As a teen who came out in high school last year, 17-year-old Bea Botelho said she gets the question “How did you know you were trans?” a lot.

“It's kind of a difficult question to answer ... I've always had that part of my identity. I just didn't know the right way to describe it,” said Botelho of New Bedford.

She also struggled with a much more basic issue: where to go to the bathroom.

Headed to Curry College this fall, Botelho said she avoided using any bathrooms at school all four years, even though she heard that a gender-neutral bathroom was available at the nurse’s office, which was single stalled and far from the other bathrooms.

Botelho, previously Brandon, announced her identity at a forum organized by some students at the Greater New Bedford Regional Vocational Technical High School last September.

Botelho’s eyes watered as she told her story of being forced to share a hotel room during an off-site school event with boys, even though she had requested to share at a room with willing girls who were friends. She was later bullied by the boys and traumatized, she said.

“When I publicly came out last year at the forum, I was not expecting the attention that it received,” she said last week. “I was bullied and harassed on a daily basis, and my school environment became toxic.”

It is experiences like Botelho’s that caused the nation and Massachusetts to adopt laws that prevent discrimination against transgender or questioning people, especially around bathroom use, experts say.

Schools conforming

Voc-Tech is in the process of converting seven gendered bathrooms into gender neutral ones, and creating private single stalls in existing locker rooms to accommodate transgender students and others who prefer more privacy, said Warley Williams, assistant principal.

“The main impetus for creating gender neutral bathrooms is to provide a space for transgender students to comfortably use the restroom, as they often choose not to use gendered bathrooms. Many transgender students develop bladder problems due to not using bathrooms in public places, said Williams in an email. Providing more gender neutral bathrooms will mitigate this issue, he said.

UMass Dartmouth already has at least one neutral bathroom, located in the Campus Center, but efforts are underway to add 20 to 40 more this year, officials said.

There has been a lot of debate about what kind of signage schools should use on those bathrooms with options ranging from the symbol of a toilet to handwashing. Eventually, the latter was accepted by the Massachusetts State College Building Authority earlier this year as an acceptable alternative to unisex signs, said Juli Parker, assistant dean of students and director of the Center for Women, Gender, & Sexuality at UMass Dartmouth.

Even at the K-12 level, schools are complying with the state’s direction to allow students to use the bathroom of his/her choice. Many are going an extra step to provide a gender-free option.

New Bedford High School, like Voc-Tech, provides a private bathroom and changing space in the nurse’s bathroom for students who prefer the privacy.

“It’s a non-issue here,” said Barbara Kaplan, school adjustment counselor. “We treat students based on what they present to us each day. Adolescents change their minds every day about many things, and we always try to meet their wants and needs.”

NBPS has students who identify as transgender or questioning as young as the elementary level but does not track numbers of LGBTQ students, officials said.

“We really work very hard to be inclusive of everyone,” Kaplan said. “Safety is the No. 1 concern, no matter what the issue.”

Superintendent Pia Durkin said she has been vocal about support for transgender students since she got here in 2013.

“Staff and families have affirmed that their children feel safe here,” she said. “We don’t expect any challenges in working with the state’s recommendations since we are all doing them. Our goal is to help make every child succeed irrespective” of their gender or orientation.

At least one transgender student at Dartmouth High School requested a separate bathroom earlier this year. The district complied by making “a non-gender specific restroom” available, said Superintendent Bonny Gifford.

“I have not been notified of any other student or staff member who has come forth with a concern or request,” she said in an email. “In general, the district has a non-discrimination policy, which guides our work. It is always our intention to ensure all staff and students are treated equitably and fairly. Our goal is to support everyone so they feel comfortable and safe, no matter the issue.

"That said, we will continue to appropriately address any concern on an individual basis as we make every attempt to provide for the uniqueness of the situation.”

Ann Marie Dargon, schools superintendent in Westport, said they haven’t heard from individual transgender students but that they have strong anti-discrimination policies in place.

“I have checked with all of our principals and to date, there have been no issues raised,” she said.

Other SouthCoast school districts, such as Fairhaven, Wareham and Old Rochester Regional, did not respond to multiple queries.

Changes and views

Early in June, the House passed legislation aimed at preventing discrimination against transgender individuals in all public places, including bathrooms, clearing one of the last remaining hurdles for the decade-old policy proposal, the State House News Service reported.

The House and Senate recently voted in favor of the slightly different bills that would bar discrimination against transgender individuals in public accommodations and allow people to use public facilities that match their gender identity rather than their biological sex.

The House version tasks the Massachusetts Commission Against Discrimination and the attorney general with determining how to determine gender identity and how to enforce laws against anyone “who asserts gender identity for an improper purpose,” according to the News Service.

Rep. John Fernandes, the House chairman of the Judiciary Committee, kicked off the emotional day of debate at the Statehouse by calling public accommodations the "bedrock" of anti-discrimination and a natural extension of the 2011 law that protected transgender individuals from discrimination in the workplace and housing, according to the News Service.

“You can't tell people it’s OK to work at the diner, but it's not to sit at the lunch counter. We learned that a long time ago,” Fernandes said.

Proponents of the anti-transgender bathroom bills argue that policies like this will let male sexual predators pretending to be transgender into women’s bathrooms; others just don't believe men can identify with another gender and that transgender people are deviants, dangerous to girls and young women.

However, research has shown that transgender people are often the ones who experience discrimination and harassment in public accommodations, and this discrimination is associated with a variety of negative physical and mental health outcomes, according to a news release from Fenway Health in Boston that works with the LGBTQ community.

“Denying transgender people access to facilities that are necessary for all of us to go about our daily lives, like restrooms, contributes to minority stress and can exacerbate negative health outcomes already affecting transgender people,” said Laura E. Durso, director of the LGBT Research and Communications Project at the Center for American Progress in a news release. “These efforts significantly limit the ability of transgender people to fully and equally participate in civic and public life.”

Too little, too late?

On one hand, LGBTQ proponents are happy that discussions about transgender people have finally gone mainstream, although many feel that acceptance and action has come too late.

“I think we are very behind the times,” said Parker pointing out that in Europe, there are single rooms or stalls everywhere catering to all people: trans, questioning, dwarf or handicapped.

On the other hand, she wondered why bathroom use is now a public issue.

You grow up in a house sharing bathrooms with parents and siblings, and you sometimes use a single bathroom in restaurants, said Parker who has offered to teach an LGBTQ class at UMass Dartmouth.

“I think, if it wasn’t for North Carolina, we wouldn’t be having this discussion,” she said.

The southeastern state passed a discriminatory bill earlier this year forcing transgender people to use public bathrooms that correspond to the gender stated on their birth certificates and not their gender identity. It led to an epic clash over transgender rights, sparking protests and lawsuits.

In May, the Obama administration issued a directive stating public schools must permit transgender students to use bathrooms and locker rooms consistent with their chosen gender identity, and the U.S. Justice Department sued North Carolina over its bathroom law after Republican Gov. Pat McCrory refused to back down, according to The Associated Press.

His term is up in November and his Democratic challenger Roy Cooper, the state's attorney general, has refused to defend the law in court.

U.S. Attorney General Loretta Lynch said the bill amounts to “state-sponsored discrimination.”

“What this law does is inflict further indignity on a population that has already suffered far more than its fair share,” Lynch said in the AP article.

The Massachusetts mandate

The state largely adopted the U.S. department of Justice and Department of Education mandate, as outlined in the May 13 “Dear Colleague” letter, widely circulated among education experts. It strongly prohibits sex discrimination in schools, whether based on a student’s gender identity or transgender status.

It spells out terminology pertaining to identity and sex, the Title IX obligation schools have to meet to qualify for federal funding including a policy of non-discrimination, and clearly states that schools “must treat students consistent with their gender identity even if their education records or identification documents indicate a different sex.”

Title IX regulations also allow schools to have sex-segregated bathrooms, locker rooms, showers, housing and single-sex classes under certain circumstances. The letter states that transgender students should be allowed to use the facilities consistent with their gender identity.

It also allows schools to update student files with the preferred gender and name to “help protect privacy and ensure personnel consistently use appropriate names and pronouns.”

Schools across the state are scrambling to meet the guidelines.

The directives were announced in 2013 to help schools follow the state’s 2011 equal opportunity law that protects transgender residents, said Jeff Perrotti, the founding director of the Department of Elementary and Secondary Education’s (DESE) Safe Schools Program for lesbian, gay, bisexual, transgender, queer, and questioning students.

‘‘These students, because of widespread misunderstanding and lack of knowledge about their lives, are at a higher risk for peer ostracism, victimization, and bullying,’’ read the DESE directive.

The Transgender Equal Rights Bill took effect in on July 1, 2012, banning discrimination in seven areas including employment, housing and education, while also enabling prosecutors to bring hate crime charges in attacks on transgender people.

Gender education and equality

It’s not enough to treat trans students equally, many schools are starting to educate students about the difference between gender and sex, as early as elementary schools.

The DESE uses resources like the Genderbread Person. Created by itspronouncedmetrosexual.com, it uses a gingerbread figure to deconstruct gender and explain identity, attraction, sex and expression.

“Sex and gender are often blended together in our culture and people get confused,” Perrotti said. “The gingerbread person is a visual we use to distinguish the different dimensions. We sometimes let people know it’s a resource, especially for younger students.”

The state also has a handout explaining terminology, such as:

Gender expression: the manner in which a person represents or expresses gender to others, often through behavior, clothing, hairstyles, activities, voice, or mannerisms.

Gender identity:a person’s gender-related identity, appearance or behavior, whether or not that gender-related identity, appearance or behavior is different from that traditionally associated with the person’s physiology or assigned sex at birth.

Gender nonconforming: a term used to describe people whose gender expression differs from stereotypic expectations. The terms “gender variant” or “gender atypical” are also used.

Transgender: an umbrella term used to describe a person whose gender identity or gender expression is different from that traditionally associated with the assigned sex at birth.

“I think it’s gone remarkably smoothly in most places,” said Perrotti who consults with schools statewide on gender issues. “People are anxious because it is something new, but most schools have made an effort.”

The question of transgender bathrooms centers around comfort and the fact that they may make some people uncomfortable is not not enough to treat people unequally, said Perrotti, adding that discomfort is not a bad thing.

“For many transgender students, bathrooms are anxiety-ridden places so when I ask, they often say they don’t use any,” he said.

This leads to problems from bladder infections to eating disorders, which is often surprising for school personnel. But to Perrotti, “Being able to use the bathroom is a fundamental right.”

While many schools have gone the extra mile to create a gender-neutral bathroom, Perrotti said the concern is that they don’t end up creating a transgender bathroom. A third bathroom should give all students a choice.

At the end of the day, it’s about equality and providing students with options, he said.

“Sometimes you know who the trans students are, sometimes you don’t,” Perrotti said. “It’s no one’s business what’s underneath a student’s clothes.”

Her view

As someone who identifies as transgender, Botelho said, “We don't want special rights or more rights than anybody else. We just want to be treated as equal.”

She also said that using transgender people as a scapegoats for bathroom physical and sexual assaults is wrong.

“The majority of these attacks are perpetrated by cisgendered individuals anyway, and if somebody has illegal intentions, gendered bathrooms are not going to stop them,” Botelho said.

(A cisgender person is one whose self-identity conforms with the gender that corresponds to their biological sex.)

Transgender women are the ones most attacked or killed in our culture. When children are attacked, the perpetrators are usually straight white people, said Parker.

The problem is not transgender people, it is people’s fears, she said, and changing perspectives take time.

For now, the transgender bathroom issue has become a “no flinch area” for administrators, at least in Massachusetts, according to Perrotti.

“Most get it when they hear how students are affected by it,” he said.

Follow Auditi Guha on Twitter @AuditiG_SCT.