in interviewing Hendrik after hearing him question the adult trans people on a panel. "They were so self-confident, so full of 'I am who I am,'" he said to me. "People said, 'Once your child can be who he is, you'll see a new person.'" Hendrik laughed. "No. It was a few steps forward, a few back. Overall the steps forward are more, but it's an ongoing fight to gain good ground."

Hendrik said he derived resilience from being a doctor. "From medicine, I learned to understand that life has challenges without always understanding where they come from. I felt, 'I'm not going to try to remedy remedy my child's mind.'" Hendrik's second source of strength was even more striking. "As a white person coming of age in apartheid, I wanted to get rid of racism in my life, and sexism, and genderism, too. My South African experience was a preparation for learning to say, 'I accept you for everything.'" my child's mind.'" Hendrik's second source of strength was even more striking. "As a white person coming of age in apartheid, I wanted to get rid of racism in my life, and sexism, and genderism, too. My South African experience was a preparation for learning to say, 'I accept you for everything.'"

Although Hendrik Koos's kind openness was different from Rex and Karen Butt's visceral enthusiasm, their children experienced similar ambivalence. Rex and Karen didn't believe in gendering childhood; they brought up their two sons with a toy kitchen and read to them from Letty Cottin Pogrebin's Stories for Free Children Stories for Free Children. "When I had a baby shower, I didn't want blue or pink," Karen said. "We had yellow and green." They told their sons that women could do anything men could do.

Elementary school was lonely for their son Jared, high school was rocky, and Haverford College was not the revelation he had hoped for. One of his friends set him up on a blind date with a girl from Bryn Mawr, with whom he had his first kiss and his first relationship. The relationship entailed sexual expectations that were alien to Jared, and one night his girlfriend walked in on him wearing her clothes. He said, "I think life would be a lot easier for me if I was a girl." She replied, "Oh, honey, you can't be a girl. Not with that nose." It was said in a tone of fun, but Jared sank into a severe depression. He had won every academic prize at his high school and was valedictorian; now, he was flunking. He had no sex life, and almost no social life. He dropped out and moved home. flunking. He had no sex life, and almost no social life. He dropped out and moved home.

Three months later, he said to his parents, "I think I'm gay." He went out on his first date with a guy and he realized he wasn't gay. He nonetheless decided to attend an LGBT conference for high school kids, partly because he felt as though he had stopped growing up and was in effect still a high school student, even at twenty-two. He dropped into the Transgender 101 panel. Two days later, he and his mother were out shopping, and he asked her to pull over so he could tell her something. "It's something big, isn't it?" she said. He told her he was trans, that that was his life path. She said, "Oh, why would anybody want to be a woman? It can be so hard being a woman." Later that day, he asked his family to gather so he could tell them; he said he was willing to lose people in his life over it. His younger brother, Chad, said, "That's bullshit. Anybody who would leave your life over this never was really in your life in the first place." Rex said, "I've been so worried about your being depressed. I don't know what the hell trans trans means, but at least you're not irretrievable to me." Jared became Cadence Case. She explained to me, "It's a measure of how supportive my parents were that my father's first question was 'Are you going to be okay if we have to save up to pay for this?'" means, but at least you're not irretrievable to me." Jared became Cadence Case. She explained to me, "It's a measure of how supportive my parents were that my father's first question was 'Are you going to be okay if we have to save up to pay for this?'"

When I met Cadence, eight years after she began transition, she was thirty, and lingering in an intermediate territory. She had long hair, male-typical fat distribution, a tall, lanky body, and no breasts. She wore earrings and gender-neutral clothes. She had endured months of electrolysis but had more to go. Her only surgery was a nose job. I asked how she had seemed before transition. "I was intelligent, compassionate, and not macho," she said. "I never came off as feminine, and I doubt I ever will. And I don't really have a problem with that. I've reached an accommodation where I don't hate myself. If you have a spectrum of gender, I'm sixty, maybe sixty-five percent towards female."

Outsiders tend to think of the urgent surgery as being genital, but that is often not the feeling of trans people. "Facial surgery is the gateway to living full-time," Cadence said. Rex and Karen had found surgeons for genital procedures, but Cadence didn't call them. Her parents interpreted her delay not as reluctance, but as unhappiness. "For a long time, she was too depressed to deal with it," her mother explained. Rex said wryly, "We're more in a hurry than she is sometimes."

Karen was reprimanded by the head of the school where she taught for talking about Cadence's transition where she could be overheard, and she was furious. "No one tells me not to talk about my kid," she said. Rex said, "I'm more activist about this than I've been about anything. It really is how I identify myself." Rex and Karen cofounded a local chapter of PFLAG-Parents, Families, and Friends of Lesbians and Gays, a group that now includes families of trans people. When I last saw them, they had just been invited to be grand marshals of the 2009 Mid-Hudson Gay Pride Parade. Rex asked the board president why they would want them in such a role, and she wrote back, "Because you love your child." Cadence said, "I think they're more comfortable with my being trans now than I am. They're just far left, while I'm radically farther left. But I don't do as much about it." It really is how I identify myself." Rex and Karen cofounded a local chapter of PFLAG-Parents, Families, and Friends of Lesbians and Gays, a group that now includes families of trans people. When I last saw them, they had just been invited to be grand marshals of the 2009 Mid-Hudson Gay Pride Parade. Rex asked the board president why they would want them in such a role, and she wrote back, "Because you love your child." Cadence said, "I think they're more comfortable with my being trans now than I am. They're just far left, while I'm radically farther left. But I don't do as much about it."

Parents such as Rex and Karen encourage their children to use therapy to explore gender issues; others, though, turn to therapy in the hope of deterring such exploration. The choice of approach will depend not only on the child's needs, but also on the parents'. Reparative therapies-psychological, religious, sometimes biological-remain ubiquitous, and the parents who seek such treatment for their children are generally motivated by sincere conviction. Stephanie Brill said, "Everybody loves their children, but they have different ideas of how to help them." She encourages parents to meet other parents and find a new normal that includes their experience. "They don't have to condone their child's wearing nail polish; it's not about arguing about what's appropriate in church," she said. "It's about expressing love, which is reassuring to the child, and also, actually, to the parent." People whose lives have been bound by strong gender conventions, however, often believe that hewing to social norms will protect their children from abuse in the world. That very notion can constitute abuse inside the family.

Jonah and Lily Marx live in New Jersey, within commuting distance of New York, but said that they did not know anyone who was gay, much less anyone who was trans. Nothing they said indicated that their son, Caleb, wanted to be a girl; he did not insist on wearing dresses, did not hate his body, had never said he was female. When I suggested a therapist who could help Caleb figure himself out, Lily said, "I need to find someone who persuades people not to have a sex change operation. That's all I can think about. Now it's third grade. The boys get tougher. The girls don't really want to play with boys anymore." But then Lily recounted, "One of the moms said, 'When we got the class list, my daughter put a thumbs-down for every boy except Caleb.' So he's not weird enough that no one likes him."

Occasional teasing seemed not to bother Caleb much; it bothered his parents, who were challenged imagining a happiness so different from their own. "He hates team sports," Lily said. "But he loves to boogieboard, ice-skate, and swim, and he dives competitively." Jonah said, "He's a very happy boy, very comfortable in his own skin. He likes ceramics and photography, but he won't do Little League or use a urinal." Lily said, "He has almost no male friendships. Middle school could only be worse. My daughter torments him: 'You're acting like a girl.' 'Stop acting weird.' Constantly." Lily and Jonah had decided to get their children a puppy and described how Caleb had responded by jumping up and down gleefully and "effeminately." Jonah said, "He's not familiar with how to be excited because he's never been in an environment with other boys who have won a game together." boogieboard, ice-skate, and swim, and he dives competitively." Jonah said, "He's a very happy boy, very comfortable in his own skin. He likes ceramics and photography, but he won't do Little League or use a urinal." Lily said, "He has almost no male friendships. Middle school could only be worse. My daughter torments him: 'You're acting like a girl.' 'Stop acting weird.' Constantly." Lily and Jonah had decided to get their children a puppy and described how Caleb had responded by jumping up and down gleefully and "effeminately." Jonah said, "He's not familiar with how to be excited because he's never been in an environment with other boys who have won a game together."

Caleb went to sleepaway camp and loved it. He had starring roles in both musicals that summer. He loved the counselor who directed them. "When we met the counselor, he had on a tight, purple T-shirt, skinny jeans, and purple Converse sneakers," Lily said. "Definitely out-of-the-box. Caleb came home asking for these clothes. I was not buying him purple sneakers. I have to protect him." I wondered about enrolling him in a local theater program. "I will not play into that," Lily said. Jonah added, "He's got a tremendous physique. He could excel at whatever sport, but he just doesn't have the interest. There's only so much that Lily and I can do to shelter him from what will inevitably be broader ridicule for how he is."

Both parents showed considerable anxiety about a future that they viewed as nearly inevitable. "I mean, he likes one boy," Lily said, shortly after telling me that all his friends were girls. "If you looked at this kid, you would think football player. He's big and tall. But he's very much like Caleb, doesn't play sports. Then there's this one other boy that he's very good friends with. His name is Karl, and he's very athletic. But when's he going to ditch Caleb? Because he's a cool kid, Karl. We love him. So I'm just wondering when it's not going to be okay to be friends with the weird kid." Lily wondered if Caleb's unwillingness to play catch or shoot baskets with his father was connected to his awareness that he's not living up to Jonah's expectations. "I personally think that he knows he's disappointed Jonah," Lily said. "If I asked him to go have a catch, he would. If I asked him to shoot baskets, he would." Jonah said, "Which begs the question as to why you don't." Lily said, with the dignity of her gender and no touch of irony, "Because I don't shoot baskets and play catch."

Caleb had never been trans, but he was mildly gender variant. He came out as gay at thirteen, and almost immediately made a suicide attempt. Sometimes, one becomes fully visible only through catastrophe: Caleb's adolescent despair spurred his parents to renounce efforts to resolve his childhood aberrance. They acknowledged clearly that he was always lovable and loved, and began the steep climb toward rebuilding his battered ego-and their own. he was always lovable and loved, and began the steep climb toward rebuilding his battered ego-and their own.

Reparative therapies for gay people are now deemed unethical by most professionals, but whether reparative therapies for trans people should be regarded the same way is widely debated. Among the most controversial figures in the field is Kenneth J. Zucker, psychologist in chief and head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto, who continues to hold considerable sway and was appointed in 2008 to lead the DSM-5 DSM-5 task force on GID. Zucker contends that natal girls who are trans see their mothers as disenfranchised and therefore wish to be men, while natal boys wish to draw close to detached mothers by becoming girls. Activists believe that the high rate of depression in children denied the right to transition is the result of their struggle to conform; Zucker believes that the wish to switch genders is a symptom of underlying depression. The hypothesis that GID sometimes has social and family origins can be defended. Zucker's views on how to treat GID are much less robust. The conservative Catholic Education Resource Center and the National Association for Research and Therapy of Homosexuality (NARTH) are both indebted to Zucker's work, though they overlay it with Christian ideology. task force on GID. Zucker contends that natal girls who are trans see their mothers as disenfranchised and therefore wish to be men, while natal boys wish to draw close to detached mothers by becoming girls. Activists believe that the high rate of depression in children denied the right to transition is the result of their struggle to conform; Zucker believes that the wish to switch genders is a symptom of underlying depression. The hypothesis that GID sometimes has social and family origins can be defended. Zucker's views on how to treat GID are much less robust. The conservative Catholic Education Resource Center and the National Association for Research and Therapy of Homosexuality (NARTH) are both indebted to Zucker's work, though they overlay it with Christian ideology.

Using techniques derived from the models Phyllis Burke criticizes in Gender Shock, Gender Shock, Zucker instructs parents to model gender roles, pushing these mothers and fathers into behavior consistent with midcentury gender stereotypes. He then asks that they impound cross-gender toys and prevent cross-dressing. Friendships with members of the same gender are to be encouraged, and cross-gender friendships are to be halted. One mother described confiscating Barbies and unicorns from a child who, when given trucks, simply refused to play. When he reverted to drawing, his parents were to take away the pink and purple crayons and insist that he draw boys; in the end, his mother said, he was living a "double life," acting like a boy in front of her, and escaping into a girl world whenever he could. Zucker instructs parents to model gender roles, pushing these mothers and fathers into behavior consistent with midcentury gender stereotypes. He then asks that they impound cross-gender toys and prevent cross-dressing. Friendships with members of the same gender are to be encouraged, and cross-gender friendships are to be halted. One mother described confiscating Barbies and unicorns from a child who, when given trucks, simply refused to play. When he reverted to drawing, his parents were to take away the pink and purple crayons and insist that he draw boys; in the end, his mother said, he was living a "double life," acting like a boy in front of her, and escaping into a girl world whenever he could.

Zucker claims that no patient who began seeing him by six has switched gender; he recently announced that a follow-up study of twenty-five girls he first saw in childhood showed only three with persistent gender dysphoria later in life. At the same time, because adolescents are less malleable than children, Zucker will sometimes recommend hormones and surgery for people who come to him later. He does so with regret. Many of Zucker's patients have determined to live in their birth gender at the end of his therapy, but a recent article in the in the Atlantic Monthly Atlantic Monthly quoted the mother of a Zucker-treated child who doubted her adult daughter, an alcoholic and self-mutilator, would outlive her. It seems overreaching to call this a success. Stephanie Brill said, "In my experience with many people who come to us after seeing Zucker, his work can alter gender expression, but it does not touch gender identity." quoted the mother of a Zucker-treated child who doubted her adult daughter, an alcoholic and self-mutilator, would outlive her. It seems overreaching to call this a success. Stephanie Brill said, "In my experience with many people who come to us after seeing Zucker, his work can alter gender expression, but it does not touch gender identity."

The question is whether trans people, like most gay people, have a fixed identity that only a fool would try to alter-or whether a child born male who says he is really female is like, in Zucker's simile, a child born black who insists he is white, and needs to be eased into accepting himself. Zucker points to the rigid way many trans children adopt the stereotypes of the opposite gender. "There is no joy in their play," he said. "They're struggling, experiencing social ostracism and difficulty establishing friendships with children of their own gender." Zucker feels that the idea of GID as a natal condition not subject to repair is "simpleminded biological reductionism." The therapists who support early transition are, in his words, "liberal essentialists." He explained, "Liberals have always been critical of biological reductionism, but here they embrace it. I think that conceptual approach is astonishingly nave and simplistic, and I think it's wrong."

Susan Coates, former head of the Childhood Gender Identity Project at Roosevelt Hospital in New York, agrees. She said, "I've seen about three hundred and fifty kids with gender issues. They are fundamentally creative, and part of the creativity allowed them to imagine solving their problems by switching gender. My experience is that no one becomes transgender who had treatment early. If you work on separation anxiety and aggression, the gender problem starts to fall away. Anxiety is what leads to gender dysphoria." Zucker and Coates are accomplished academics who have personal integrity, but-like some of the activists who attack them-they seem to imply that universals exist in a field of highly varied stories.

You can damage someone who is trans by preventing him or her from living in his or her true gender; you can damage someone who has GID but will not be trans by trapping him or her in an ill-fitting cross-gender identity. The trans-friendly therapist Michele Angello said, "Parents tell me often, and it's sort of PC, that they are following their child's lead. If your child is seven, you probably don't let them choose what they're going to eat for dinner, let alone if they're going to transition to a new gender. There is a very, very occasional phenomenon where the parents have their own mental health issues and their kid is not the most masculine male, so they've decided that their child is trans. The kid isn't transgender and is being talked into it." Stephanie Brill said, "It's important not to overdiagnose transgender children. That's a very small part of the gender variant population." Brill said, "It's important not to overdiagnose transgender children. That's a very small part of the gender variant population."

When Dolores Martinez was fourteen and still a boy named Diego, living in Massachusetts, his mother caught him with his first boyfriend. "I was in a miniskirt doing the dirty," Dolores said. "I put on my boy clothes again and went downstairs and she said, 'Your father said to be out or he's gonna kill you.' I was on the streets for four years, and I was convicted of a major, violent crime and sent to prison. It saved my life. I spent almost four years in prison happier than ever before. When you're in there, either you're a man, or they'll turn you into a woman. So I was a sister. That was my first experience at being myself one hundred percent." After she was released, Dolores learned that her mother had lied. "She told my father I ran away. When he found out what she'd done, that was their divorce. When I told him about my transition, he said, 'Oh, thank God.'" Dolores spent ten years in therapy before her first hormone shot. Eventually she met Gustaf Prell, a transman who was the love of her life, and they were legally married-under the law, however, she was a man and he was a woman.

When Tyler Holmes was a confused little girl named Serena, she "wished for boy parts," but "didn't really wish to be a boy." She had a brief relationship with a sixteen-year-old, Freddie Johnson, and became pregnant. When their son, Louie, was born, Freddie expressed little interest. But when Louie was two, Freddie's mother began complaining to the Department of Social Services about Serena. Louie's guardian ad litem, ad litem, assigned to look after the child's interests, told Serena to sign something. "I didn't know what it was, and I signed it, and it turned out it was for custody," Tyler said. "I lost my child." When Serena befriended Gustaf Prell and Dolores Martinez soon thereafter, she began to question her allegiance to her own gender. When she was hospitalized for endometriosis, her doctors said it could be treated with an estrogen-based medication, but Serena said that she'd prefer treatment with testosterone, that she really wanted facial hair and a lower voice. She began calling herself Tyler. assigned to look after the child's interests, told Serena to sign something. "I didn't know what it was, and I signed it, and it turned out it was for custody," Tyler said. "I lost my child." When Serena befriended Gustaf Prell and Dolores Martinez soon thereafter, she began to question her allegiance to her own gender. When she was hospitalized for endometriosis, her doctors said it could be treated with an estrogen-based medication, but Serena said that she'd prefer treatment with testosterone, that she really wanted facial hair and a lower voice. She began calling herself Tyler.

One Thursday in 2008, Gustaf, who had always been depressive, went to the emergency room of a local hospital seeking admission because he was suicidal; he was told that no beds were available to a transgender person. He hanged himself two days later, age twenty-seven. Dolores filed a complaint, but the Board of Mental Health found the hospital not at fault. Because transgender people are not a protected class, the ruling stated, the hospital had discretion to refuse them admission if their presence might disturb other patients.

After Gustaf was gone, it seemed natural for Tyler and Dolores to get together. I asked whether the fact that neither of them had made a surgical transition had any bearing on their attraction. Tyler said, "Love and relationships aren't based on what you have underneath your clothes, what pronouns you go by, or the name you use. With Dolores, it's based on the person she is and the way I feel about her, and the person I am and the way she feels about me. Dolores has expressed wanting some form of surgery at some point, but that's her thing as far as when or what she wants." Dolores said, "I see Tyler as a boy with benefits; he straps it on so I can select a size."

In the five years since Tyler relinquished custody, Louie, now seven, has lived with his paternal grandmother. Tyler and Dolores are allowed to see Louie only once a week, for a supervised visit. Tyler said he didn't think Louie had noticed his transition; I felt that Tyler's full beard might have clued Louie in, not to mention Dolores's habit of addressing him with male pronouns. Both Tyler and Dolores were interested in Louie's gendered behavior. Dolores said, "Louie could be like my husband was, where he was a girl one day and a boy the next. He likes My Little Ponies, which we have to sneak in to him because he's not allowed any girl toys. I'm not a doctor, but I think he's genderqueer right now." Tyler said, "He's never said anything about being trans or wanting to be a girl, but I never said anything when I was little." It seemed to me that absent any assertion from Louie that he wanted to be a girl, he was probably not trans. He did, however, do badly with male stereotypes. He inhabited a polarized world with either a terrifying genderlessness or an oppressive genderedness. "He might not know for sure that he's a girl," Tyler said. "He might not know for sure that he's a boy. He might float back and forth from day to day, and that's okay, too. I don't want him to lose twenty-five years of his life like I did."

Perhaps the immutable error of parenthood is that we give our children what we wanted, whether they want it or not. We heal our wounds with the love we wish we'd received, but are often blind to the wounds we inflict. Dolores said, "I want Louie to be comfortable with himself whether he's a male, female, somewhere in the middle. I have a lot more years to fix than a youngster. My life is not what I want for him." Children should be able to be themselves; they also want rules and boundaries, and I feared that Dolores and Tyler's infinitely permissive idea of love might be petrifying to a child. The longing of a child is to be seen, and once the child is seen, he or she wants to be loved for a true self. Dolores and Tyler were full of love unnuanced by seeing. "He's the most beautiful boy that I've ever seen, and probably the most beautiful child on the planet for all I know," Tyler said. "It's cool, because it's almost like I'm transitioning with my son. He has it a little bit better than most trans kids because he has two trans parents. We're not going to let him do it by himself like our parents did. He has people who will go with him." Dolores said, "His transition needs to move forward. I see him living in my yesterday. So hopefully he can learn from my tomorrow." because it's almost like I'm transitioning with my son. He has it a little bit better than most trans kids because he has two trans parents. We're not going to let him do it by himself like our parents did. He has people who will go with him." Dolores said, "His transition needs to move forward. I see him living in my yesterday. So hopefully he can learn from my tomorrow."

The debate over gender identity was once framed as a nature-nurture divide; nowadays, it's an intractable-tractable divide, which is equally hard to call. Clearly nature is involved, but the question is whether nurture enables it, whether it can and should disable it. The answers are frustratingly vague. Psychodynamics has proposed a range of contradictory explanations for cross-gender identification; as Amy Bloom wryly pointed out in her book Normal, Normal, it's either absent fathers and overinvolved mothers, or dominant fathers and submissive mothers; it's parents who encourage cross-gender identification and play, or who forbid and thereby mystify cross-gender identification and play. Some little boys may want to wear dresses because they have brutal fathers who scare them and loving mothers with whom they identify; others may have a condition determined by genetics, brain development, or the uterine environment. it's either absent fathers and overinvolved mothers, or dominant fathers and submissive mothers; it's parents who encourage cross-gender identification and play, or who forbid and thereby mystify cross-gender identification and play. Some little boys may want to wear dresses because they have brutal fathers who scare them and loving mothers with whom they identify; others may have a condition determined by genetics, brain development, or the uterine environment.

Transitioning is still bound up with the medical and therapeutic communities. In the best cases, this means that responsible professionals can separate the fears and desires of the parents from those of their offspring and distinguish between an immutable imperative and a transient neurosis. That can, however, be daunting. Separating the psychiatric, the endocrine, and the neurocognitive seems almost poignantly old-fashioned. Modern psychiatry seeks the chemical pathways of emotional and thought disorders, but attempts to distinguish mind from brain are still primitive, and a condition as complex as GID must be described from multiple angles at once. Heino Meyer-Bahlburg, who serves on the DSM DSM committee, acknowledged that the description of GID "cannot be achieved on a purely scientific basis." committee, acknowledged that the description of GID "cannot be achieved on a purely scientific basis."

In his own practice, Meyer-Bahlburg believes that transition is best avoided if possible. "It's terrible to mutilate a healthy body and make someone infertile," he said. "Sexual functioning is not terrific even in the best cases and is horrific in the worst. There is some feeling that you're enhancing a disorder rather than treating it." He believes in a centrist treatment. "We try to introduce them to more of their same-sex peers," he said, "and if their fathers have already turned into sissy-boy-hating, distant fathers, as happens in this homophobic country, we try to get them to reengage positively and to develop a relationship. Many of these children become more comfortable in their birth gender, and even if they don't, they can have a broader circle of friends and experiences." That said, he has also put children on puberty blockers as early as eleven. "Sometimes, I help patients make the change, and sometimes, in a noncoercive fashion, I try to stop them from doing so," he said. "It's only based on my own intuition; I have no algorithm." Edgardo Menvielle said, "Most young children don't come with a claim about their identity. They are brought because they are different in their gender expression. Whether they should transition or not? You're never really sure you're doing the right thing." Many of these children become more comfortable in their birth gender, and even if they don't, they can have a broader circle of friends and experiences." That said, he has also put children on puberty blockers as early as eleven. "Sometimes, I help patients make the change, and sometimes, in a noncoercive fashion, I try to stop them from doing so," he said. "It's only based on my own intuition; I have no algorithm." Edgardo Menvielle said, "Most young children don't come with a claim about their identity. They are brought because they are different in their gender expression. Whether they should transition or not? You're never really sure you're doing the right thing."

Members of the trans community often fear therapists who steer children away from their true selves; parents are more likely to fear that their children will have surgery and come to regret it. It is impossible to know how many people who have transitioned socially but not physically have transitioned back. We do know, however, that as many as one in a hundred people who have had sex-reassignment surgery wish they had not done so.

Danielle Berry, born Dan Bunten, underwent sex-reassignment surgery in 1992 at forty-three in what she later described as a "midlife crisis." She subsequently said, "I'm now concerned that much of what I took as a gender dysfunction might have been nothing more than a neurotic sexual obsession. I was a cross-dresser for all of my sexual life and had always fantasized going femme as an ultimate turn-on. I just wish I would have tried more options before I jumped off the precipice."

The Iraqi-born Sam Hashimi underwent sex-reassignment surgery in England after his wife left him in 1997. "Trudi had never worked a day of her life," he said. "She'd think nothing of spending a few thousand pounds on a dress. I always used to wonder what it would be like to have none of the responsibility I had, to have doors opened for me and all the privileges a woman seems to have." So he became Samantha Kane. But Samantha found "being a woman rather shallow and limiting" and decided she'd made a terrible mistake. She underwent a painful and unsatisfactory "reversal" of her genital surgery and, after adopting the new name Charles, sued the psychiatrist who had supported the surgical transition.

Such stories are unfortunately used to discredit the trans movement as a whole. Cases of profound postsurgical regret make headlines, while much less space is given to people who would have been much happier with a full surgical transition but were never able to achieve one. Mistakes will be made in both directions, and lives can be ruined either way. Some children who are supported in conforming to a chosen gender identity may later feel trapped by it; their parents and doctors may make misguided decisions about hormone blockers, hormones, or surgery. Other children, not supported for transition, live and die in despair. It is terrible to perform unnecessary surgery on a healthy body, but it is also terrible to deny succor to a mind that knows itself. and doctors may make misguided decisions about hormone blockers, hormones, or surgery. Other children, not supported for transition, live and die in despair. It is terrible to perform unnecessary surgery on a healthy body, but it is also terrible to deny succor to a mind that knows itself.

Far more boys are referred for treatment for GID than girls. However, this does not mean that more natal boys have gender-atypical behavior than natal girls, only that they worry their parents more. Feminism won for women many rights formerly reserved for men. Girls who are aggressive and dominant are often admired; the very word tomboy tomboy has a measure of fondness built into it-though there is no shortage of insults for assertive women. In contrast, no movement seeks to legitimize stereotypically feminine traits in men. Girls can be masculine; boys are effeminate. Girls in jeans and T-shirts wear "unisex clothing," but boys in skirts are "in drag." Kim Pearson described asking that everyone in a parents group who had been a tomboy to raise her hand; hands went up all over the room. She then asked everyone who had been a sissy to raise his hand. No one stirred. has a measure of fondness built into it-though there is no shortage of insults for assertive women. In contrast, no movement seeks to legitimize stereotypically feminine traits in men. Girls can be masculine; boys are effeminate. Girls in jeans and T-shirts wear "unisex clothing," but boys in skirts are "in drag." Kim Pearson described asking that everyone in a parents group who had been a tomboy to raise her hand; hands went up all over the room. She then asked everyone who had been a sissy to raise his hand. No one stirred.

When Scott Earle was a tomboy named Anne-Marie, her parents regarded her toughness as a sign of strength. They were both pediatricians, living in liberal Vermont. "I loved the idea of having a woman unencumbered by limits," Lynn Luginbuhl, Scott's mother, said. Gender irregularities were plentiful in Scott's early life. "As a little girl, Anne-Marie had this beautiful curly blonde hair," Scott's father, Morris, said. "One morning we got up and Anne-Marie, who was eighteen months old, was in her older brother Ben's room, and Ben, maybe five, had cut off all her hair. Ben got in trouble, but later I wondered if Anne-Marie somehow asked for it." Lynn said, "We had this pink, down snowsuit. My mother said to Anne-Marie, age four, 'Oh, you're a beautiful pink lady in that snowsuit.' Anne-Marie refused to put it on. We finally dyed it black, and then she would wear it."

In Anne-Marie's first conversation with other trans people online, when she was fourteen, the name Scott Scott emerged, and she realized that was what she wanted to be called. A few months later, her parents returned from a party to find a letter on their dresser: "Dear Mommy and Daddy, I have to be a guy. I'm trans." Morris recalled, "I didn't even know what that word meant. We walked downstairs to the basement where Scott was watching TV, and I said, 'Is there anything that would make us not think you're one of the greatest people we ever met?'" emerged, and she realized that was what she wanted to be called. A few months later, her parents returned from a party to find a letter on their dresser: "Dear Mommy and Daddy, I have to be a guy. I'm trans." Morris recalled, "I didn't even know what that word meant. We walked downstairs to the basement where Scott was watching TV, and I said, 'Is there anything that would make us not think you're one of the greatest people we ever met?'"

Lynn called some gay friends for advice, but they knew no more about being trans than she did. "I found a therapist who helped make people less inclined to transition physically," she said. "Scott hated her. I had to come to an understanding that he really was going to live as a guy. We eventually found a therapist who had counseled seventy transgender people, and she felt Scott didn't need to see her because he was so clear. I thought I was raising this strong woman, but most eight-year-old girls do not wear boys' underwear." For Morris, the challenge to accepting Scott's new identity wasn't a conservative belief in an unbreachable wall between maleness and femaleness, but a utopian belief that no natural disparity exists between genders-which made transition pointless. But he didn't fight Scott's wishes. "If there's a snowstorm, you don't spend time trying to get it to go away," he said. people less inclined to transition physically," she said. "Scott hated her. I had to come to an understanding that he really was going to live as a guy. We eventually found a therapist who had counseled seventy transgender people, and she felt Scott didn't need to see her because he was so clear. I thought I was raising this strong woman, but most eight-year-old girls do not wear boys' underwear." For Morris, the challenge to accepting Scott's new identity wasn't a conservative belief in an unbreachable wall between maleness and femaleness, but a utopian belief that no natural disparity exists between genders-which made transition pointless. But he didn't fight Scott's wishes. "If there's a snowstorm, you don't spend time trying to get it to go away," he said.

They called their local endocrinologist at the University of Vermont (UVM), where they were both referring physicians, and he said he didn't deal with such cases. Lynn was shocked. "As pediatricians, when we take care of people, we need to leave our opinions at the door," she said. "Our job is to meet people on their terms. This was no different." She eventually found a trans health group in Philadelphia, drove Scott seven hours down, went to the appointment, and drove straight back. In testimony before the Vermont Senate on trans rights, years later, Lynn said, "I think what is hard is when you don't know what to do, or when there is nothing you can do. It was very clear that there were lots of things to do. So we just did them."

Scott, academically advanced, was boarding at St. Paul's, a New England prep school. Lynn drove him back after Christmas break; they stopped at a gas station, and when Scott used the men's room, his mother realized how far along he was. When he came out as trans at a school assembly shortly after his return, he was greeted with support from other students and much of the faculty, but not from the school administration, led by an ostensibly broad-minded Episcopal bishop. He told Lynn that her daughter needed to grow out of this and suggested that Scott might have a better time starting fresh in a new place. "I knew he was just trying to get rid of me," Scott said, so he left.

He met up with trans people on the Internet, then in real life; he dyed his hair blue and got a Mohawk. He said he didn't care about academics, and might not finish his education. Lynn said to him, "Look, we've worked really hard to respect you and let you be who you are, and now we're asking you to finish school and go to college." Scott agreed it was a fair bargain. Lynn suggested that he go to college early and register as a guy. UVM was eager to have him, so in what would have been his junior year of high school, he became a freshman in college.

Morris took Scott to freshman orientation. "He was wearing a T-shirt from some trans event," Morris said. "I was thinking, 'If you want to be a guy, be a guy, but don't go wear this trans shirt and look all weird.' We got to the orientation, and a number of the volunteers said, 'Hey, I went to that conference,' or, 'Great T-shirt.'" Scott had a single room with a private bathroom in a boys' dorm, but he hated the beer drinkers and football players, so he joined the UVM Pride Suite, with a variety of gay undergrads. The following year, he established a seven-person suite for trans people. He went on to start a trans conference at the university, to convince UVM that students should be able to put whatever name they wanted on their student IDs, and to get the designation want to be a guy, be a guy, but don't go wear this trans shirt and look all weird.' We got to the orientation, and a number of the volunteers said, 'Hey, I went to that conference,' or, 'Great T-shirt.'" Scott had a single room with a private bathroom in a boys' dorm, but he hated the beer drinkers and football players, so he joined the UVM Pride Suite, with a variety of gay undergrads. The following year, he established a seven-person suite for trans people. He went on to start a trans conference at the university, to convince UVM that students should be able to put whatever name they wanted on their student IDs, and to get the designation transgender transgender added to housing forms. added to housing forms.

I first saw the family soon after Scott began his freshman year. When I went back, two years later, Scott had moved away from a trans identity and toward an exclusively male one-a gay male one. "I still haven't figured out how the person who was my daughter who likes guys is therefore gay," Morris said. In the general population, some men are gay because they are attracted to men, and when they become women, they remain attracted to men. Some men are gay because they are attracted to sameness, and once they become women, they are attracted to women. These are not independent variables; they are components of a complex relationship with one's own and other people's gender. By some estimates, about half of transwomen and a third of transmen are gay or bisexual.

Lynn said, "I asked him lots of questions about how people have sex. He discussed it with me because he was being gracious and I wanted to know. I worry because there are anatomical things that are different, given that he doesn't want bottom surgery, so he's got to meet one hell of a nice guy not to mind. But people have richly varied tastes. During those transition years, I would stop by UVM pretty often for lunch, and we'd talk on the phone quite a bit. In the last year he's been much less forthcoming. He's doing what a normal teenager does." Scott said, "I'm fine being out as gay, but I'm not out as trans except to close friends. For a while, my transition was most of what I thought about and did. I'm no longer interested in making my life like an example. I am probably going to medical school. I know my being out could be important for other medical students who have trans issues. But it's also my life."

Scott's younger brother, Charlie, said he didn't have a hard time with his old friends learning that his sister was now his brother. But he has a hard time telling newer friends that his brother used to be his sister. When those friends come over, Charlie puts away the framed photos of Scott as a little girl. Scott doesn't mind his parents having the photos out, and he doesn't mind Charlie putting them away. Lynn said, "If we get rid of them, we erase his childhood. I had a daughter until Scott turned fourteen. Of course, I didn't have a daughter really, because Scott was Scott the whole time. But also, I did." turned fourteen. Of course, I didn't have a daughter really, because Scott was Scott the whole time. But also, I did."

I found two models for political engagement among trans people. Some activists were newly affirmed in their gender and eager to claim a loud trans identity; over time, I saw them become comfortable passing, wanting simply to live the gender they had always felt themselves to be. For them, activism had been a form of catharsis. Others had made their transitions quietly and privately, often at a great distance from everyone they knew and loved. Over time, they became comfortable with themselves and worked to spare others the difficulty they had experienced. For them, activism was a mechanism of gratitude. Many activists associated themselves with organizations such as TransYouth Family Allies (TYFA), Gender Spectrum, Mermaids (UK), PFLAG Transgender Network, TransFamily of Cleveland, TransActive, Genderfork, the National Center for Transgender Equality, the Transgender Legal Defense & Education Fund (TLDEF), and the Transkids Purple Rainbow Foundation. Some activists were not themselves trans but had an oblique relationship to the trans community. I was especially drawn to two groups that represent the differing archetypes of support for trans children: Gender Spectrum and TYFA.

Stephanie Brill, who founded Gender Spectrum in 2007, trades richly in nuance-sometimes at the expense of clarity, but always with an acknowledgment that among human experiences gender lies at the pinnacle of complexity. She is versed in gender theory and queer theory and can spin the obscure vocabulary of abstract philosophy into a dazzling array of options for you or for your child. She believes that a just society must have room for boys who like dolls, for heterosexuals who cross-dress at home, for women who are tough at the office and turn kittenish with intimates, for male kids with long hair who want to learn ballet, and for little girls who are interested only in baseball and climbing trees. Kim Pearson and Shannon Garcia, who run TYFA, a group founded in 2006, are equally intelligent, but they are first and foremost mothers of trans kids. Whereas Stephanie Brill radiates intellect, they emanate a Midwestern, everymom warmth. They are large and loud women who can finish each other's jokes. You can call them in the middle of the night, and they'll wake up fast and throw themselves into solving your problem. They can sway a high school principal in a conservative, small town in Middle America by showing that gender variance is a common experience requiring extremely obvious accommodations; they have the kind of courage that makes other people brave.

Stephanie Brill is based in the San Francisco Bay Area, and Gender Spectrum helps liberal families proceed through transition with acuity and self-assurance. Brill encourages parents and patients to explore the many places in the gender middle before they commit to a leap from one side to the other. That is an excellent approach where feasible; it is not feasible in the previously mentioned small towns, where shifting from male to female (or vice versa) is already more than anyone is prepared to entertain. Gender Spectrum is for families pondering the nature of identity; TYFA is for families whose children will kill themselves if they have to live one more day in their natal gender.

Kim Pearson and Shannon Garcia met online in 2006; in January 2007, they set up TYFA, with Amy Guarr, another mom, who is treasurer of the organization, and Jenn Burleton, a transwoman who went on to found TransActive. Ten months later, Amy Guarr's trans son, Ian Benson, took his own life. "It has shaped the way we do things," Kim said. "Because even a kid who's fully supported is still hugely at risk. Children who come out in adolescence know they may lose parents, siblings, friends; they are already at the end of their ropes. So do not ever assume that you have time as a parent to have your own pity party. You can grieve about your child transitioning to another gender, or you can grieve about your child being dead." After the first of Kim and Shannon's workshops that I attended, the two women engaged an anxious father who said, "But what if he changes his mind?" Shannon said, "You just explained how he told you on the changing table at two that he was a girl, and that message hasn't changed in thirteen years. You're worrying about the future. Talk to your kid about today, right now." It took them about ten minutes to bring this man around to an acceptance he had been unable to achieve for over a decade.

While most of her work is with parents, Kim Pearson told me that what she finds hardest is helping trans people to keep their dignity. She described meeting a transwoman, Janice, who introduced herself as "a postoperative transsexual." Kim replied, "Do you view yourself as a woman?" Janice said she did. Kim said, "So I view myself as a woman, and I've never, ever introduced myself by my genitalia. I'm going to challenge you to introduce yourself as a woman, or as a transgender woman, and never to discuss your surgery with a stranger again. Adult trans people say they don't want to be judged by what's under their clothes. Well, then stop introducing yourself by what's under your clothes."

For some families transition is harrowing; for others it is easier; and for some, such as the Pearsons, it's a celebration. Shawn-Dedric Pearson, living in a small town in Arizona, came out officially on May 6, 2006, and a few months later his mother started TransYouth Family Allies, and they boarded a joint bandwagon to change the world. living in a small town in Arizona, came out officially on May 6, 2006, and a few months later his mother started TransYouth Family Allies, and they boarded a joint bandwagon to change the world.

"I'd faced a lot of expectations of how I should be growing up," Kim said. "I didn't want to do that with my kids. At three, Shawn was going, 'I don't do dresses!' We're like, 'If it's going to be a big deal, we'll switch to pants.'" Nevertheless, her daughter was always unhappy. When Shawn was twelve, she wrote to her parents that she was a lesbian. Things got better for a little while, then they got worse than before. Shawn was failing at school and had constant stomachaches and headaches. "Shawn was staying in a dark room with the covers pulled up," Kim said. "Not eating, or eating constantly. Not sleeping, or sleeping constantly. You could so clearly tell that something horrible was wrong. But we couldn't figure out what."

The Pearsons started family therapy. A few months later, they happened to watch the movie Transamerica, Transamerica, and Shawn, then fourteen, knew the answer. A few weeks after that, Kim and Shawn walked into the counselor's office and the dynamic was changed. "I went in with a depressed daughter, and I came out with a happy son," Kim said. "Shawn says, 'I'm not a lesbian. I'm transgender. I'm totally a guy. You know that's who I am.' I said, 'I feel like I've been working on a jigsaw puzzle all of your life, and there were some pieces that never fit. Today, I see those pieces just fitting perfectly. But I have no freaking clue what we do now.' He just blithely says, 'That's okay, Mom. I've got a list. I need a legal name change, I need you to enroll me in school as a boy, and I need to get binders for my chest.'" Kim, who didn't really want to do any of those things, was horrified. "Somewhere in there he said he wanted to get men's shampoo and deodorant and socks," she recalled, "so I said, 'I don't know how to do any of the things you're talking about. But I am really good at shopping. So, what do you say we start there?' He was animated, his face was lighting up. I hadn't seen this kind of spark for years." and Shawn, then fourteen, knew the answer. A few weeks after that, Kim and Shawn walked into the counselor's office and the dynamic was changed. "I went in with a depressed daughter, and I came out with a happy son," Kim said. "Shawn says, 'I'm not a lesbian. I'm transgender. I'm totally a guy. You know that's who I am.' I said, 'I feel like I've been working on a jigsaw puzzle all of your life, and there were some pieces that never fit. Today, I see those pieces just fitting perfectly. But I have no freaking clue what we do now.' He just blithely says, 'That's okay, Mom. I've got a list. I need a legal name change, I need you to enroll me in school as a boy, and I need to get binders for my chest.'" Kim, who didn't really want to do any of those things, was horrified. "Somewhere in there he said he wanted to get men's shampoo and deodorant and socks," she recalled, "so I said, 'I don't know how to do any of the things you're talking about. But I am really good at shopping. So, what do you say we start there?' He was animated, his face was lighting up. I hadn't seen this kind of spark for years."

When they got home, Shawn found his father, John, relaxing after a long day of work at Home Depot and started showing off his new purchases. Kim took John into their bedroom and explained. John sat staring into space. Kim said, "So, say something." John said, "I don't know what to say." John explained to me, "I went into a cave for twenty-six days. I had to go through a transition myself." After twenty-six days of silence, John made his peace with the idea.

Shawn came out in early June. The therapist cut the family loose in midsummer, and Shawn returned to school on testosterone and with a new name. Kim said, "It was transition at warp speed." Shawn had asked Kim to talk to the school. "I approached it as a medical problem," she said. "If my child was diabetic, you'd make sure he had privacy to give himself shots. We need to look at what restroom he'll use." The school made the nurse's restroom available. Shawn's legal name change hadn't yet come through, and the principal initially refused to alter school records. "I convinced him that the less people knew, the less parents would come to school upset that Shawn was in class with their kids," Kim said. asked Kim to talk to the school. "I approached it as a medical problem," she said. "If my child was diabetic, you'd make sure he had privacy to give himself shots. We need to look at what restroom he'll use." The school made the nurse's restroom available. Shawn's legal name change hadn't yet come through, and the principal initially refused to alter school records. "I convinced him that the less people knew, the less parents would come to school upset that Shawn was in class with their kids," Kim said.

The family sent around a letter giving everyone the update. The first phone call they had came from one of the people in their community from whom Kim had expected condemnation. "He said, 'Shawn is always welcome in this home. He will always be safe with us,'" Kim recalled. "I started crying. We had prepared ourselves for negative reactions. We really hadn't thought about what it would be like to get a positive one." Kim's work in the computer industry felt increasingly meaningless and had become physically difficult because of fibromyalgia in her hands. "My church is Unity Church," Kim said. "The philosophy is, have faith that things will go as they should. So I had this conversation with the universe. I said, my perfect job would involve travel and public speaking; would use my teaching and course-design skills; I'd be writing. Two weeks later, Shawn came out. Three months later, I was founding TYFA. It was exactly what I asked for."

Soon thereafter, Shawn and Kim headed off to give a presentation at San Diego State University. The car was running low on gas, and Shawn spotted an Indian casino with a gas station. Kim recalled, "I needed to use the restroom. I said, 'I'm taking twenty dollars with me. I'll be back in five minutes.' Put my twenty dollars in a slot machine and hit a ten-thousand-dollar jackpot. That paid for the start-up fees and filing as a nonprofit." Shawn's brother created a website and hosted it on two old computers in his parents' bedroom.

John said, "I never thought I was marrying an activist. I went to hear her in Vegas about a month ago. I always knew Kim was a good communicator. But I was blown away." Kim later wrote to me, "I have found my calling; I have found my purpose; I am using my God-given talents in a way that is satisfying to me and of service to others." She recounted a schedule that involved crisscrossing the country, mostly by car, to do five school trainings in one week, including two full days of driving to do one in Ohio. I wondered whether that one couldn't have been rescheduled. "How can we tell the sixteen-year-old that we can't come?" Kim said. "People say, 'How do you do so much?' I'm like, 'How do you not?'"

Shannon and John Garcia had six boys, or so they thought, in Indiana, in what Shannon has described as "a white-bread neighborhood in a white-bread town in a white-bread state." Their youngest son developed language quickly and at fifteen months said, "I'm not a boy. I'm a girl." Shannon said, "Sure you are," and kept changing the diaper. At two, he asked for a Barbie doll. By the time he was three, Shannon thought he was gay. At four, he entered the Christian preschool his five brothers had attended. At the first parent-teacher meeting, his teacher said, "Your son will not be allowed to play dress-up because boys don't wear skirts." Shannon was outraged. "That was the first time that our son discovered that the way he felt was not acceptable to others outside. Within days, we started to see anxiety."

John, however, was furious with his wife. "It was my fault. I babied him," Shannon said. "He was going to fix it." John confiscated all the girlish toys. He took his son out to the yard, said, "I'm going to butch you up," and gave him a baseball bat. John threw the ball over and over and over, saying, "I want you to hit it." His son stood there with the bat with tears streaming down his face. Shannon said, "It was very ugly in our home. I wanted it fixed, too. But I knew that shaming our son was not the way to do it. I owed it to John to try his way. All that happened is that our child grew to hate him."

The following September, Shannon's son resisted kindergarten with tearful entreaties, saying, "It's too hard to pretend to be a boy all day long." Shannon steeled herself to it. When first grade started, Shannon began bribing him. "If you don't cry all week, I'll buy you a Barbie this weekend," she said. Each week they would choose the bribe, trying to keep it from John. Then one week, the little boy said, "Can I have a quarter instead of a toy?" Shannon asked why. He said, "Because on the way to school, we pass a house with a wishing well. I'm going to ask the bus driver if she'll stop so I can wish I'm a girl."

John kept saying, "You have a penis. That means you're a boy." One day, Shannon noticed that her son had been in the bathroom an awfully long time and pushed the door open. "He had a pair of my best, sharpest sewing scissors poised, ready to cut. Penis in the scissors. I said, 'What are you doing?' He said, 'This doesn't belong here. So I'm going to cut it off.' I said, 'You can't do that.' He said, 'Why not?' I said, 'Because if you ever want to have girl parts, they need that to make them.' I pulled that one right out of my ass. He handed me the scissors and said, 'Okay.'"

The family was preparing to go away to Tennessee for Thanksgiving, and Shannon decided it was a perfect opportunity to experiment. Her husband opposed it; her other five sons hated the idea. Their youngest announced that her new name was Keely. When they set out, Keely was dressed in pink from head to toe, with a barrette taped in her crew cut. "We drive several hours and then stop to eat," Shannon said. "We sit down at the table. My child had never spoken to a stranger, ever. When the waitress gets to Keely, she says, 'And what will you have, pretty girl?' Keely says, 'I'll have chocolate milk, please.' I went to the restroom and I was an absolute puddle of tears on a public bathroom floor. Over the next forty-eight hours, words cannot describe the difference. It was so profound that my husband said, 'I hope you've looked into homeschool options, because she can never go to school as a boy again.'" announced that her new name was Keely. When they set out, Keely was dressed in pink from head to toe, with a barrette taped in her crew cut. "We drive several hours and then stop to eat," Shannon said. "We sit down at the table. My child had never spoken to a stranger, ever. When the waitress gets to Keely, she says, 'And what will you have, pretty girl?' Keely says, 'I'll have chocolate milk, please.' I went to the restroom and I was an absolute puddle of tears on a public bathroom floor. Over the next forty-eight hours, words cannot describe the difference. It was so profound that my husband said, 'I hope you've looked into homeschool options, because she can never go to school as a boy again.'"

They enrolled Keely at a new school and changed the name and gender designation on her educational records. She had previously qualified for services under Title I, a federally funded program for learning-disabled students. Within six months, she was two grade levels ahead in reading, and at grade level for math. "Twelve months later, we went to the doctor for a checkup," Shannon said. "The doctor walked into the exam room and Keely started talking, and I don't think she shut up the whole time we were there. His mouth was hanging open, and he said, 'There is absolutely no way this is the same child that I saw for six years.' She was that profoundly different."

By the time I met Keely, she was seven: beautiful, chatty, and poised beyond her years, with a wicked glint of humor. "I know it was definitely maneuvered by God Himself," Shannon wrote to me afterward. "It was a simple choice for me: a dead son or a living daughter. It really is the choice that most parents with trans kids face. Keely has always been told that she can marry whomever she wants. She told me that she wasn't going to disclose her status to her 'person,' and I told her that it wouldn't be right to withhold that information. I told her that if the person really loved her...She finished the sentence, 'Then they won't care!' I said, 'Exactly.' 'Exactly.'"

Many parents lag far behind this level of acceptance. More than half of trans people are rejected by their families; even in families with some acceptance, it often comes from only one parent. "In a two-parent family, it's not unusual for one parent to hold the fear and the other to hold the acceptance," Brill said. In her memoir of working with disadvantaged trans kids, Cris Beam writes of the mother of one transgirl, "She told Christina she wished she would just die of AIDS if she was going to act this way." An ostensibly more sophisticated mother wrote in a letter to her trans daughter, "For you to insinuate your man-dressed-as-a-woman self into the whole process process and and actuality actuality of being a woman is arrogant and insulting. You discredit and discount of being a woman is arrogant and insulting. You discredit and discount not only my own experience of being female but the entire community of women." not only my own experience of being female but the entire community of women."

In May 2009, a popular radio program out of Sacramento, Rob, Arnie & Dawn in the Morning, Rob, Arnie & Dawn in the Morning, featured a segment on trans kids. Rob Williams and Arnie States referred to the kids as "idiots" and "freaks," out "for attention," with "a mental disorder that just needs to somehow be gotten out of them." They added, "It makes me sick. 'Mommy, I'm a girl trapped in a boy's body. I want to wear a featured a segment on trans kids. Rob Williams and Arnie States referred to the kids as "idiots" and "freaks," out "for attention," with "a mental disorder that just needs to somehow be gotten out of them." They added, "It makes me sick. 'Mommy, I'm a girl trapped in a boy's body. I want to wear a dwess dwess.'" Later they said, "Allowing transgenders to exist, pretty soon it becomes normal to fall in love with animals." One boasted that if his son ever put on high heels, he'd beat him with his own shoe.

Outcry about this broadcast triggered an advertising boycott. Kim Pearson and San Diego transgender activist Autumn Sandeen were invited to appear on the show to discuss the issue. Kim explained that any trans-inclined child whose mother had driven him or her to school while listening to the broadcast would now never broach the subject with her. When the show opened to call-ins, one came from the brother of a transman who had killed himself. Kim warned Williams and States that they had blood on their hands. When the show began, they had made it clear that their apology was required to mollify advertisers; by the end, they were abject.

While wealth and education do not guarantee families of trans kids an easy time, poverty increases the chances that everything will go horribly wrong. Indigence exacerbated the difficulties for Hailey Krueger and Jane Ritter. Each had lived a long secret life. Neither wanted to admit to her mother that she was a lesbian, and both married men. Their hollow marriages were full of lies and abuse and dysfunction. Hailey had dropped out of school in Kansas in the ninth grade; Jane had completed high school in Missouri, but had no professional qualifications. Jane had an adolescent daughter; each had a young son. Hailey was femme, and Jane was butch, and they met in a homeless shelter in Wichita.

Hailey's husband was given to cross-dressing, but only at home and in complete privacy. Soon after marriage, they had a son, whom they named Jayden. "My child was always embarrassed of down there," Hailey said. "He was always trying to hide it, even when he was a baby. He sat down to pee and wiped, like a girl." At five, Jayden declared that his name was Hannah, after Hannah Montana, the Disney character who lives as a normal teenager by day and a rock star by night; that story had resonance for many trans kids I met who were leading a double life.

Jane said, "The first time I met Jayden, in the shelter, age six, I honestly thought it was a girl." After a few months, Hailey and Jane moved out to a trailer with Jayden, and Jane's kids, Bryan and Lillian. "Jayden had just had enough of hiding," Hailey said. "We settled in, and he says, 'Mama, can I put my bra on?' I said, 'Go ahead. No one can see it.'" Jayden told Jane he had something to tell her. "He goes, 'I got a bra on,'" Jane said. "I said, 'Okay.' He was like, 'You're not mad?' I said, 'No, baby, because Mama Jane thinks that everybody needs to be themselves.' His face lit up, and he was so happy." Jane told Bryan and Lillian, "Nobody's going to make no fun." Before long Jayden started introducing himself to other children as Hannah. His father was horrified. out to a trailer with Jayden, and Jane's kids, Bryan and Lillian. "Jayden had just had enough of hiding," Hailey said. "We settled in, and he says, 'Mama, can I put my bra on?' I said, 'Go ahead. No one can see it.'" Jayden told Jane he had something to tell her. "He goes, 'I got a bra on,'" Jane said. "I said, 'Okay.' He was like, 'You're not mad?' I said, 'No, baby, because Mama Jane thinks that everybody needs to be themselves.' His face lit up, and he was so happy." Jane told Bryan and Lillian, "Nobody's going to make no fun." Before long Jayden started introducing himself to other children as Hannah. His father was horrified.

Jane found a job at McDonald's, and Hailey, at Dollar General. They moved into a depressed area of Wichita. By the time Jayden was seven, he was sporting fingernail polish at school. "The school would bring it up, and I'm like, 'Kids will be kids,'" Hailey said. "Then he started wanting to grow his hair out. He wanted a pair of tights, makeup. He cried a lot, wanting to go to school as a girl." As soon as Jayden came home, he'd put on girl clothes. One night, he said to Jane, "I'm so mad at you." Jane said, "Why, baby?" Jayden said, "Because you're able to be who you are. And I can't." Jane said to me, "That just about broke my heart."

The school wanted Jayden in therapy, but Hailey and Jane didn't want him to see someone who would, as Jane put it, "deprogram" him. They had never heard the word transgender, transgender, had no idea that there were other children like Hannah. They learned of a sixty-five-year-old transwoman, Leona Lambert, who ran a support group. Leona, in turn, introduced them to the Metropolitan Community Church (MCC), the LGBT-positive denomination to which she belonged, and to her pastor, the Reverend Kristina Kohl. MCC was the first public place where Hannah presented herself as a girl. had no idea that there were other children like Hannah. They learned of a sixty-five-year-old transwoman, Leona Lambert, who ran a support group. Leona, in turn, introduced them to the Metropolitan Community Church (MCC), the LGBT-positive denomination to which she belonged, and to her pastor, the Reverend Kristina Kohl. MCC was the first public place where Hannah presented herself as a girl.

When Hannah entered first grade, pressure mounted from the school for her to act more like a boy; pressure mounted from Hannah to go to school as a girl. Leona said to Hannah, "For your safety, it's best for you to live a double life right now. They'll beat you up, they'll pick on you. Just fit the norm. Then when you get home, run put on that dress and watch TV. There is no law to protect you in this state." Kristina Kohl said, "All her life, she'll have to make concessions. We all do." Hailey and Jane had three meetings at school to discuss the situation. "I told Jayden, 'If you're purple, and you're the only purple person in this world, I'd love you to death,'" Hailey said. "'But you cannot be Hannah at school.'" Jane said, "Hannah was calling herself a freak. It upset me so bad. I said, 'Hannah, please do not use that word. You are not a freak.'"

Jane's daughter had moved out, but her son was home. Bryan has since been given diagnoses of oppositional defiant disorder-a dysregulated relationship to those in authority-and major depression. At thirteen, he took to attacking his mother. He eventually made a suicide attempt, so Jane contacted Social Services to get him treatment. Bryan complained about his mothers to the social worker and was put into state care. Among his accusations, he said they encouraged his brother to wear dresses.

On February 24, 2009, Jane got Hannah ready for school. "I gave her a hug and a kiss, and I said, 'I got a surprise when you get out of school. We're going to eat pizza and go bowling.'" At one thirty, the social worker who had done Bryan's intake called Hailey. "I've got your child," she said. "You have a court date Tuesday at eight thirty in the morning." The social worker had interviewed Jayden at school and asked what he would wish if he had three wishes. Jayden said, "Change all my boy clothes into girl clothes; me be a girl; my boy body parts be girl body parts." The social worker presented this as evidence that Hailey and Jane had "convinced" their child that he was female. The paperwork noted that Hailey had a female partner, and that her child was therefore subject to "more confusion and social difficulties than other children." The judge ruled that Hannah be placed in a foster family with "healthy parents."

In a little more than a week, Hailey and Jane had lost both children. Kristina became their chief adviser. "Hailey and Jane are educationally challenged; they come out of generational poverty," Kristina told me. "The kids hadn't been to a dentist or a doctor, didn't have shoes that fit. It's not simple. But they love those kids, and Hannah absolutely loves her home." Hannah's foster family would not allow Hannah to use her female name, wear female clothes, or do anything else outside masculine norms. On Hailey and Jane's first supervised visit there, Hannah said, "If I have to be a boy to go home, I will. I'll do anything to go home."

Social and Rehabilitative Services of Kansas (SRS) was now in charge. "SRS dug up some 1950-something psychiatric journal entry about cross-dressers," Kristina told me. "I'm like, 'This has no bearing on the situation we're here to discuss.' But I don't have much clout. I don't know if you can understand how bad it is here." It can be hard to tease the transphobia apart from the homophobia. SRS continued to say in court, "We're not giving this child back to lesbians." SRS finally appointed a therapist, Mia Huntsman, for Hannah and her mothers. They all loved Mia. Hailey said, "We brought Hannah some dresses in therapy because Mia said that she could wear them. Hannah was, 'Oh, I don't want to do it in case my foster parents find out.' Mia said, 'I'm the therapist, I set guidelines. For your safety, you can do this only in my office, at home, and at church. You can be yourself in these three places.'" On another occasion, Mia said, "I know you want to talk to your mama. I'll leave the room so you can talk." Hannah said, "No, don't do that. I don't want to get in trouble from SRS." Hailey wept openly. "Hannah is that scared," she told me, complaining that Hannah had withdrawn. "She was like a bird being able to fly, okay? Free. Now, even with us, it's like she's caged." I don't want to do it in case my foster parents find out.' Mia said, 'I'm the therapist, I set guidelines. For your safety, you can do this only in my office, at home, and at church. You can be yourself in these three places.'" On another occasion, Mia said, "I know you want to talk to your mama. I'll leave the room so you can talk." Hannah said, "No, don't do that. I don't want to get in trouble from SRS." Hailey wept openly. "Hannah is that scared," she told me, complaining that Hannah had withdrawn. "She was like a bird being able to fly, okay? Free. Now, even with us, it's like she's caged."

Leona Lambert drove Hailey and Jane to their therapy sessions with Hannah and was eventually allowed to participate. "God, I wish I'd had her guts at that age," Leona said. "Even with being taken away from her moms, seeing her with her little heart broken, I want to trade places with Hannah so bad." Leona showed me her business card, which said FEMALE IMPERSONATOR FEMALE IMPERSONATOR. I asked her if that was how she thought of herself. She said, "That was the best I could do. I hope Hannah will do better."