From the time they are born, we put our boys in blue beanies and our girls in pink ones. It's a societal norm, an expectation even, that you are what you are born a boy or a girl.
From early on, we divide toys and activities by very distinct gender lines, with superheroes and trucks and muck on one side and princesses and dolls and all things frilly on the other.
Many children land, enthusiastically, on the expected side. Others dabble in both "girl" and "boy" things. But what if your kid, even from an early age, mostly showed interest in doing opposite-gender things? More important, what if they wanted to BE the opposite gender or a less-defined mix of both? And what if they wanted to test those limits in public places, like school? Would you let them?
It's not, of course, that pat of a process. Parents don't just decide to let their kids switch genders. But, whether parents are dragged through the process, or if they decide to work it through more openly, more kids are challenging the boundaries of traditional gender, and going public at younger ages.
And they are doing so with the guidance of a growing faction of medical experts who no longer see this as something to be fixed. Last year, the American Psychiatric Association removed "gender identity disorder" from its list of mental health ailments.
Some experts predict that views on gender will evolve in much the same way they have for sexual orientation, since homosexuality was removed as a mental illness nearly four decadesago. Today, the gender spectrum includes those who are transgender, who see themselves as the opposite gender, and those who are gender variant, or gender nonconforming, whose gender is more "fluid." For kids, it means they identify part of themselves as boy and part as girl.
"Now these kids are beginning to have a voice and I think that's what's been making things interesting and challenging and difficult, sometimes depending on the family, the kid, or the school," says Dr. Robert Garofalo, director of the Center for Gender, Sexuality and HIV Prevention at Lurie Children's Hospital of Chicago.
While the numbers are relatively small, it means that, increasingly, schools are having to figure out how to accommodate them, some more successfully than others.
The questions often start with the basics: Which bathroom do they use? Where do they change for gym class? What if teachers or students don't want to use the pronoun, "he" or "she," or a new name the student prefers? It can be difficult, and uncomfortable. In Colorado, for instance, the parents of a 6-year-old transgender girl are suing their school district for trying to make her use a separate bathroom.
The center at Lurie opened recently, in part, to meet the demand from parents seeking guidance for children who are questioning their gender identity and to provide support to older transgender youth who sometimes struggle more in adolescence, even facing a greater suicide risk, especially if they have no backing from family and others around them.
The center also serves as a resource for schools with transgender and gender variant students.
Increasingly, those students are making the transition as early as elementary school, if not before.
And schools are taking notice. The San Francisco Unified School District recently added a transgender category in student health surveys. The survey found that 1.6 percent of high school students and 1 percent of middle school students identified as transgender or gender variant. Elementary students weren't in the survey, but Kevin Gogin, the program manager for school health programs, says the district has seen more young transgender and gender variant students, too.
Sixteen states and the District of Columbia have transgender rights laws, according to Michael Silverman, the executive director of the Transgender Legal Defense and Education Fund in New York City. But even in states that don't have laws, he says districts are often open to guidance.
"By and large, most educators want to do the right thing and want to know how to treat all of their children equally," Silverman says. But often, they don't know how.
In California, which has had protections for transgender people for some time, a new law requires schools to provide transgender and gender variant students with "equal and full access to programs and facilities," such as gender-neutral bathrooms, if need be, and private changing areas for gym and sports.
There can be resistance, of course even in families and friends.
Of course, how a school staff and a community react still varies widely from place to place. But overall, attitudes about differences in gender identity have been changing, even in the last decade, says Eli Erlick, a transgender student and graduating high school senior in Willits.
When Erlick began her transition from boy to girl at age 8, she says that even she didn't know what the word "transgender" meant. She just knew that she wanted to live life as a girl. "I thought I was the only person like this," she says.
School was difficult. Some teachers made fun of her in front of the class, she says. To avoid dealing with which bathroom to use, she would pretend to be sick, so she could go home and use the facilities there.
Now Erlick is the director of an organization called Trans Student Equality Resources, which provides schools with training and information about students like her. Erlick also has helped her school district and others in California develop transgender policies.
Some schools in other states are doing the same.
"There is definitely more awareness," says Kristyn Westphal, vice principal at Grant High School in Portland, Ore.
There, they've established a student support team to determine how well the school is meeting the needs of transgender and other students. Earlier this year, the school also created individual gender-neutral bathrooms that any student can use.
Bathrooms often become a focal point because, when children are young, the transition is often more "social," a change in clothing and hairstyle.
As some kids move into puberty, they might use hormone blockers and, eventually, start hormone therapy to help their bodies transform from male to female, or vice versa. But any kind of surgery, experts say, is still relatively rare, even in adolescence.
The parents of Coy Mathis, are suing their school district in Fountain, Colo., because a separate bathroom was not a workable solution. Kathryn Mathis, Coy's mother, says it's about more than that.
"If it were just a toilet, then just having the gender-neutral option would be fine. But it's really about being accepted," Mathis says.
Mathis says she's heard from several parents who've made the decision for their transgender children to go "stealth." In other words, they make the transition from boy to girl or girl to boy and then move, so no one knows.
"That's how they're doing it ... because there aren't laws to protect them," Mathis says.
But Scott Morrison, a transgender student at Grant High School in Oregon, says having support at home and at school, as he did, makes a big difference.
Morrison, a graduating senior, moved to Oregon from Virginia three years ago.
"Gender identity is probably the most important part of me," Morrison says. "It's the most important discovery I've made about myself."
He transitioned from female to male a year later and says support from his mom, his friends and his new school and help from a counselor likely prevented him from committing suicide.
According to a 2010 National Transgender Discrimination Survey, 41 percent of transgender people surveyed said they had attempted suicide. That figure rose to 51 percent for those who said they'd also been bullied, harassed, assaulted or expelled because they were transgender or gender nonconforming at school. The survey was a joint project of the National Center for Transgender Equality and the National Gay and Lesbian Task Force.
With more support and an ability to live more openly, however, some wonder if it will be better for transgender and gender variant kids.
"I'll be really curious to see what this next generation looks like," says Masen Davis, the executive director of the Transgender Law Center, a civil rights and advocacy organization based in San Francisco. "I'm hopeful."
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