Jay woke in darkness, the summer and a girlhood behind him. A sharp pain stabbed through his stomach. In an hour, he would be a high school freshman.

Please, he thought, don't let anyone recognize me.

He dragged himself out of bed and lumbered through the double-wide trailer he shared with his mom and two sisters. His mother was at work, his siblings asleep. Only his dog, a 9-pound Chihuahua named Chico, marked Jay's passing from one life to the next.

Jay faced the bathroom mirror. He was 14. His dark brown hair spiked just the right way. His jaw was square, his eyebrows full and wild. But his body betrayed him. He was 5-foot-2 and curvy in all the wrong places.

He tugged one sports bra over his chest and then another. He pulled on a black T-shirt, hoping it would hide his curves. He eyed the silhouette, and his stomach rumbled with anxiety.

Not flat enough.

He had finished eighth grade with long hair and a different name. At his new school in southwest Washington, most of the 2,000 kids had never known the girl Jay supposed he used to be. As long as his contours didn't give his secret away, "Jay" was a clean slate, a boy who could be anyone.

He took one final look in the mirror. Puberty was pulling him in a direction he didn't want to go, and reversing it would take more than a haircut and an outfit. But how much more? He was a boyish work in progress, only beginning to figure out how to become himself. His mom and his doctors had little precedent for how to help.

He had taken great pains to start school as this boy with no past. His mom had met with the principal, and a counselor had created a plan. Jay could use the staff bathroom. Teachers would avoid his birth name, a long and Latina moniker that stung Jay every time he heard it.

About a Boy: Day 1 18 Gallery: About a Boy: Day 1

Jay stepped outside and knew he should feel lucky. Whole generations had lived and died without any of the opportunities he would have. He was a teenager coming of age in an era Time magazine had declared the Transgender Tipping Point.

By his senior year, Jay's quiet life would ride a surge in civil rights.

Barack Obama would become the first president to say the word "transgender" in a State of the Union speech. Target would strip gender labels off its toy aisles. In Oregon, student-athletes would gain the right to decide whether to play on the girls' team or the boys'. Girls would wear tuxedos to prom.

That didn't make the path forward easy or safe. North Carolina would forfeit $3.7 billion to keep people like Jay out of the bathroom. An Oregon city councilman an hour from Jay's house would threaten an "ass-whooping" to transgender students who used "the opposite sex's facilities." Even Washington, the liberal state Jay called home, would consider a bill rolling back his right to choose the locker room that felt right. President Donald Trump would take over for Obama and ban transgender people from serving in the military.

But that morning, Jay was just a teenager, just a boy walking to school. He didn't want to be a trailblazer. He wanted to be normal.

Jay (right) had been depressed since he was 4. In photos, he grimaced while his sisters Maria (left) and Angie (center) smiled. (Family photo)

"THAT'S NOT ME"

He was 12 when "girl" started to feel like the wrong word for him. He didn't know what he was, yet.

I'm a ghost without a body.



He avoided mirrors, but his reflection found him anyway. There were mirrors in the hallway and next to the kitchen table. Turned off, the flat-screen TV was a black projection of the body he tried to hide. Even the coffee table, a glass-top smeared with after-school snacks, caught his form.

His face was round and so was his body. He turned away in disgust.

That's not me.

His family called him YaYa then. He dressed to disappear. He pulled his thick hair into a ponytail, the imperfect gathering too far left or right to be stylish. He wore an oversized gray sweatshirt every day and kept the hood up to hide his hair.

He tried to do what other girls did. He shaved his eyebrows and curled his hair. Both felt wrong. His stomach knotted every time someone called him "she."

In other parts of the country, people might have talked. Girls in guys sweatshirts were tomboys or worse. In Vancouver, Washington, a suburb just north of Portland, most people looked the other way. He had friends who wore makeup, but no one ever pressured him to try it.

Still, some days, he couldn't bring himself to walk the hallways. He skipped class at least once a week in seventh grade. He passed whole days in bed, the sheets pulled up to his neck. In the shadows of his bedroom, Jay could be almost nothing at all.

Jay dressed to disappear. He wore the same grey sweatshirt every day. (Family photo)

His mother took him to doctors, but there was no word for the way Jay felt. He struggled to explain that he felt sick because he didn't feel like himself.

I feel like I am walking on glass, he wanted to say. But the words came out, "My stomach hurts."

The doctor gave him omeprazole for heartburn and Zofran for nausea. Jay trawled the internet for a better diagnosis. Surfing on a years-old iPod, he landed on YouTube, where every video was a current that pulled him toward another. Eventually the river carried him to a four-minute video called "BOYS CAN HAVE A VAG." A 20-something woman with long hair and perfect eyebrows laid out her argument.

Gender, she said, is like a suitcase. When you're born, doctors look between your legs and assign you one. Boy luggage contains sports, trucks and action figures. It comes with short hair and abs, toughness and courage. The girl suitcase has soft curves and graceful movements, dresses and jewelry, patience and nurturing.

But what if all those things felt wrong? she asked. "You might start to feel broken, like there was no room for who you were in that stifling suitcase."

That's it.

People who don't identify with their suitcase, the YouTube host explained, are transgender.

Jay typed "transgender" in the search box. He watched documentaries and first-person testimonials and began to imagine the possibilities. Puberty blockers could stop his period. Shots could deepen his alto voice. With surgeries, he could even rid himself of ovaries and breasts.

It might take years, he realized, but maybe the world would see him as a guy.

That recognition was a window opening and door slamming shut. He'd never have a kid, he thought. He would always have this history - a girlhood that screeched to a halt. He was afraid of shots. He dreaded surgeries and secrets.

He didn't want to be that word, "transgender." He searched for other explanations, but nothing fit.

After a month, he resigned himself.

This is my label.

One afternoon while his mom worked, Jay called his younger sisters to the living room. They were 8 and 10 - old enough, he hoped, to understand.

"I need to show you a video," he told them. He streamed one of the YouTube videos on the TV. A trans guy appeared on the screen and explained how he came out to his family.

Jay stood while his sisters watched from the couch.

"This is how I feel," Jay said when it ended.

"So you're becoming a boy?" asked his youngest sister, Angie.

Jay paused. He couldn't bring himself to say it out loud.

"Kind of."

"Do you want me to tell mom?" Maria asked.

"No," he said. Jay hadn't talked to his mother much the past year, but he knew he had to tell her.

The next day, he crept to the other side of their trailer, his heart knocking. He pushed open his mom's bedroom door, stood in the doorway and watched her play Candy Crush. She was zoned out after a 12-hour workday. Maybe she'd be too tired to talk about it. She already had on her favorite pajamas, gray sweatpants and a tan tank top.

"I think I figured it out," he said.

He took a deep breath.

"I'm a boy."

His mom looked up from the phone.

"So you want to be a butch lesbian?"

"No," he said. He walked toward her.

"A boy."

Nancy Munoz was 16 when she had Jay. She spent half her life dreaming for the baby she thought of as a girl. (Family photo)

"WHAT WENT WRONG?"

Nancy Munoz spent half her life dreaming of who her oldest daughter would become. Nancy was 16 when she gave birth, 29 when her 13-year-old told her everything she'd imagined was wrong.

That night, Nancy fell into bed and reminisced. Her oldest had been a perfect baby, fluffy and cute in tiny dresses. What went wrong? She racked her brain for answers. Nancy didn't wear makeup or skirts. Maybe she hadn't taught her kids how to be women. They saw their dad only once every few months. Maybe Jay wanted to be the man his childhood lacked.

Nancy couldn't help but think of the ways she had failed. She had wanted to be a secretary working in an office. Instead, she earned minimum wage working double shifts at a home for disabled adults. She longed for her three girls to have all the things she never had, wedding dresses and quinceanera parties.

Jay had been a perfect baby, Nancy thought. But he cried every time his mother laid out dresses. (Family photo)

Had all her dreams been the wrong ones?

A thought came. Her perfect oldest baby had cried every time Nancy suggested dresses. Jay had only wanted to wear one outfit when he was young. It was green camouflage with a Scooby-Doo print. A boy's outfit.

When that outfit wore out, Nancy combed four stores for a replacement. She prided herself on being the kind of mother who would do anything to make her children happy. She bought them pizza even if she couldn't afford lunch for herself. She let them have cats and birds and hamsters.

But this? What would it take to make her daughter a boy?

The next morning, Nancy searched online. Doctors had spent two decades looking for biological proof of what makes someone transgender, she learned. So far, they had only theories.

Some blamed hormone imbalances or psychosocial factors. Others found proof in patients' brains. Some people, researchers believed, were just born transgender.

Nancy couldn't see inside Jay's head. As she read, though, the pieces started to fall into place. He had loved Hot Wheels. He'd never harbored crushes on boys. And that walk, she thought. Girls sway and glide through life. Her child traversed the world with stiff hips and steel legs.

Nancy kept reading. Nearly 80 percent of kids who came out as transgender had been harassed at school. A third said they had been physically assaulted. Ninety percent of transgender adults had been harassed at work. Nearly half had attempted suicide.

That was not the life Nancy wanted for her child. And yet, she thought, what was the life Jay had now?

He had been depressed since he was 4. She had taken him to counseling, but still he spent so many hours in a dark bedroom. When he said he had figured himself out, his eyes had flickered.

There was a spark, she thought. I have to run toward that light.

Jay came out to his sisters first. "So, you're becoming a boy?" asked his youngest sister, Angie. (Kristyna Wentz-Graff/2015)

"I KNOW SHE'S A BOY"

They started slow. One afternoon at Walmart, Jay ventured to the boys section. His new life began with button-downs and boxer shorts. He wore a men's T-shirt for his eighth grade yearbook photo, a subtle victory his classmates didn't notice.

Jay's sisters tried to use "he" when talking about their oldest sibling. It didn't feel right. They still called him YaYa, a girlish name carved from the one his mother had chosen before he was born. He still had long hair. Everyone else thought of him as a girl.

In the winter of 2013, Jay spent an hour each week untangling his thoughts with a counselor. Jay had depression and anxiety, the counselor said. He also had what's listed in the Diagnostic and Statistical Manual of Mental Disorders as "gender dysphoria."

That feeling might go away, the counselor said. Some kids grow up and find there were other reasons their brains and bodies felt mismatched. The therapist suggested Jay practice living as a boy one day a week. If it felt right, he said, Jay could try longer.

Nancy told the girls to think of the process as a kind of ultrasound.

"Your sister thinks she is a boy," Nancy said. "We're going to find out. It's kind of like being pregnant all over again. What are we going to have? A girl or a boy?"

"She's a boy," Angie said. "I know she's a boy."

Jay tried, but the experiment felt too much like dressing up, as if Halloween came once a week. He wanted to be a boy all the time.

"Why don't we wait until you finish eighth grade?" his mother asked. That way, he could transition without 750 preteens watching.

On the first day of summer vacation, Nancy drove Jay to Supercuts. He pulled the hoodie off, climbed into the barber's chair and asked for a guy's style.

"Are you sure?" the stylist asked.

"Yeah," he said. "Not a pixie cut. A boy's cut."

The job was cheap and fast. When he left, his hair was a palm tree, a porcupine's splayed spikes.

It's ugly, Jay thought. But he didn't care. He was one step closer, he thought, to looking right.

Jay started high school with a new haircut and a new name. The cosmetic changes had worked, he thought. Everyone at school thought of him as a guy. Jay's mom, Nancy (right), accompanies him at school conferences. (Kristyna Wentz-Graff/2015)

GOING STEALTH

By the time Jay started high school in August 2014, his hair looked just how he wanted, shaved on the sides and high on top. He tramped through hallways in Timberland boots and black T-shirts. The cosmetic changes had worked, he thought. Everyone at school thought of him as a guy.

Other transgender kids wrote online that they longed to live undetected. But "going stealth," as Jay called it, had its limitations. Jay used the nurse's office to change clothes for P.E. His blood pressure rose anytime someone saw him emerging in gym shorts.

He was afraid to use the bathroom. People asked questions when he used the teachers' bathroom, and he didn't feel safe in the men's room. What if a guy came in and noticed Jay sitting in a stall? He just held it.

Jay lived in one of the most liberal regions of the country. His school had a day of silence for transgender rights. Still, he worried his classmates would treat him differently if they knew. They might ask what his name used to be. They might want to see pictures of the years he spent miserable and mistaken for something else.

Passing was a gift he tried to preserve. Jay played dumb when LGBT issues came up in class. He avoided the diversity club, a lunchtime gathering of ethnic minorities and gay students.

"I don't want everybody wondering, 'Why is this straight dude in here,'" Jay told his mom. "What would I say?"

Few people in his neighborhood noticed. Theirs was the last mobile home on a dead-end road where no other kids lived. When their favorite taco truck owner asked, "Didn't you have three daughters?" Nancy said no, she'd always had a son.

Then, a month into school, people started asking questions.

Roughly a quarter of the students at Jay's high school had also attended his middle school. Occasionally, old classmates noticed him in the throng. One guy stopped Jay at the end of biology class.

"Didn't you used to be a girl?"

"What? No way," Jay said. "Do you want to see inside my pants?"

Sometimes teenagers whispered. A few times, they shouted down the hallway.

"Jay, are you a girl?"

He joked in class, but he didn't invite anyone home after school. How would he explain the long-haired school pictures that hung on the walls?

Instead, he lived his life in video games. He remade himself into a businessman with a family on The Sims. He crashed through Grand Theft Auto as basic_killa, a hipster renegade with nothing to lose.

Jay didn't invite anyone home after school. Instead, he lived his life in video games. (Kristyna Wentz-Graff/2016)

Then, one day in health class, a tall girl with wavy blonde hair struck up a conversation. Jay had drawn a poster showing the rap group Odd Future's donut logo. Maddie liked it. They started talking about music, and soon, Maddie and Jay were inseparable.

She was, he thought, an ideal friend. They found the same pedestrian things funny. They spent whole afternoons and nights hanging out or texting. Maddie and Jay both possessed a quiet maturity that made adults say they had old souls.

Maddie had heard the rumors, and at first, she told people they were wrong. Jay just had a "small voice." That didn't make him a girl.

The more she thought about it, the more Maddie wondered. That Thanksgiving, she decided to ask him.

Jay was at home, sick with another stomachache, when the text message came in.

People keep saying you're a girl.

His heart dropped. He wasn't ready.

Yeah ...

Maddie was shocked. She had never knowingly met a transgender person. She asked her mom for advice. When she texted Jay back, though, she kept her cool.

I'm not going to treat you different. You can tell me anything you want, and I'll never be here to judge.

As winter neared, other boys grew taller and deeper-voiced. Jay remained the same. His face was smooth, his voice high and lilted.

"People think I'm a late-bloomer," Jay told his mom.

Something had to change, he told her. He couldn't stay frozen in time while his classmates became men. He needed testosterone to do what his own biology would not.

Jay lived half an hour from one of the few doctors in America who knew what to do. Dr. Karin Selva (right), a pediatric endocrinologist, had become a national expert in treating transgender children. (Kristyna Wentz-Graff/2016)

THE T-CLINIC

If Jay had lived anywhere else, his journey might have stalled right there.

In the fall of 2014, most doctors didn't know how to help him. His pediatrician offered him birth control to stop his period. But Jay didn't want girl hormones.

Fortunately, Jay lived half an hour from one of the few doctors in America who knew what to do. Dr. Karin Selva was a pediatric endocrinologist in Portland. When she read Jay's chart, she recognized all the signs.

Depression. Anxiety. Frequent trips to the emergency room with stomach complaints.

Then Selva opened the door to her exam room and saw a boy with a fresh haircut and big grin. She was his only hope.

Selva knew how to treat hormone imbalances, but in the three years since a transgender patient first approached her, she'd had to learn on the fly. She'd hunted for research and mentors. Only one study, conducted in the Netherlands, examined how hormone treatments affected children as they became adults. Only one U.S. clinic, Boston Children's Hospital, specialized in transgender adolescent care.

By the time Jay arrived, Selva had treated 48 transgender patients. They made up less than 5 percent of her work, but that was enough to make her a national expert.

She traveled the country training other endocrinologists, and she convinced Randall Children's Hospital officials to set aside one day every other month for the program she called the T-Clinic. The appointments were always full.

Families came from six hours away, bringing children as young as 8. Selva's research suggested there might be thousands of transgender adolescents just in the metropolitan area. A Portland Public Schools survey found that 3 percent of middle and high school students identify as transgender. Leaders at a local advocacy group told Selva they were working with 450 transgender kids, nearly two-thirds of whom were under 12.

The work could be daunting. Adolescent brains aren't fully developed. Teenagers take risks and try out identities. The more transgender patients she had seen, though, the more Selva thought of the oath physicians take: Do no harm.

"Abstaining is actually doing harm," she said. "Puberty is happening, and it's making it worse for these kids."

Once a child went through puberty, physical changes became much harder to reverse. She could arrest a patient's development to buy time. She could even reroute a teenager's puberty. Selva's task was to figure out when and how to intervene.

"I just love these kids," said Connie Earnest-Ritchey, a nurse at Legacy Health's Transgender Clinic. "I think it's an honor to be able to make such a difference in their lives. What they have to go through is not easy." (Kristyna Wentz-Graff/2016)

Jay was a week shy of his 15th birthday. Two years had passed since he told his mother he was a boy. He hadn't wavered.

The puberty blocker Lupron was a good place to start, Selva told Jay and Nancy. The medicine would shut down his production of estrogen. His period would stop.

The medication was completely reversible. Doctors had been using Lupron for 40 years on kids who started puberty too early. But the shots cost nearly $20,000 a year, more than Nancy took home annually. She earned only $10.80 an hour.

Jay qualified for public health benefits, Selva noted. Just a few months before, Oregon had become the first state to provide Medicaid coverage for transgender adolescents using the blockers. Washington was close to approving a similar plan, and Selva thought she might be able to lobby the state to pay.

"What about testosterone?" Jay asked.

Testosterone was cheaper, Selva told them, and more powerful. The hormone would change Jay in ways that could not be reversed. Once his voice deepened, it would never go back. With testosterone, Jay would grow facial hair and an Adam's apple. Those changes, too, could not be undone.

Jay was making a rest-of-his-life decision. Go home and think about it, Selva said.

After Jay transitioned, his mother left a few old photos hanging in the house. One of his middle school pictures hung right outside his room. The pictures reminded Jay of a painful time. "I didn't really know how to be myself because I didn't know what part of me was not being myself." (Kristyna Wentz-Graff/2015)

"IT STILL HURTS"

Nancy's relatives told her she was making a mistake. What kind of mother lets her daughter become a boy? Jay's dad accused her of enabling Jay. Other people said she was a bad mom.

"He's still alive," she countered. "Would I rather have a dead child because I didn't support him?"

Nancy had already given up so many of her own dreams. She had never gone to college, never found a job she loved. She wasn't pushing him to transition. She was sacrificing, again, so he could have the life she had missed.

Every step forward took Nancy further from the daughter she raised. She stopped calling him YaYa, but some nights, Nancy flipped through her files and stared at the name on his birth certificate. She had spent 13 years calling that name to dinner, writing it on presents and permission slips.

After Jay cut his hair, he grumbled about the family photos Nancy shared on Facebook. He looked miserable in most of them, grimacing while his younger sisters beamed.

Over time, Nancy deleted the snapshots that showed him in white dresses. She took down the gap-toothed toddler in floral print. She removed the 8-month ultrasound that revealed a girl with big cheeks.

She kept his basketball photo for a while. It was a sporty pose, she assured him. He looked more like a Native American guy than a Latina girl.

"It still hurts," Jay told her.

Nancy deleted the photos and felt like she was erasing her baby from her life. It was as if YaYa had died and Nancy had inherited this teenage boy with no backstory.

What if she got old and couldn't remember anything? What if pictures became her only link to the past?

I'm going to ask myself, 'Is this kid really mine?' And if he is mine, how come I don't have any pictures of him when he was a baby?

She searched her leather-bound albums for photos she could keep. Maybe there was one of him in a diaper, she hoped, one shot that appeared genderless. She flipped the pages, looking for the Scooby-Doo outfit. How had she never taken a picture of her 4-year-old's favorite clothes?

Nancy wished she could start over again. She would shove him back inside her and deliver him right. His photos would be Hot Wheels and Scooby-Doo prints.

She didn't need him to be a girl. She just wanted proof that he was hers.

THE GIFT

The Christmas tree glowed pink that year. Jay's mom pointed to the big red box below.

"There's an extra present for you," she said.

He tore away the wrapping paper. Inside, he found another box. He opened it and pulled out a glass bottle. The vial was red-topped, smaller than his thumb.

"What is it?" he asked.

"Read it," Nancy said.

Testosterone cypionate injection, USP

200 mg/mL

It wasn't fair, he thought, that he needed medicine to trigger what happened naturally to other boys. He wished he had been born "right," a guy with all the guy parts.

He carried the vial to the couch in disbelief. He laughed, then cried, then laughed again.

"Mom," he said. "It's so little."

The hormone would change him, the doctor had said, in ways he could never undo. Jay held up the vial. The testosterone gleamed in the Christmas lights.

-- Casey Parks

503-221-8271

cparks@oregonian.com; @caseyparks