When Robert Garofalo, the head of adolescent medicine at the Ann & Robert H. Lurie Children’s Hospital of Chicago, gives his seminars for pediatricians on how to care for gender-nonconforming children and transgender youth, he always takes care to tell the story of a 6-year-old kid he calls Andrew. Andrew, born with male anatomy, likes to play with dolls and makeup, and since age 3, Andrew has identified as a girl. When Andrew was 4, a pediatrician waved off this behavior as “just a phase.”
Two years later, though, Andrew’s parents are beginning to wonder if they’ve been “oppressing” their child. They notice Andrew is happiest at home, where they allow Andrew to wear dresses. Out of the house, the 6-year-old is starting to withdraw socially and dread going to school.
Garofalo specializes in treating kids from what he calls marginalized youth populations, specifically HIV-positive and LGBTQ children, and Andrew’s story—a kind of composite story built from the real-life experiences of many of Garofalo’s patients over the years—serves as a cautionary tale for pediatricians about the dangers of responding dismissively or ambivalently when gender-nonconforming children and their families seek guidance. For many parents and kids, pediatricians’ offices are one of the first stops when a child displays non-conformity; many parents, naturally, direct their “so my son wears dresses” and “how should I handle my daughter telling me she’s a boy” questions to the same place they direct the myriad other “hey-what-should-I-do, is-this-normal” queries that invariably accompany parenting.