INTERNATIONAL model Andreja Pejic is a trailblazer and role model for thousands of young people.

The first model to star in Jean Paul Gaultier’s men's wear and womenswear shows in Paris, the Broadmeadows boy had sex reassignment surgery last year and is now making the film Andrej (a) about her life and transformation into a woman.

“I have the opportunity to tell this very interesting story that should expose a lot of truth about society, about being a transgender individual and also about fashion, and about living life as a woman,” Pejic told the Herald Sun recently. “I feel there are so many kids all around the world who will relate.”

One of those kids is Melburnian Marco Fink, who met Pejic last year and tweeted it was the

“best day ever!”.

Fink used to envy the girls at primary school, their freedom to wear dresses and express their femininity. But as a prepubescent boy, these feelings were confusing and frightening.

“My entire view of being transgender was shaped by extreme examples on The Jerry Springer Show, and CSI Miami where they (transgender people) were almost always the murder victims,” the now 20-year-old tells Weekend.

“I thought, ‘If that’s what these feelings mean, I want nothing to do with it’ and I went into a really deep denial.”

Struggling to cope as a student at Armadale’s King David School, a coeducational Jewish school, Fink’s lifeline at the age of 15 was the Richmond-based Minus18 Foundation, a support group for transgender and same-sex attracted people.

“I met a transgender person for the first time,” Fink says. “He was just so amazing, so happy, so inspired, everyone around him was warm. My fear had always been that I had to choose being honest and being myself or success and family and happiness.”

media_camera Australian model Andreja Pejic. Picture: Getty Images

But it wasn’t until last year that Fink found the courage to tell her parents she identified as female and wanted to be recognised as a woman.

“My parents were shell-shocked,” she admits. “I’d really made a point to keep it under wraps, so when I finally did speak to them, they were like, ‘Oh, my goodness, where is this coming from?’

“I’d been openly bisexual for many years, and they were like, ‘OK, Marco is attracted to both girls and boys, whatever,’ but the gender stuff caught them off-guard.”

Fink says Pejic was her main inspiration. “I thought, ‘If she can do it in front of the whole world, I can too’,” Fink says.

“Seeing a happy, healthy, gorgeous and successful person like Andreja not just exist, but thrive really helped me break down assumptions I’d made about what my future held and made me a lot more confident.”

Fink’s experience of gender dysphoria is shared by an estimated 2-4 per cent of Australians.

There are no population-based studies, but it is thought between 400,000 and 800,000 people across the country identify as transgender.

In recent times, positive stories have played out in the media, including Pejic talking about her gender-reassignment surgery, Angelina Jolie and Brad Pitt supporting eight-year-old daughter Shiloh’s decision to be known as John and dress as a boy and, of course, Bruce Jenner confirming in a recent interview with Diane Sawyer, after months of intense media speculation, that he is transitioning to be a woman.

It’s even a topic we’re slowly seeing creep into prime time with long-running daytime soap The Bold and the Beautiful introducing a transgender character, with the first episodes airing in Australia last week.

But despite these gains in mainstream media, discrimination and depression remain the biggest challenges for people who feel their gender identity is different from their biological body.

Fink, now Minus18 Foundation’s communications manager, wants others experiencing gender dysphoria to know support is available.

“I think it’s important for young people to realise that while not everyone can access services as early as they’d like to, there is still hope and there are always options,” she says.

Where to get help Minus18 minus18.org.au

email: info@minus18.org.au The Gender Centre gendercentre.org.au

Ph: (02) 9569 2366 Royal Children’s Hospital Gender Dysphoria Service rch.org.au

Ph: 9345 4719 Transgender Victoria transgendervictoria.com

Ph: 9517 6613 Safe Schools Coalition safeschoolscoalitionvictoria.org.au

Ph: 9479 8738 beyondblue beyondblue.org.au

1300 22 4636

A recent La Trobe University survey found about 60 per cent of transgender males and 50 per cent of transgender females suffered depression.

Another 2007 survey found almost 90 per cent of transgender people in Australia and New Zealand had experienced discrimination, including verbal abuse, social exclusion, physical threats and violence.

Clinical leader of the Centre for Adolescent Health at the Royal Children’s Hospital Dr Michelle Telfer says attempted suicide rates for transgender people are unacceptably high — up to 30 per cent in adolescence and as high as 50 per cent over a person’s lifetime.

Telfer says suicide prevention was one reason a gender dysphoria clinic was set up at the hospital in 2003, where the number of children and adolescents treated has increased exponentially.

“What we have seen is an increase from one referral in 2003 to 104 new referrals last year, and this year we are on track to receive between 120 and 150 new referrals,” Telfer says.

Since 2010 the Safe Schools Coalition Victoria has helped 32 students at 32 different primary and secondary schools across Victoria change their gender identity in supportive environments.

“We are seeing more and more in primary schools in the early years — grade one, two and three,” SSCV co-ordinator Roz Ward says. “Particularly because parents are able to access much more information than they used to, to recognise that their child’s gender nonconforming behaviour may be more than play.”

She says transgender adults recall childhood experiences of being forced to wear a dress or

of having all their sister’s dolls removed from the house to stop them playing with them.

“Now if you ask any specialist in the transgender field they would say that is really damaging to a child’s health and wellbeing,” she says. “Their recommendation is to follow the child’s lead and go with what they are asking for and expressing.”

SSCV runs sessions for school staff, discussing issues such as the toilet facilities the student will use, the uniform they will wear, the sports teams they will join and the personal pronouns students and staff should use.

“It may seem complicated, but the transition is much more about the school transitioning than the student, because the student is just affirming who they really are,” Ward says.

Telfer says parents at the RCH gender dysphoria clinic often ask if they have contributed to their child’s gender nonconforming behaviour.

“Often they ask, ‘Is it something I’ve done?’ ‘Am I making things worse by allowing them to be who they are?’ ” she says.

Telfer says it is common for one parent to be more accepting than the other.

“The less-accepting parent often blames the other, ‘Oh, you are allowing him to be like this, you are encouraging it and it’s going to be your fault if things don’t change.’

“But what we know is that gender is mostly a biological entity, that someone’s born

a particular way and that’s the way they are.

“If they identify as transgender and they are of an adolescent age, then that is not going to change. It is not a phase that someone can influence. It is just how someone is.”

Telfer says celebrities such as Jolie and Pitt have helped change community attitudes.

Conversely, Warren Beatty and Annette Bening’s lack of public support for their transgender son Stephen Ira, now 22, has been condemned, especially after he tweeted that he’d had conversion therapy.

There is a push to outlaw conversion therapy in the US, and Telfer is not aware of any such practice in Australia.

“We know now that treatment can be extremely harmful, and is more likely to end with a young person who is very unhappy and even suicidal,” she says.

Telfer says the treatment in adolescence includes the use of puberty blockers.

“The puberty blockers allow the young person to grow emotionally, socially and psychologically, but their body doesn’t develop secondary sexual characteristics.” The treatment is reversible, she says, but if the person decides to continue they are given testosterone for male transition and oestrogen for female transition.

“This approach to treatment improves mental health outcomes, reduces anxiety, reduces depression and decreases the suicide risk significantly.”

Pejic, who legally changed her name from Andrej to Andreja last year, used puberty-blocking hormones as a teenager after coming out to her mother, Jadranka.

Recently back home for the Virgin Australia Melbourne Fashion Festival, she said she tried to avoid causing her mother further stress after her family had fled the Bosnian war and settled in Broadmeadows in 2000. But at 14 she could no longer hide the truth.

“It was a shock. It took her a while to get her head around it,” Pejic, 23, admitted.

“She didn’t know anything about it; a lot of parents don’t. But she is someone who loves her kids so much, there was nothing that could take away from that.”

It took Pejic three months to recover from sexual reassignment surgery last year and she now strives to publicly support the gay, bisexual and transgender community.

“We should give people the freedom to express who they are. Humanity is — surprise, surprise — more complicated than we thought,” she said in March.

media_camera Bruce Jenner talks about his gender realignment on US television.

The Gender Centre counsellor Anthony Carlino says the transition for every person who identifies as transgender is different.

“Besides getting used to the changes in the body, I think anyone who understands the process

of transition knows that it is a psychological one,” he says.

“With many of my clients this becomes the final stage of self-acceptance, because no matter how many surgeries you have you are never going to be born in the body you truly want,

you will never be biologically the sex that you want to be. That can be a real struggle for people to come to acceptance with.”

Carlino says a small number of people have gender reassignment surgery in Australia, but the majority go to Thailand, where it costs between $15,000 and $25,000 for male to female surgery.

“It varies because some girls will go over there and they will want facial feminisation and they will want boobs. It depends how much they want to get done,” he says.

The $100,000 price tag for female-to-male transition reflects the complexity of that operation and transmen often limit surgery to the removal of breast tissue.

Telfer believes there should be Medicare funding for gender reassignment surgery here.

“These are not cosmetic procedures, but therapeutic procedures that reduce anxiety, depression and suicide.,” she says.

In Australia, it is not legal to have gender affirmation surgery until the age of 18, and the Gender Dysphoria Clinic at Monash Medical Centre caters for adults.

Fink, who has decided to keep her birth name for now, is in no hurry to have gender affirmation surgery, but she would love to have a partner and children.

“I have a lovely and supportive family and I’m really grateful for that and I’d love to one day give that same environment to another person.”

DEFINITIONS FOR A NEW IDENTITY

TRANSGENDER is an umbrella term describing a broad range of nonconforming gender identities and/or expressions.

The Gender Centre counsellor Anthony Carlino says people can struggle with the idea of transgender because it is easier to see the world as male and female rather than as a spectrum.

He says it useful to think of gender in two ways: gender identity and gender expression. Gender identity refers to a person’s internal sense of being male, female or something else. Gender expression refers to behaviour, clothing, hairstyles, voice and body characteristics.

Carlino says the transition for every person who identifies as transgender is different.

“You may have two men who express their identity in very, very different ways.”

He says gender is also confused with sexuality. “We know that some people are heterosexual and some are homosexual and some are bisexual, and people may identify anywhere along that spectrum, and gender is not too different from that, in terms of it’s not black or white.”

He says “gender-queer” describes people who do not identify as male or female. “Non-binary” is also used.

“They may still feel they are not in the right body. They may have been born with a female body and go, ‘I don’t feel male or female, but I want to have a male body because I know that is what I will feel most comfortable in.’ ”

He says the preferred pronouns for gender-queer people are “they” and “ze”.

Though it is often reported that people with gender dysphoria experience it from a young age, Carlino says some clients don’t recognise it until later in life.

“I’ve had people in their 50s and 60s who have said, ‘I had no idea until the last couple of years.’ ”