It is understandable that to people who have not had the opportunity to meet someone who is transgender, the concept of ‘being born in the wrong body’ seems utterly impossible. Society has progressed so dramatically in the past few decades that some may be led to say “this didn’t exist when I was a kid.” In fact it did, and long before that. Gender non-conformity has been around as long as humans, being recognized in texts as ancient as the Old Testament.

As the Massachusetts Public Accommodation bill awaits approval by the Legislature, it seems appropriate to share some of the experiences I’ve collected in my role as a physician for transgender patients. The human experience can be easily misunderstood when discussing a group as a whole. Make no mistake, however, that this bill is designed to address the very private concerns of very real individuals.

All of our nation’s established, mainstream medical and mental health associations – the American Medical Association, the American Psychological Association, the American Psychiatric Association, the American Association of Child and Adolescent Psychology and more – agree that being transgender is a legitimate medical condition and support legal protection from discrimination.

In 2005, I met a transgender individual for the first time in my professional career; she had transitioned in her 50s and had already built a family life. She had been living what many would consider a great life; she had a successful and lucrative career, a spouse and children. As a man. When I met her I remember feeling overwhelmed and frankly a little conflicted. Why would somebody give this all up for womanhood? Why would she subject herself to the stares, the gossip, the potential alienation of her family?

What I failed to completely comprehend in 2005 I came to understand after meeting another patient in 2007. She (born male) was about 12 years old and had traveled from England with her family to seek medical treatment to prevent masculinization. She was a tween girl in all aspects; growth of facial hair, a deepening voice and developing a broader, more angular male figure would be devastating. Her mother wept as she told stories of her daughter’s early life. From toddlerhood she clearly expressed that she was a girl, she chose stereotypical “girl” toys, and constantly fought about clothing, haircuts, and swim suits. She had crushes on members of the latest boy band and wanted to wear make-up.

It is work that I love; I love meeting new patients and hearing their stories. I love when I see kids and adolescents being accepted for who they are despite how they started out their lives. I love hearing that this teen has a new boyfriend/girlfriend who knows about their transgender status and don’t care. I love watching these kids transform their body to match their brain and watching them thrive as they do so.

I challenge everyone to consider for one moment the strength and courage it takes for a child, an adolescent, a parent or a spouse to be able to say the words that they have swallowed for so many years. I challenge everyone to consider why anyone would willingly put themselves in a position to be pointed at, discriminated against, and whispered about, if not to be true to who they are.

As we move toward a more inclusive society it is imperative that our state law fully protect these individuals. Who gives anybody the right to judge somebody else based on what is under their clothes? It may not be possible for everyone to understand or accept that some people are transgender, but it should be expected that our state law protect them from discrimination in the communities where they live and work.

Jeremi Carswell, MD, of Sudbury is the medical director of the GeMS (Gender Management Services) at Boston Children's Hospital.