(CNN) Sometimes it's hard to be what you want to be when people only know you for what you used to be.

This is the challenge facing Marcelas Owens, who just turned 17. For much of life, people have only known Marcelas as the "Obamacare kid."

He was the chubby 11-year-old African-American boy who stood next to President Barack Obama as he signed Obamacare into law at a White House ceremony on March 23, 2010. He was the miniature health care activist in the black vest dwarfed by powerful lawmakers in a famous photo of that moment. He was a modern-day Peter Pan, perpetually frozen in childhood even as the news cycle moved on.

But so has Marcelas. As supporters prepare to mark the sixth anniversary of Obamacare's signing, Marcelas is marking another rite of passage -- as a transgender teen. After years of questions, she is starting to tell family and friends what she has long known: Though born male, she's long identified as a female.

"I'm going through a reinvention process," she says. "I'm growing into adulthood. I'm not the Obamacare kid anymore."

Will they still like me?

Marcelas doesn't look like a kid anymore. The chipmunk cheeks are gone. So is the baby fat. And the voice is deepened. She's a teenager now. She listens to hip-hop artist Drake and Michael Jackson. Hangs out at the mall with friends. Even writes songs to express what she struggles to say to others in conversations.

Each March, Marcelas goes through a ritual. She gets calls from the media to talk about her front row seat at a historic moment. She's proud of her role in Obamacare. And she understands why people would be curious about that kid in the White House picture.

"If I wasn't me, I would like to know, where did he go?" Marcelas says.

She wonders, though, how people will react to her answer. Will they still like her now or do they prefer the kid in the photograph?

Marcelas Owens keeps a reminder of the "old Marcelas" in her family's living room. President Obama signed the picture, "To Marcelas. You helped make history at an early age. Barack Obama. "

She calls that kid the old Marcelas, understands the world saw her as a boy and is OK with using male pronouns for that period of her life.

"I like it that I can be called the Obamacare kid, but in some ways I wish I could look past the Obamacare kid and become Marcelas and people would have the same reaction to me that they had with the Obamacare kid."

Marcelas lives in a townhome in Seattle with two younger sisters, Myanna, 12, and Monique, 13, and their grandmother, Gina Owens. On March 10, Marcelas celebrated her 17th birthday with her family by eating beef tacos with cheese and a birthday cake topped with white frosting.

The first person she told about being transgender was her grandmother, who took over raising the three siblings after their mother, Tiffany, died at 27 from pulmonary hypertension.

Transgender people identify with a gender different from the sex assigned on their birth certificate. Owens shared her reaction to Marcelas' announcement in a Facebook post last week. It was addressed to "My first born grandchild."

Owens wrote:

"On this day [March 10] you were born to the world as your mother's 1st child. You are 17 now, and have in so, so many ways, made your mom & me very proud. We both have watched you grow & become the person you are today.

"So today, on your 17th birthday; I tell you AND the world; My grandson is on a new journey in life... I am so happy that SHE has trusted our relationship enough where SHE felt more comfortable sharing with me first; BEFORE the rest of the world... I give my heart & blessing to HER. I LOVE YOU AND YOUR COURAGE IN LIFE, MORE THAN YOU WILL EVER KNOW. Walk your journey in love & light."

Owens says, though, that it wasn't easy at first to hear the news from Marcelas.

"I didn't like the idea," she says. "For me he was born into the world as Marcelas Owens, the boy his mom created. That's how I wish he would stay. But I also told Marcelas that he's always had the ability to think through things himself. And he's always had the foresight to talk to me."

Marcelas may have some difficult days ahead, but she's had them before. The world may only know Marcelas as the cute kid who stood next to Obama, but few know about the pain Marcelas had to endure to get there.

'You can't let anybody die like my mom did'

The year is 2007. Marcelas is on the verge of tears. He is just 7. He is at a Seattle hospital with his grandmother and his sisters when he hears the news. His mother has died.

Marcelas' grandmother reaches out and gives him a hug.

"It's time to go home, Marcelas," she says.

"We don't have a home anymore," Marcelas says, his eyes welling. "Momma's gone."

Marcelas was too young to understand that his grandmother would now be his caretaker. His father was never part of his life, according to his grandmother.

"When my mother passed away, I really thought me and my sisters were going to have to live on our own. I thought I was going to have to start getting a job and start to pay bills," Marcelas says now.

Marcelas' mother died because she didn't have health insurance, Owens says. She was diagnosed with pulmonary hypertension in 2006. Her illness caused her to miss days at work, which led to her losing her job. She was denied Medicaid because she had earned too much money working the previous year.

Marcelas Owens checks her makeup before attending school. Most of her classmates have been supportive, but some became angry when she told them about her transition.

Marcelas' loss led to him becoming a child activist in one of the most vicious political fights in American history. He comes from a family of activists, though. His mother and grandmother were volunteers in the Washington Community Action Network, a Seattle group formed to fight for economic and social justice. Washington CAN!, as it's known, became involved in the fight for Obamacare.

And so did Marcelas' family. He would attend Obamacare rallies staged by Washington CAN! with his mother and grandmother. After his mother died, he started sharing his hurt and anger at events. Organizers saw a natural spokesman, a vulnerable kid who could give a human face to an abstract political issue.

Marcelas stepped into a new role. While other kids his age could barely mumble while speaking before a class, he was speaking to crowds of up to 6,000 people at rallies. At one rally in Seattle, he met U.S. Sen. Patty Murray, a Democrat from the state of Washington. Murray later told a Huffington Post reporter about that meeting.

"I went to that rally and, after I spoke, I turned around and there was this little boy looking right straight up at me with his big brown eyes," she said. "And he said to me, 'You can't let anybody die like my mom did.' "

Marcelas made a powerful friend in Washington. And when the Affordable Care Act was passed, he was invited to the White House signing ceremony. He still talks about the experience with a sense of awe.

It was a blur. The memories from that day are now just fragments: rushing to Nordstrom with his family to buy a vest and tie that he could wear to the ceremony; having a nightmare the night before that he might do something embarrassing; being struck by how small the White House looked from inside.

He couldn't believe that a kid from Seattle was helping make history.

"The whole thing felt like a dream," Marcelas says. "It all went fast. I was doubting myself. How did I do this?"

And then he saw Obama.

The President was talking to some lawmakers when he saw Marcelas, stopped and walked over with an outstretched hand. Marcelas noticed that he just happened to be wearing the same color tie as Obama.

"Oh, you're Marcelas," Obama said, shaking his hand.

Marcelas doesn't remember what he said in response, only what he felt.

"I was scared I was going to say something to embarrass myself."

Then came the signing ceremony. All the lawmakers angling for a place in front of the cameras bolted in front of him; all Marcelas could see were their backs. Then he heard someone tell a grinning man to move and make way for the kid. It was Sen. Harry Reid from Nevada telling Vice President Joe Biden to make way for Marcelas.

As Biden moved behind him, Marcelas says, the vice president told him to count the number of pens Obama used as they passed by. After Obama signed the bill, the President turned to Marcelas and said, "I'm proud of you."

Then he gave Marcelas a parting gift.

"I got a high five and fist bump from Barack Obama," Marcelas says.

When he returned home, he slowly realized that he had become a mini-celebrity. Someone in Africa sent his family a newspaper clip of Marcelas standing next to Obama. People would stop and stare at him in the streets of Seattle, then approach him to ask, "Excuse me, are you that Obamacare kid?" The photo he took with Obama became one of the most widely distributed images from the whole battle over Obamacare.

There was one group, though, that wasn't impressed. When he returned to his elementary school in Seattle, his classmates shrugged at the pictures of him with Obama.

"They thought it was boring," Marcelas says. "They were like, 'So everybody meets the President.'"

Another group gave him an even worse review. They said he was exploited by politicians and was too young to know what he was talking about. They were members of the conservative media. Talk radio host Rush Limbaugh said that Marcelas' mother would have died anyway because Obamacare didn't kick in until 2014. And conservative columnist Michelle Malkin said Democrats used Marcelas as a "human kiddie shield."

And then, of course, large swaths of the country had already mobilized to destroy Obamacare.

Angry politicians said Obamacare would doom America; wide-eyed protesters at town hall meetings looked as if they were going to explode. When a reporter asked Marcelas about all the outrage over Obamacare and the criticism he was receiving, he shrugged.

Marcelas Owens finds refuge in the music she listens to at home. She wants to be a surgeon one day, but she also dabbles in writing songs.

"I don't have any bad comments," he said at the time. "I just know my mom and grandmother told me that people are going to have their own opinions but that doesn't always make what they say right."

Today, Marcelas says she wasn't a puppet manipulated by adults.

"I don't think I was too young,'' she says. "No kid should have to see their parents struggle without health care and not be able to get care just because they're sick and missing workdays."

Another drama awaited Marcelas, but this time the struggle would take place within.

Telling the one you love

Even as just a boy, Marcelas had these questions: Why was he never interested in playing the games other boys played? Why did he like trying on his sister's clothes? Why did he feel he was born in the wrong body?

He started searching for answers. He went online and learned about transgender people. When he was in the fifth grade, he chose to write a class paper on a transgender woman.

"She was saying that when she was little she always identified more with girls," Marcelas says of the woman. "I started realizing that I did the same."

While gays and lesbians have moved to mainstream acceptance, transgender people are still often looked at with suspicion and are frequently victims of hate crimes. Former Olympian Caitlyn Jenner, author Janet Mock and actress Laverne Cox are making people more aware of transgender people, but transgender people of color have only recently become prominent in popular culture.

Marcelas didn't know it at the time, but he was moving from being involved in one explosive political issue to another -- all before reaching adolescence.

On the surface, though, Marcelas remained the Obamacare kid. He became an honor roll student, graduating from middle school magna cum laude with a 3.8 GPA. He got awards for being a community activist. He dutifully gave interviews each year when Obamacare's anniversary came around, once even wearing the same blue tie and vest he wore at the White House signing for a television interview.

But in private, he continued to dress in his sisters' clothes, buy girl's clothes on the side and hurriedly wipe off the makeup on his face when his grandmother returned home.

"I kept it to myself for a long time," she says now.

Marcelas, though, outgrew the just-an-average-boy facade she had maintained, just as she outgrew the black suit she wore at the White House signing. At 16, she decided she wasn't going to wipe the makeup off her face anymore. She was going to tell the person she loved the most.

It was an autumn evening near dark and her grandmother was downstairs watching television. Marcelas put on a black wig, a red-and-white striped skirt and pink lipstick.

Then she walked downstairs and stood before her grandmother. Owens didn't bat an eye, Marcelas recalls.

"Grandma, if I wanted to be a girl, what would you tell me that I should do?"

Owens thought Marcelas was joking at first. Then she realized her grandchild was serious. She told Marcelas that if she wanted her honest opinion, she preferred that she would stay a boy.

"But I would respect you if you decided to change and be somebody else," she said.

She hugged Marcelas, who returned upstairs -- where her sisters gave her tips on wearing makeup the right way.

Marcelas says she didn't wear a skirt and makeup to shock her grandmother. She just wanted to get it all out at once.

"I wanted to tell her how I felt but also show her how I felt."

Her grandmother's acceptance came as a relief.

"Even though she preferred me as a boy she respected my choice to choose," Marcelas says. "That gave me a sort of blessing."

How did Owens, though, do in a moment what some people struggle a lifetime to do -- accept someone they love as transgender?

"I already had in my mind an inkling, so I really wasn't shocked," she says.

Before she could ask others to accept her, Marcelas Owens had to learn how to accept herself. She sums up her attitude toward life now with one word: "fearless."

When Marcelas turned 6, Owens asked him what he wanted for his birthday. He said a bouquet of flowers. And when she gave Marcelas the flowers, he paraded them before his friend as if it was a prize. When he was asked the same question for his birthday two years later, Marcelas asked for a pink dress shirt.

Yet another reason Owens was so accepting was because of her own struggles. She had learned to accept what she could not control.

She had lost her daughter, gone through a divorce, became disabled after a car accident and at one point became homeless when she lost a job. There is a steeliness about Owens. She talks in a calm, measured voice as if nothing can shake her anymore. On her Facebook page, she doesn't display her photo; she instead identifies herself with a graphic of a can with the caption, "WHUP ASS."

"You learn how to be accepting of what comes next," she says, citing her struggles. "You learn how to see things with an open eye and an open ear and not be judgmental."

'I can't let that stop me'

Marcelas hopes others feel the same way. She is starting to find out.

On March 9, the day before her 17th birthday, she wrote on Facebook:

"I've been learning about self-love. Finding myself may equal losing those I was once close to, I continue to search. Closed minds equal closed hearts, I remain forever open."

She's starting to give other glimpses of her transition to the outside world. She recently posted a Facebook selfie wearing makeup and lipstick.

One male commentator wrote back:

"Bro males don't put on makeup unless their feminine"

Marcelas responded that there are other reasons for wearing makeup besides being gay.

Marcelas is also starting to consider hormone therapy and other options. Obamacare prohibits insurers from denying coverage to transgender people on the basis of their identity. The Obama administration ended a 33-year ban on Medicare coverage for gender reassignment surgery in 2014.

When Marcelas began telling friends and classmates, the reaction was mixed.

"At first they thought I was joking," she says. "Once they saw I was serious, they were confused, and then they got mad."

Others, however, went online to support her.

One Asian-American friend wrote:

"It's all good. I come from an Asian community and family and everybody freaking expects me to be some freaking sort of scholar and go to a 4 year university big college, but nope I ain't going cause' I love myself and my path."

Another told Marcelas:

"Fully support you in this major transformational time. Be you. There's only one of you. Do it your way, with love."

But then again, there was another Marcelas -- the one in the photos standing next to Obama. For a long time, she couldn't be what she wanted because of what that photo represented to people.

"When I was thinking of coming out, I was thinking a lot of the Obamacare kid thing," she says. "I was like, I'm the Obamacare kid and I have to live as the Obamacare kid. That was kind of my reason for not identifying as who I was."

Then she realized that her experience as a kid didn't have to be a burden; it could be a blessing.

If she could help others in one struggle, why not another? Transgender teens, especially those of color, have few people to look up to. Maybe she could lead the way. If she could deal with Rush Limbaugh's scorn at 11, maybe she could handle being out in front of another divisive issue.

"This would be kind of a new thing," she says. "I would help advance another issue. It'll be good for me."

Marcelas not only looks different now; the world looks different as well.

"With me being able to express myself, I feel like everything has got a lot brighter," Marcelas says. "When I was dressing in boy's clothes, that was something that felt unnatural. People are going to get to know the real me."

When someone on Facebook posted the photo of Marcelas standing next to Obama, he commented that Marcelas looked so cute as a chubby little kid.

Marcelas jumped on the comment thread with a message:

She's not the Obamacare kid anymore.

"The past is the past. We gotta' make new memories so when we look back it will be worth looking back on. I actually like me in the present better anyway."