Almost a decade ago, Judy Caplan Peters’s four-year-old made an announcement that would shake their family’s values to its core. “Mommy,” the little one said, hand on chest as if to recite the pledge of allegiance, “I’m a boy.”

A simple enough statement except that, up until that moment, her child had been raised a girl. Sander*, as he’s known now, had been born with a girl’s anatomy, went by a girl’s name, and dressed in girls’ clothes.

His mother did not try to argue him out of it. She’d seen the signs, beginning with the phone calls from school advising that her child refused to sit with the girls when the students were divided by gender. Or saying that Sander had a headache, a stomachache, or just wasn’t feeling well and wanted to come home. She knew Sander was not happy on some fundamental level, which, for her, meant she did not have a choice in the matter. “You either love your child for who they are,” she says, “or you don’t. It’s that simple.”

Simple but not easy. “I had to go through a grieving process,” Caplan Peters admits, “because I was losing my daughter, but then you realize that your child is not dead or sick or lost, which, God forbid, some parents have to deal with. Your child is healthy. There is nothing wrong with them. This is how they were born.”

For the estimated 150,000 trans teenagers in America, the threat of death is real. No fewer than 40 percent of trans adults have attempted suicide in their lifetimes. Jack Turban, M.D., a researcher and psychiatrist at Harvard Medical School, recalls seeing a transgender girl so disgusted by her genitals that she refused to go to the bathroom, causing intestinal damage severe enough that she needed surgery. As recently as ten years ago, Turban explained, it was assumed that the state of being “misgendered” inevitably made children miserable and that the only way for these kids to thrive was to be somehow “cured.” But faced with the alarming instances of self-harm among this population, doctors finally began to wonder: What if there was nothing inherently wrong with these kids? What if the problem was how they were treated by the world? If these children were accepted and loved, if their parents helped them to embrace the gender they felt they were born to—through either drug therapy or nonmedical “social transitions”—would they be happier? Would the suicide rate drop? The studies were small, but the message was clear: Acceptance is protection.