By Cynthia Tavilla

Our children will not meet our every expectation, fulfill our every dream, or follow our agenda. Our children live out their own destinies, after all, not ours. Many of our children will be different from us physically, intellectually, socially, artistically, athletically, religiously, and politically. Our role is to nurture these individuals, as they discover who they are and who they are becoming, and to allow and support their emerging uniqueness. There are conservative traditionalists whose children turn to communes, church leaders whose children are atheists, and the proverbial macho football-loving father whose son falls in love with ballet. These children may be forever burdened by their parents’ agendas.

And then there’s Lily.

Lily is seven. When she was two, Lily declared that she was a girl, despite the male body that housed her, despite her given name “Matthew,” and despite the efforts of her two older brothers to bond with her over the ability to pee standing up. With doubts and fears that many could never imagine, Lily’s parents set out to understand their third child and how she needed to be loved and supported. Experts gave differing advice in how to “train” their child to be a boy. When this only made their three-year-old a depressed shell of the child they knew, they turned to Children’s Hospital in Boston. Here they learned from gender variance experts, healers whose work is so controversial that they receive death threats.

At Children’s, Gender Identity Disorder is a medical issue. There they treat a multitude of sexual development issues. The gonads in a human fetus form at six weeks of gestation. By 12 weeks, these gonads differentiate, yet many babies are born with genitals that don’t make for an easy “It’s a girl/boy!” announcement. Historically, when babies presented with both male and female genitalia or ambiguous secondary sex organs, it was up to parents and doctors to choose which gender the child would be raised. No one asked the baby. This didn’t always turn out well, however, and it became clear that gender identity was more than what parts one had under the diaper.

Several weeks after the differentiation of the gonads, the part of the brain believed to dictate gender identity forms. This is the subjective part of the person that feels male or female. In those eight weeks of chromosomal, hormonal, neurological, and structural development of the fetus, much can occur. (Gender Identity is not to be confused with gender role, which refers to the expected behaviors that one’s society deems appropriate for men and women, girls and boys. Our culture has made strides in loosening previously rigid gender roles, allowing for male nurses, female firefighters, and stay-at-home dads.)

Lily was never confused. She had a penis, but that did not dissuade her from what she knew: she was a girl. Her parents allowed her to dress as she wished, and her depression vanished. Neighbors and school personnel accepted this. Kindergarten children called her by her given male name, but consistently used female pronouns when referring to her. In late fall of her Kindergarten year, she chose her new name without prompting, and it was announced to her class.

Lily is a delightful child with many interests, friends, and dreams. She is also fortunate to have parents who have the financial and emotional resources to help her be her own self. If she still identifies as a girl by the time she reaches puberty, she will be treated by an endocrinologist to postpone the development of secondary sex characteristics: the facial and skeletal structures of a male. Without treatment, transgender adolescents in puberty are at high risk for suicide. Lily will be spared. At some point, Lily will be allowed to take female hormones, and eventually may choose to have plastic surgery to make her body congruent with her identity.

My friend Michelle was not so fortunate. At the orphanage she was sent to at age three, she was often caught wearing a dress. Michelle was a genetic male, but the nuns in 1952 were unaware of Gender Identity Disorder; they beat her and locked her in a closet for hours at a time. Robert, as she was known then, went undercover for a few years until escape was possible. Imprisoned by her anatomy, she escaped through drugs and traded sex for hormones. Now imprisoned by the state, as thirty percent of transgender individuals are, she receives hormones as part of the medically necessary treatment afforded to inmates with a diagnosis of GID. In the United States, prisoners are housed in male or female facilities depending on their genitals. Michelle still has a penis (despite auto-castration attempts) and so she lives in an all-male prison.

I will tell her Lily’s story. She will cry, understanding the pain of a child who knows what no one else knows: they are not who they appear to be. She will cry to know that there are parents who love their children beyond expectation, beyond their own understanding, beyond comfort.

Lily is a beautiful child.

So was Michelle.

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Cynthia Tavilla has worked as a licensed psychologist for over twenty years. Her writing reflects her interests in relationships, spirituality, and recovery, and her essays have appeared in The Lexington Minuteman and The Pilot. She lives in Arlington, MA, and enjoys reading, photography, and spending time with her two children.