A Boy's Life

Since he could speak, Brandon, now 8, has insisted that he was meant to be a girl. This summer, his parents decided to let him grow up as one. His case, and a rising number of others like it, illuminates a heated scientific debate about the nature of gender—and raises troubling questions about whether the limits of child indulgence have stretched too far.
transgender child
"Me and My Pets,"
a self-portrait drawn by Brandon
in kindergarten
(Courtesy of the family)

For the transgender community, born in the wrong body is the catchphrase that best captures this moment. It implies that the anatomy deceives where the brain tells the truth; that gender destiny is set before a baby takes its first breath. But the empirical evidence does not fit this argument so neatly. Milton Diamond says his study of identical transgender twins shows the same genetic predisposition that has been found for homosexuality: if one twin has switched to the opposite sex, there is a 50 percent chance that the other will as well. But his survey has not yet been published, and no one else has found nearly that degree of correlation. Eric Vilain, a geneticist at UCLA who specializes in sexual development and sex differences in the brain, says the studies on twins are mixed and that, on the whole, “there is no evidence of a biological influence on transsexualism yet.”

In 1995, a study published in Nature looked at the brains of six adult male-to-female transsexuals and showed that certain regions of their brains were closer in size to those of women than of men. This study seemed to echo a famous 1991 study about gay men, published in Science by the neuroscientist Simon LeVay. LeVay had studied a portion of the hypothalamus that governs sexual behavior, and he discovered that in gay men, its size was much closer to women’s than to straight men’s; his findings helped legitimize the notion that homosexuality is hardwired. But in the transsexual study, the sample size was small, and the subjects had already received significant feminizing hormone treatments, which can affect brain structure.

Transsexualism is far less common than homo­sexuality, and the research is in its infancy. Scattered studies have looked at brain activity, finger size, familial recurrence, and birth order. One hypothesis involves hormonal imbalances during pregnancy. In 1988, researchers injected hormones into pregnant rhesus monkeys; the hormones seemed to masculinize the brains but not the bodies of their female babies. “Are we expecting to find some biological component [to gender identity]?” asks Vilain. “Certainly I am. But my hunch is, it’s going to be mild. My hunch is that sexual orientation is probably much more hardwired than gender identity. I’m not saying [gender identity is] entirely determined by the social environment. I’m just saying that it’s much more malleable.”

Vilain has spent his career working with intersex patients, who are born with the anatomy of both sexes. He says his hardest job is to persuade the parents to leave the genitals ambiguous and wait until the child has grown up, and can choose his or her own course. This experience has influenced his views on parents with young transgender kids. “I’m torn here. I’m very ambivalent. I know [the parents] are saying the children are born this way. But I’m still on the fence. I consider the child my patient, not the parents, and I don’t want to alleviate the anxiety of the parents by surgically fixing the child. We don’t know the long-term effects of making these decisions for the child. We’re playing God here, a little bit.”

Even some supporters of hormone blockers worry that the availability of the drugs will encourage parents to make definitive decisions about younger and younger kids. This is one reason why doctors at the clinic in the Netherlands ask parents not to let young children live as the other gender until they are about to go on blockers. “We discourage it because the chances are very high that your child will not be a transsexual,” says Cohen-Kettenis. The Dutch studies of their own patients show that among young children who have gender-identity disorder, only 20 to 25 percent still want to switch gender at adolescence; other studies show similar or even lower rates of persistence.

The most extensive study on transgender boys was published in 1987 as The “Sissy Boy Syndrome” and the Development of Homosexuality. For 15 years, Dr. Richard Green followed 44 boys who exhibited extreme feminine behaviors, and a control group of boys who did not. The boys in the feminine group all played with dolls, preferred the company of girls to boys, and avoided “rough-and-tumble play.” Reports from their parents sound very much like the testimonies one reads on the listservs today. “He started … cross-dressing when he was about 3,” reported one mother. “[He stood] in front of the mirror and he took his penis and he folded it under, and he said, ‘Look, Mommy, I’m a girl,’” said another.

Green expected most of the boys in the study to end up as transsexuals, but nothing like that happened. Three-fourths of the 44 boys turned out to be gay or bisexual (Green says a few more have since contacted him and told him they too were gay). Only one became a transsexual. “We can’t tell a pre-gay from a pre-transsexual at 8,” says Green, who recently retired from running the adult gender-identity clinic in England. “Are you helping or hurting a kid by allowing them to live as the other gender? If everyone is caught up in facilitating the thing, then there may be a hell of a lot of pressure to remain that way, regardless of how strongly the kid still feels gender-dysphoric. Who knows? That’s a study that hasn’t found its investigator yet.”

Out on the sidewalk in Philadelphia, Tina was going through Marl­boro after Marl­boro, stubbing them out half-smoked against city buildings. The conference’s first day had just ended, with Tina asking another mom, “So how do you know if one of these kids stays that way or if he changes?” and the mom suggesting she could wait awhile and see.

“Wait? Wait for what?” Tina suddenly said to Bill. “He’s already waited six years, and now I don’t care about any of that no more.” Bill looked worried, but she threw an Army phrase at him: “Suck it up and drive on, soldier.”

The organizers had planned a pool party for that night, and Tina had come to a decision: Brandon would wear exactly the kind of bathing suit he’d always wanted. She had spotted a Macy’s a couple of blocks away. I walked with her and Bill and Brandon into the hush and glow, the headless mannequins sporting golf shorts with $80 price tags. They quietly took the escalator one floor up, to the girls’ bathing-suit department. Brandon leaped off at the top and ran to the first suit that caught his eye: a teal Hannah Montana bikini studded with jewels and glitter. “Oh, I love this one,” he said.

“So that’s the one you want?” asked Tina.

Brandon hesitated. He was used to doing his cross-dressing somewhat furtively. Normally he would just grab the shiniest thing he saw, for fear his chance would evaporate. But as he came to understand that both Tina and Bill were on board, he slowed down a bit. He carefully looked through all the racks. Bill, calm now, was helping him. “You want a one-piece or two-piece?” Bill asked. Tina, meanwhile, was having a harder time. “I’ll get used to it,” she said. She had tried twice to call Brandon “she,” Tina suddenly confessed, but “it just don’t sound right,” she said, her eyes tearing.

Brandon decided to try on an orange one-piece with polka dots, a sky-blue-and-pink two-piece, and a Hawaiian-print tank­ini with a brown background and pink hibiscus flowers. He went into a dressing room and stayed there a long, long time. Finally, he called in the adults. Brandon had settled on the least showy of the three: the Hawaiian print with the brown background. He had it on and was shyly looking in the mirror. He wasn’t doing backflips or grinning from ear to ear; he was still and at peace, gently fingering the price tag. He mentioned that he didn’t want to wear the suit again until he’d had a chance to wash his feet.

At the pool party, Brandon immediately ran into a friend he’d made earlier, the transgender boy who’d shared his balloon puppy. The pool was in a small room in the corner of a hotel basement, with low ceilings and no windows. The echoes of 70 giddy children filled the space. Siblings were there, too, so it was impossible to know who had been born a boy and who a girl. They were all just smooth limbs and wet hair and an occasional slip that sent one crying to his or her mother.

Bill sat next to me on a bench and spilled his concerns. He was worried about Tina’s stepfather, who would never accept this. He was worried that Brandon’s father might find out and demand custody. He was worried about Brandon’s best friend, whose parents were strict evangelical Christians. He was worried about their own pastor, who had sternly advised them to take away all of Brandon’s girl-toys and girl-clothes. “Maybe if we just pray hard enough,” Bill had told Tina.

Brandon raced by, arm in arm with his new friend, giggling. Tina and Bill didn’t know this yet, but Brandon had already started telling the other kids that his name was Bridget, after the pet mouse he’d recently buried (“My beloved Bridget. Rest With the Lord,” the memorial in his room read). The comment of an older transsexual from Brooklyn who’d sat behind Tina in a session earlier that day echoed in my head. He’d had his sex-change operation when he was in his 50s, and in his wild, wispy wig, he looked like a biblical prophet, with breasts. “You think you have troubles now,” he’d yelled out to Tina. “Wait until next week. Once you let the genie out of the bottle, she’s not going back in!”

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Hanna Rosin is an Atlantic contributing editor and the author of God’s Harvard: A Christian College on a Mission to Save America (2007).

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