Beth McGarrity forced a smile as she rejoined a group of moms around the dining room table in a spacious home in Newcastle-on-Tyne, England.

A few months earlier, in the summer of 2000, she and her husband, Russ, had moved to England from Cincinnati with their two young children for Russ' promotion with Procter & Gamble. Now, they mingled at a barbecue with the families of other expat employees and their friends.

Outside, 2-year-old Alyson* tumbled after a soccer ball with the boys in the tree-shaded backyard as Russ and the other dads looked on. Upstairs, 5-year-old Russie* laughed with a group of girls as they sorted through pink dresses and layers of chiffon.

Twice, Beth had gone up the big staircase. "Russie, do you want to go outside and play some football?" she'd asked.

"No," he had said, looking puzzled the first time; upset the second. "I'm having fun here."

Beth put on a brave face for the others around the table, but she had seen their sideways glances. As their conversation picked up again, she felt completely alone. It would have been easier, she thought, if someone had just come out and asked why her son was playing dress-up. Then she could have said what was on her mind: "Because he's having fun. Who cares?"

Later, after tucking the kids into bed, Beth and Russ sat down to talk. Whatever was going on with Russie, they agreed, was persistent and real. And while they didn't totally understand it, they knew their love was unconditional.

At the same time, they worried for their kind, outgoing oldest child. How would the rest of the world treat him?

The McGarrity family in a holiday vacation photo. Courtesy of Beth McGarrity

Challenging Years

A decade later, in 2011, the family was back in Cincinnati, Ohio. Beth worked as a home-based data quality specialist for Procter & Gamble, getting up at 5:20 a.m. every weekday, to begin tackling the day's tasks before her teens — now in junior high and high school — awoke. But her husband's frequent travel as an IT manager meant Beth was also tasked with emotionally supporting her oldest child as he navigated his junior year of high school.

Adolescence had become increasingly difficult for Russ. And while Beth and Russ Sr. had known for years that he wouldn't be a "typical" male by societal standards, they were unsure of where that would take him. Was he gay? Or perhaps a straight male who loved the female look? They felt reluctant and ill-equipped to define it for him. "I knew what being transgender was," Beth says in retrospect, "but it really wasn't as big of a topic of discussion as it is now."

For Russ, the pressure of every school day started with what to wear. Dressing like a stereotypical guy didn't wash for someone who found joy and energy in wearing the latest styles. Over time, he developed an androgynous look: short hair, makeup, skinny jeans, and tops designed for girls.

"We support you," Beth and Russ Sr. would say. "But are you sure you want to wear that pink shirt to school today? It might cause you some issues."

Most often, the answer was yes. But the outcomes were excruciating. On an "easy" day, Russ would be greeted at school by a football player's taunt: "Hey, fag, you're gay." On bad days, there were interactions with school administrators who didn't seem equipped to understand or support a student who didn't fit expected gender norms.

Russ McGarrity's senior portrait. Courtesy of Beth McGarrity

In one case, Russ spilled water on a purse and hurried into the women's restroom with a female friend to empty its contents. When they emerged, a school administrator was waiting. At home that evening, Russ broke down as he said he'd been ordered to the office and threatened with expulsion. To him, it meant that no bathroom would feel right to use at school.

"I did not choose this for myself," he wept as his parents listened. "I wish there was a way that I could not be this way."

At the same time, he was resolute. "I would rather be hated for who I am," he said, "than loved for who I am not."

In public with Russ, Beth experienced his challenges firsthand. When the two shopped their favorite mall together, adults would stop, jaws dropped, as they stared at his Ugg boots and makeup over a shadow of facial hair. "Excuse me," Beth would say, looking them in the eye. "Do you need something?"

By then, she had let go of any expectations she'd had for Russ's high school years. That had been the easy part. Now, as Russ missed day after day of school, she became concerned that he wouldn't graduate. She made frequent trips to the school to talk with administrators and to gather missed assignments.

Her concerns intensified as Russ fell into depression. Normally social and funny, he spent hours in his room alone, rebuffing her suggestions of counseling.

The Truth Comes Out

Meanwhile, low-key Aly seemed to be thriving as a junior high tomboy who loved sports, baggy jeans, and T-shirts. She had good friends and earned good grades. But for years, she had been quietly struggling, desperate to spare her parents any additional worries as they worked to support her brother.

It was Russ who finally got her to talk about it. "I heard you like girls," he said one evening when their parents were out with friends. "Is that true?"

"Well, it's deeper than that," Aly replied. Quiet and studious, she had been researching gender identity online. Now, just a few weeks shy of her 15th birthday, she sat down with Russ to describe some things she had learned, including the term other teens were using on YouTube for feelings that sounded a lot like hers: transgender — experiencing psychological gender differently from the gender observed at birth.

"You need to tell Moot," Russ said, using a nickname he'd coined — a twist on the German word for "Mother."

When Beth and Russ Sr. arrived home, they could see the kids upstairs, talking in Russ' room.

"Moot," Russ called down. "We've gotta talk."

When Beth walked in, the kids were sitting side by side on the bed, laptop computers on their laps. But her mother's instinct kicked in when she saw their faces. "They both looked happy, but nervous," she recalls.

Russ spoke first. "Moot," he said, looking at his sister, "Aly has something to say."

"It's going to be really hard," Aly said. She paused. "I've had a lot of stuff going on in my head and haven't wanted to tell you, because I knew you were dealing with a lot with Russ. But since we're so close, and you can always tell when something's bothering me, I know I have to tell you now. Moot, I've figured out what's going on with me. I know that I'm transgender.

"I've always wanted to be a boy," Aly continued. "I never told you this, but when I was little, I would go to sleep and wish that I'd wake up a boy. Every time we did the wishbone at Thanksgiving and I won, I would wish that I was a boy."

Beth was floored. But above all, she wanted to express her unconditional love. "I'll support you no matter what," she said, hugging Aly tightly.

As the conversation continued, she learned that Aly wanted to begin transitioning after high school, including surgery to remove her breasts. It was a lot for Beth to absorb, and she knew that even the natural hormones of the teen years could make decision-making difficult.

"Why don't you really think about it?" she said. "I want to make sure you know what you are going to go through, because you're really young."

As she left the room, Beth heard Russ reassuring his younger sister. "I'm here if you ever want to talk," he said. "You can hang out in my room if you want."

Beth went downstairs and poured a big glass of wine for herself and one for Russ Sr. When she got to their room, she closed the door. "Oh my God, I can't believe the conversation I just had with the kids," she said.

The two talked into the night. "Are you sure it's not Russ' influence on Aly that's driving this?" he asked at one point.

It was hard to be sure. They agreed that waiting, watching, and never wavering in their love would provide their answer.

That night, Beth and Russ Sr. had tossed and turned while their youngest slept soundly. "All this weight had been lifted off my shoulders," Aly, now known as Gavin, says, "because I was finally being honest with myself and with Moot."

A Difficult Path

A month later, Russ came out as transgender, too. "I had just finished work," Beth recalls, "and Russ said to me, 'I have something to tell you, Moot.' So we went outside to our screened-in porch and sat at the table out there." As he struggled for words to describe the anxiety and isolation he'd felt for so many years, Russ began to cry. Beth looked him in the eye. "No matter what you tell me, I'll still love you," she assured him.

After their talk that day, he'd agreed to see a counselor, who in turn told him about a new teen center at the Cincinnati Children's Hospital Medical Center Transgender Program.

Through doctors and staff there, the McGarritys were able to put their story into context. Though little research exists on transgender Americans, current estimates suggest that 0.3% of the population, or one adult in about every 333, is transgender.

The McGarritys learned, for example, that clusters of transgender individuals within families aren't uncommon. They discovered that their kids were not alone in their deep distress over the persistent discomfort they were experiencing in daily life. "Theirs is an issue of gender identity, not sexual orientation," Richard Ryan, Ph.D., a professor of psychology at the University of Rochester, points out. "It's a way of living, so it's there all the time."

In fact, for many transgender Americans, that can lead to tragedy: In a survey conducted by the National Gay and Lesbian Task Force and National Center for Transgender Equity, 41% of transgender and gender non-conforming adult respondents reported having attempted suicide. The study suggested that negative experiences of anti-transgender bias might be a major factor. Among transgender students who reported having also been harassed or bullied at school (like Russ), the percentage jumped to 50 to 54%. (By comparison, just 4.6% of the overall U.S. population have reported a suicide attempt.) Fortunately, Russ and Aly both had a solid support system at home.

The family was also reassured to discover that gender variance isn't learned, isn't chosen, and isn't determined by parenting. "There's no evidence that parenting style or a history of abuse or anything along those lines causes this," Dr. Lee Ann Conrad recalls telling them.

"This is not a choice," Sarah Painer, a social worker who works closely with program participants, added. "Nobody would choose a higher risk of murder and a higher risk of suicide."

Fears and Hope

Beth blinked back tears as she drove one day. For eight months since Aly's revelation, she had kept up a brave front. But inside, she ached over the pain she anticipated for her kids. As transgender children transition to adulthood, they face disproportionate levels of discrimination in employment, housing, and health care. Even more alarming are levels of sexual violence and violent hate crimes experienced by transgender people.

As Russ and Aly began to discuss options, including hormone therapy and surgeries, Beth also worried about the judgment a family with two transgender children might draw. She had learned years earlier to focus on friends who could support them, but it hurt when the parents of one of Aly's longtime friends forbade their daughter from hanging out with Aly, citing religious reasons.

Beth didn't consider herself a religious person, but during those months, she prayed a lot. "OK, I need some help going through this," she would say as she drove, usually after dropping off Aly at her friend Olivia's house. "I'm really kind of lost right now, and I'm not sure I can handle being the supportive parent I need to be here."

It was a song by the hip-hop duo Macklemore & Ryan Lewis that finally nudged her to find the strength she would need for the task ahead. She had heard the popular "Same Love" release on the radio countless times over those difficult months. But that afternoon, the refrain — "I can't change, even if I tried, even if I wanted to" — sparked an insight.

"God has chosen me to be the parent of these two kids, she thought. What am I struggling for? It's an honor. I need to step up and get them where they need to be."

Beth and Rai McGarrity filming her YouTube blog (left), Russ and G at a rock concert. Courtesy of Beth McGarrity

Moving Forward

Beth smiled as she walked alongside her family in the Cincinnati Pride Parade on a mild Saturday in June 2015. Like the dozens of P&G employees around them, she wore a blue T-shirt emblazoned with "Love Has No Labels." So much had changed since Russ and Aly had begun their transitions to Rai and Gavin, affectionately known as G. To Beth's relief, G had not been bullied. Preparing for his sophomore year of high school, the 17-year-old was already planning for college and a career in psychology so he could help smooth the path for other transgender children. Rai, too, had begun talking about college.

Beside her, 20-year-old Rai held her head high as she videotaped the experience for 60,000 YouTube channel subscribers. Vlogging as Raiden Quinn, she had logged more than 6.5 million views with her edgy humor and genuine commentary on life as a transgender woman. (Part of that process was undergoing a painful facial feminization surgery.) Rai's boyfriend, Joey, waved a rainbow flag as he walked alongside her. "Can we do this every day?" he joked.

Just ahead of them, Russ, Sr., walked beside G and his friend Olivia. Cheers rose into the summer sky.

Both Rai and G express their gratitude for parents who loved them unconditionally. "Even in the years when Moot didn't know what was going on, before I came out," G says, "I knew that all she cared about, at the end of the day, was me and Rai being happy."

Had Beth known what she knows now, she would have sought hormone therapy for her children sooner. "Having them transition before puberty would have prevented G from having to go through the top [chest] surgery he's going to have to do next summer," she says, "and Rai wouldn't have had to do the facial feminization and the breast augmentation surgery that she will be doing soon."

"People ask me what I've lost," Beth continues, "but I don't feel that I've lost anything. I have my son and daughter the way they should be."

Russ chuckles as he recalls the years when he and Beth were starting their family and hoping for a boy and a girl. "As it so happened," he says, "we did have one of each — just in a different order than we originally thought."

"It's like Christmas every morning now," Beth adds. "I can see the happiness on Rai and G's faces."

Like many mothers, she feels a mix of pride and relief — multiplied by about a thousand — over her children's transition into the adults she had always known they could be.

"I feel like my kids are at a place now where I can sit back and take a deep breath," she says. "They're happy. And every minute we spend with them, I feel, is a gift.

"You can't ask for any more than that."

Rai, Beth, Gavin and Russ McGarrity today. Courtesy of Beth McGarrity

*With the family's permission, the name and gender which they used at the time was used in the article for clarity.

If you or someone you love has questions about gender identity, ask with your health care provider for information or the name of a professional who will be able to help. You can also learn more through the Gay, Lesbian, & Straight Education Network or the Family Acceptance Project.

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