Evan Singleton, 12, has been living as a boy for five years. He was the first patient in what would become Genecis, a Children’s Medical Center Dallas program for transgender youth.(Andy Jacobsohn/Staff Photographer)

Free to be themselves Children’s Medical Center Dallas opens clinic for transgender children and teenagers,the only pediatric center of its type in the Southwest The first clue came while Mela Singleton was giving her 2-year-old daughter Evie a bath. “You’re such a pretty little girl,” she cooed. Evie responded, “I a boy.” Singleton didn’t think too much of it at the time, but over the next several years, her daughter’s protests got louder and more pointed. Evie insisted on standing up while urinating, rejected anything frilly or stereotypically girly and would dissolve into frustrated tears when people referred to her by the female pronoun, “she.” Then after Evie had an epic meltdown at about the age of 7, Singleton and her husband, Bryan, said they finally got it. Evie was born with a boy’s brain and girl parts. So, they changed their child’s name to Evan, cut his hair and bought a new wardrobe. That lasted about two years, until Evan started growing breasts. Frantic, the Singletons ended up at the door of Dr. Ximena Lopez, a pediatric endocrinologist at Children’s Medical Center Dallas. Soon after, Evan became the first patient in what would become a new clinic for transgender children and teenagers. Five things to know about Dallas’ transgender community: 1. The Trans Pride Initiative estimates that at least 7,500 transgender people live in Dallas. The figure is based on a Williams Institute study estimating that transgender people make up 0.3 percent of the national population. 2. City of Dallas employees have had transgender health care on their insurance plans since January. However, surgery is not covered. 3. Ty Lee Underwood, a transgender woman, was slain last February in Tyler. She is one of eight transgender women who have been homicide victims across the country this year. Some of these cases are being investigated as hate crimes. 4. Transgender people can turn to the Resource Center’s Gender Education, Advocacy and Resources program for legal advice, social events and health care. Other organizations like The Trans Pride Initiative and Transgender Law Center, a national organization, provide resources for transgender people as well. 5. The Plano City Council passed an ordinance in December that extends equal rights protections to people regardless of their sexual orientation or gender identity. Certain religious organizations have petitioned to put the ordinance to a citywide vote, but they have been unsuccessful. By Jasmine Aguilera | Staff Writer The Genecis program — GENder Education and Care, Interdisciplinary Support — officially opened its doors last month, even though Lopez and other specialists have been treating young patients for three years. It’s the only pediatric clinic of its type in the Southwest. “People have this idea that transgender people are just weird and awkward and troubled,” said Lopez, Genecis’s medical director and an assistant professor of pediatrics at UT Southwestern. “That’s because historically people came out as transgendered adults when they’d … spent much of their lives depressed because they were not being themselves.” But medical advances and increased public awareness of gender dysphoria — consider this week’s announcement of the “I am Cait” docu-drama featuring Caitlyn Jenner, the former Bruce Jenner — suggest there may be a greater chance for social acceptance. “These children have an opportunity to have a normal life,” Lopez said. “The new generation of transgender people we’ll see are completely different. They’ll look normal like you and me. And they’ll be happy.” The treatment at Children’s works like this: When appropriate, doctors prescribe drugs to delay puberty, usually around the age of 12. About four years later, patients are administered cross-sex hormones that trigger a transition to adulthood in their identified gender. Therapy is required at all stages, including a six-month assessment, before children are considered for medical intervention.


Dr. Meredith Chapman, a psychiatrist at Genecis, said she looks for several traits while screening patients. They should identify as cross-gender consistently over time, and there should be a discrepancy about how they feel and how they’re perceived by the world. That conflict, she said, often stirs emotions and sets kids up for ridicule. “As human beings, we live in a world that is gray,” said Chapman, an assistant professor of psychiatry at UT Southwestern. “But we strive for a world that is black and white, yes or no, with binary males and females. For a lot of people, it’s a very foreign concept to try to imagine someone who’s unbelievably distressed by this incongruence between their sex and gender.” Pain of pretending Evan Singleton, the Genecis program’s first patient, is now a moon-faced 12-year-old with sculpted neck-length hair. He’s been living five years as a boy but remembers the pain of pretending. “All the girls were doing Barbie dolls and nail polish, and I just wasn’t one of them,” he said. “All the boys were doing skateboards and helmets, and I wanted to do that stuff. I never felt right in that body.” His mother said in the early years she nudged Evan toward an identity as a tomboy, but the label didn’t fit. “All the girls were doing Barbie dolls and nail polish and I just wasn’t one of them...I never felt right in that body.” Evan Singleton “You have two questions when this starts evolving,” she said. “The first one is, ‘How do I feel about it’ and the second question is, ‘What do I do?’” Transgender people face maze of difficulties with health insurance, doctors After nearly 50 years living as a man, Leslie McMurray was reborn — but then lost nearly everything: her home, her marriage of 33 years and her job as a radio program director in Dallas. Read more here McKinney mom also faces transition while finding help for transgender daughter Parents of transgender children often experience their own transformation. Christina Pippin’s transition isn’t visible to the naked eye, but she changed along with her transgender daughter, Kammie, who began presenting as a girl when she was 9. Read more here Read more about transgender issues on our LGBTQ Insiders Blog here After research, Singleton said, she called at least 100 endocrinologists to ask whether they would consider administering puberty-blocking medicine for her son. All of them turned her away, except Lopez. “She didn’t say, ‘Sure let’s just shoot this kid full of medication and figure it out later,’ ” said Singleton. “She said, ‘OK, let me look into this. Let me call some of my fellow [endocrinologists] who have experience with this.’” Lopez said she was unprepared for her first transgender patient. The topic wasn’t covered in medical school. But she remembered a day in 2007 while training at Massachusetts General Hospital in Boston, when Dr. Norman Spack, a pioneer in the treatment of transgender children, brought one of his patients over for a presentation. “He was a Middle Eastern patient and when he told me he was born a girl, I couldn’t believe it,” she said. “In every way, he looked like a male. He was an MIT student, and I thought, ‘This is the right thing to do.’” The therapy used to treat transgender children is called “The Dutch Protocol” because it began more than a decade ago in the Netherlands. One study there of 70 patients — a small sample size — suggests children who’ve been treated with cross-sex hormones grow into emotionally stable adults. The first treatment for transgender youth began in 2007 at Boston Children’s Hospital. Last year, there were 24 clinics clustered mostly on the East Coast and California. Today, there are 40. “It’s growing really fast,” Lopez said. “And the main reason is parents are demanding it and bringing patients to the door of pediatric endocrinologists because they know this is available.”

Evan Singleton watches his mother, Mela Singleton, examine a rescued bird at their home in Murphy, where she runs the Dallas Wildlife Center, a wildlife rehabilitation clinic. (Andy Jacobsohn/Staff Photographer)