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Kim Pearson, executive director of TYFA, says she has a Ph.D. in “previously had daughter.” After seeing the movie Transamerica in June 2006, her 14-year-old girl came out to her as transgender, presented a list of to-dos she’d researched on the Internet, and at once began her transition to Shawn. Pearson wishes she had known what was going on in time to give her “fabulous” son the advantage of puberty blockers, but it was too late. Instead she got him a prescription for testosterone, earlier than protocols usually suggest. The decision may have saved his life. “I later asked him, ‘Had we not gotten it, how much time do you think you had?’ He answered, ‘Six months, top.’ ”

Although TYFA focuses on a hopeful message for parents of transgender kids, and suggests that they will one day celebrate the “journey” their child is taking them on, suicide is the dark energy behind the group’s efforts. (The child of another of its three founders killed himself at 16.) “Trans kids are the highest suicide risk on the planet, bar none,” says Pearson. Not because of their transgenderism per se but because of the reaction, real or anticipated, they feel the truth will elicit if exposed. And so, though she understands how parents can be so afraid of making a mistake that they’d rather do nothing at all, Pearson encourages them to act fast. Especially with an adolescent, they may not have time to get comfortable with a medical intervention, or to leave the decision until adulthood. “That’s assuming your child lives to 18.”

But when a child is still a child, still in the single-digit haze that parents like to assume is sexless and even genderless, with no rebellions or acne or sapling mustaches to spoil the illusion, the risk-benefit analysis may seem more ambiguous. A 10-year-old I’ll call Nick, who was born a girl but has been living as a boy for several years already, appears to be a happy, well-adjusted kid. Pleasingly androgynous and typically chaotic, he’s faced few external problems, perhaps because his parents work hard at supporting his identity while keeping their confusions to themselves. His sister, just 7, accepts him without reserve.

Still, some things make them wonder. When Nick was 4, a newborn brother died without ever making it home from the hospital. Not immediately, but soon thereafter, “the transgender thing started to happen,” says his mother. First it was I like boy things, then I’m a tomboy, then I wish I was a boy, and eventually, by second grade, I am a boy. “So one of our first thoughts was that this was a psychological way of replacing a boy in our family. Of soothing our grief.” She pauses. “But you could think back to anyone’s childhood and ask: Did this make me that? At a certain point the why doesn’t matter.”

Nick’s parents are not quite sure they’re at that point. Are his air-guitar slashes and karate kicks just typical boyishness, they wonder, or an expression of something unsettled? “He wrestles with it daily,” his father says. “The inner frustration that comes with being in the wrong body. And as a result he has moments of deep, deep anger, to the point we’ve had incidents with him punching other kids.” He looks at his wife sheepishly. “And the guidance counselor once.”

“Yes, but this guidance counselor had kicked him out of the boys’ bathroom unfairly,” she quickly adds. “A whole bunch of boys were in there fooling around and she only kicked him out.”

Their ambivalence is almost physical, and everything they say seems to recapitulate the struggle they have gone through to find the right loving way to look at their son. “We’re following Nick’s lead but,” says his father, and that’s the complete sentence. The prospect of using puberty blockers only intensifies their uncertainty. On the one hand they resent that most endocrinologists, following the protocol, require a child to complete a year of therapy before receiving treatment. “Honestly,” says his mother, “you can tattoo a third of your body or get double-D boobs without therapy. Why do you have to prove yourself to get hormones?”

On the other hand, they admit to the usual resistance, if for an unusual reason. “I was thinking that my child at least has to have the grounding in the fact that she is a biological girl,” says Nick’s father. “That we’ll love and accept her in whatever form she wants to express that, but there’s no moving forward without a basis in biological fact. I didn’t want to be validating a pretend life. And then, too, you feel like doing that shouldn’t be in your control. Do we sign the paper that stops puberty for our child, which is a natural biological process? It’s a godlike thing. A wrong godlike thing.”