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I was born male and identify as female. I transitioned when I was 6 or 7 to more of a girl. Second grade was the last year of Liam. And this year, I changed my name officially. But today, as transgender adults gain wider acceptance, many children are transitioning, too, with new medical options and at younger and younger ages.

This is a new generation, growing up trans. November 7th, Initially, a tomboy came to mind, right? I just wish I were a boy. You were born this way. And then starting 2nd grade, the tone of our conversation just took on a more serious depth. I did feel a pressure from society, from our family members. And he has talked about suicide or killing himself before, which is why we immediately sought the help of professionals.

I think he finds a great deal of reassurance knowing that there are things— there are steps we can take where he can look like— more like a boy and pass to be more like a boy. Happy belated. NARRATOR: One of the biggest developments in the treatment of transgender kids came in , with the introduction of hormone blockers, drugs that suspend puberty and slow all physical development.

So the idea is that we can just put the pause button on puberty and let children have a little more time to grow and develop and be more confident of their gender identity. Of course. NARRATOR: But there is growing consensus that the more intense gender dysphoria is in childhood, the more likely it is to persist and that puberty itself can also be a telling predictor. And my husband and I want to do anything we need to to keep his emotional wellbeing in mind and how he feels about himself. Early intervention does make a huge difference.

So really starting puberty-blocking medications as early as possible is really important for some people who are really experiencing distress. We typically want to see that has had a little bit of pubertal development. The medications that we use for puberty blockers all work, and for the most part have few side effects. So we have been— we have worked on an option that we have that we can offer here now, actually, which is called Vantas. And its FDA approval is for men with prostate cancer, but this has been used successfully by pediatric endocrinologists taking care of kids like Daniel, and it seems to work just as well and it is a lot less expensive.

I much prefer to take care of conditions that have been well researched and well studied for 50 years, and that is not the case here. And I think the take-home message today is that nothing is going to happen quickly, OK? I am 13 years old, and I identify as a girl. I mean, the hormone blockers are, like, my life saver. But me turning into a man is just— probably the most horrifying thing ever I could ever think of in the farthest reaches of my mind is me not going on the hormone blockers anymore and me developing into a man. That would just be horrible. The hormone blockers, they give me a space where I can really feel completely just sure of myself, and I can just have that little breathing space before I enter puberty.

But there was a long period of time when she was living in secret as a girl. KERRY: —very confusing. I think a lot of people are completely just comfortable and fluid, but for me, I was really scared. My name before was Ian. And then I guess when I was around 9 years old, I started deliberating, like, maybe I should change my name because to really show the world that I wanted to fully transition.

So every day—. And there was an order to it. Cinderella, Belle, Ariel—. And on that day, I would have to call her that. And she wrote on her calendar every day, like, what princess I was supposed to be! ARIEL: It just made me think, like, she cares about me so much that she writes on her calendar what— who I am each day, which was really amazing and made me so happy.

I can play mermaids in the water. And the garden is going to be so pretty with hummingbirds—. And it was like I was putting on costumes. I started really going through puberty. That was— that is horrible. I hate it. I was wearing three sports bras. I was very self-conscious of my chest because guys obviously do not have a chest. They are flat, completely. And so before that, I was able to pass. I was able to kind of be a guy. When I looked in the mirror, I saw this small girl who was not supposed to look like that. I felt like I just needed to look the way I looked in my head, to be who I was and feel comfortable with who I am.

ALEX: Middle school can be kind of a scary time for lots of people. Even after I started really transitioning, I would— I would want to stay home because I know that everyone there knew me as a real girl. I mean, I can deal with that. I want to keep the friends that I have, so I kind of just let it go. I definitely get depressed sometimes. I will listen and dance for hours. And in my imaginary world, I am a guy. I have a flat chest.

There are definitely girls and guys in this world, and they just help so much. And that definitely helps. I think at times, my mom can get a bit worried. I definitely know the boundary line. And they do feel that Alex has his feet firmly planted in the ground, in reality, but that it has been a mechanism to deal with his problems. He wants those shut down. And then there are potential side effects and possible long-term effects that are not known.

And not making a decision has implications also because, you know, doing nothing is not really an option here. And based on our conversation with Alex, doing nothing is not really an option. Two years ago, when Ariel first transitioned, she and her mom decided to make a fresh start. They moved to a new town and enrolled in a new school where nobody had known her as Ian. But her classmates or any of the students in the school did not know. And I wanted that for her not because we were even embarrassed or we wanted to hide it, but I wanted everybody to just know Ariel as Ariel.

And it was just sort of, like, tension between us. But we still would be where we are now, I think. Like— and it would have changed our relationship. I definitely know that. ARIEL: I remember a couple years back, like, everyone was talking about, like, having babies, and it— it really makes me upset. Could I have to deal with that? I kind of just— I just either walk away or I just kind of deal with it. Is that what upsets you? It felt sort of like an act. So I kind of feel lost sometimes. Once I really realized that they were perfectly fine with me being transgender, it was, like, a whole new world for me.

I always thought her name was Karen. You got to build up that upper body muscle. BEN: Try and talk in a deeper voice. Burp— you have to burp. Just let it fly. Girls do that all the time. Just treat her like that. I had thoughts of hurting myself, cutting myself, killing myself even. I got very close, very close, twice. Not allowed. I finally told him, which was not that long ago. And there were some things about me that— or about it that kind of bothered me a little bit. I was really kind of surprised and put off by it, quite honestly. It was still hard. It was horrible. Cross-sex hormones, estrogen and testosterone, used to be given only to adults.

But treatment guidelines established in now include children, though they do not recommend starting before the age of Chief, Adolescent Med.

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