Book Review: How to be a girl, by Marlo Mack

A Mother’s Memoir of How to Raise a Transgender Girl

*** 3/3 ***

I absolutely loved this book.  It is a touching memoir, a true story of a mother coming to terms with her AMAB daughter’s assertions that she was a girl, and their collective journey to letting that develop.  I will be honest.  I cried an awful lot as I read it.  Perhaps you won’t, but for me it spoke to so many feelings lying deep inside of me, emotions felt, emotions buried, and it also gave me new perspective on my relationship with my departed mother.

I also think of how much better it is to be growing up today as trans than it was when I was born, before we even had the word “transgender” or non-binary…when transsexualism was classed as a disease—I believe in many countries and in the official desktop manual of the psychology industry, it still is.

For me, it is an extraordinary gift.  It has so enriched my life, how I see things, how I experience things, has defined me.  I wouldn’t trade it for anything, even though being it comes at a cost.  

Aside on Charitable Giving

[As someone who believes in giving, this speaks to me.  I’ve been giving to Planned Parenthood in the USA for many years, mainly in support of female reproductive rights, and the irony is not lost on me that as I go forward, it is very likely that it will be Planned Parenthood that will in part be assisting me on my own journey with hormones.] 

I support a charity focussed on the victims of child sex abuse.  And, I very actively give to a charity that provides support to transgender people contemplating suicide.  It is a big issue, and one that matters to the community, and to me very much.  While we never did it, the Domme I played with for a while speculated that a severe punishment would be to suspend my giving to charity.  She understood how bound up with my sense of well-being these acts of giving are, and would have been spot on in thinking it was an effective way to change my behaviour.]

I have just added an Amazon Affiliate link to this site–why? When a reader clicks on a link from this site about one of the books I review and then goes and buys it, I will get paid a commission. I will take every penny of commission and I will also match it, and will donate to Planned Parenthood, a vital and embattled resource for women, minorities and the gender diverse. In the case of this book, when you buy it, the author will donate £1 to the Mermaids Charity, which supports transgender youth. This policy in my case will apply to all books I review on this site–every penny earned will be matched and donated.

Book Content

Below is a summation of some of the key points made.  I transcribe, quote and paraphrase:

Forward, by Susie Green, CEO of Mermaids

She describes her own path into Mermaids, and also how she met Marlo Mack, the author of the book.  She writes, “Being gay seemed to be a much less imposing outcome than being trans.  The public attitude to being trans is horrific.”

Step One: Take a Deep Breath

The author describes those first moments, when at the age of three, her future daughter came out to her.

“Mama,” he said, “something went wrong in your tummy.”  I heard my purse hit the floor.  “It did?”

“Yes,” he said, “And it made me come out as a boy instead of a girl.”  The tips of his fingers dug into my palm, and I looked up at the three-year-old face tilted up at mine.  The perfect brow was creased down the middle.  His pale blue eyes, looking like circles cut from a summer sky were flooding with tears, but did not blink.”

“Breathe,” I told both of us.  “Take a deep breath.”

He ignored me.  “Put me back, Mama,” he rasped, “put me back so I can come out again as a girl.”  He gasped for air and his body curled up into sobs.  I sank to my knees and reached for him, but he pushed me away and pointed with his whole arm at my stomach.  “Please, Mama!” my child howled.  “Put me back!”

She writes of how her feminism had not prepared her for this.  That she understood that there is no such thing as a girl colour, toy, or career.  “I knew that each generation’s unquestioned assumptions about gender roles would be mocked or tossed aside by the next.  Perhaps one day my grandchildren would buy dresses for their little boys or return to the androgynous days…but I didn’t have time to wait for social norms to evolve.  I needed a world that would allow for a child like mine.  Right now.”

She writes about her struggles to come to terms with the implications of this, for her daughter, for herself, for her family, for her neighbourhood, for schooling, and for life.

“A June 1918 article from the trade publication Earnshaw’s Infant’s Department said, “The generally accepted role is pink for the boys, and blue for the girls.  The reason is that pink, being a more decided and stronger colour, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl.”

Smithsonian Magazine, April 7, 2011

Step Two: Let Go

She threw herself into learning, and joined a support group for parents of transgender children.  “It was at the support group that I learned a new statistic: 40%.  The suicide attempt rate for kids like mine is around 40%.  40% may, unfortunately, be a low estimate of the number of transgender youth attempting suicide.  In a 2019 study published in the journal Pediatrics, more than half of transgender adolescents studied report having attempted suicide.  [I note that the suicide attempt rate in the general population is 1/100th this rate, or 0.5%].

At the support group, in conversation with other parents:

“Dammit,” I said, “why can’t he just be gay?”

“Yeah, we all say that,” muttered a Dad sitting next to me.

[I used to think this too, how much easier it would be to be gay…how nobody regards that so bad anymore…how much easier it is to be invisible].

She decides to speak to her daughter’s teacher, to let her know that her son was now her daughter.  The teacher says, “this is going to be ‘tricky’ and that the school would need to consider other parents’ feelings. 

“We need to respect different families’ belief systems,” she said.  Belief systems?  “Would we consider their ‘belief systems’ if they were racist?”

“That’s not the same thing,” she said.

“I think it is.”

Was it the same?  Not exactly…I had been completely pre-occupied with my own responses to my child’s battle with boyhood and hadn’t spent much time considering how the wider world would respond to it…and what the teacher was trying to tell me was that the response was going to include things I wasn’t used to: Suspicion.  Fear.  Rejection.  Exclusion.  Because my child was different.  And in that way, this was very much like racism and every other bigotry that hides behind euphemisms like “belief systems”.

She goes on to note that “the teacher was right in claiming that our situation was different from racism in many ways, and one of them was this: Although the other parents could be expected to have some idea about what racism was (and that it was bad), they probably couldn’t be expected to know anything about transgender people, let alone transgender children.  Nor could we assume that they would have any idea what transphobia was (and that it was also bad)…But what I heard the schoolteacher saying, loud and clear, was this: Your child’s difference is a problem.”

“A mama-bear rage roared in my ears.  Whoever my baby turned out to be, it would not be determined by community debate.”

While this was playing out, her marriage also dissolved, and her daughter was spending time alternating with her ex-husband, who had already accepted that his son was now his daughter, and had done so without consulting her, and had done so first.

“I remembered something a mom had said in a support group: Our kids are already leaving the station.  Are we gonna get on the train with them or get left behind?”

She decides to go to see a therapist to help her come to terms with her own feelings, and for guidance in how to parent a transgender child.

“So, its all up to me,” I declared, awash in self-pity.  “I’m his mother.  I have to say yes or no, boy or girl, like I’m God.”  It was too much, this awful burdensome power.  If I continued to push back, would my child one day try to jump off our roof?  And if I said yes to girlhood, was I dooming my child to a life of perpetual pain and outsiderhood?  Which choice held the greatest dangers?  “I don’t want this choice,” I said to my therapist.  “I just can’t make it.”

“Well, that’s great!” she replied.  “Congratulations.”  She was actually smiling.


“That you don’t want this choice, this power to choose.  Because you don’t have it.”

“I don’t?”


Then she set me free. 

“You know,” she said, “if your child isn’t transgender, there is nothing you can to do make them transgender.  And if your child is transgender, there is nothing you can do to stop them from being who they are.”

We parents do not get to decide who our children will be, at four or fourteen or 40.  This fact is terrifying, but true.

That evening she sat down with her daughter.

“I need to ask you a question,” I said.

“What question, Mama?”

“Are you really sure that you want to be a girl?”


“No?”  What the hell was this?  Had I read everything wrong?

“I don’t want to be a girl,” my child said, “I am a girl.”

Step Three:  Tell Your Story

From that moment on, my fight with my child was finally over.  My fight with the rest of the world began.

“Gender identity development occurs much earlier than the development of sexual orientation.  Children usually have a sense of their gender identity between age two to five and they typically become cognizant of their sexual orientation around age nine or ten.  Transgender children may begin to play in a way that is not expected for children of their sex from a very young age.  Gender-diverse boys typically experience more negative reactions from their parents and more victimization at school than gender-diverse girls.  This is due to the great latitude given to girls expressing masculine behaviours in a society that over-values male behaviours and undervalues female behaviours.”

American Psychological Association, Fact Sheet: Gender Diversity and Transgender Identity in Children.

She explains to her parents.

“No, this has nothing to do with sex, Dad.  Transgender is who you are, not whom you love.  Little kids aren’t really old enough to really know who they’re attracted to.  But they do know what gender they are, right?”  [Based on my own experience, this bears repeating—every single person I have spoken to about being trans has immediately asked about sexual orientation—so few people understand that the trans experience is all about identity not about sexuality].

Her grandmother says, “Oh, we always knew there were people like that.  A lot of them were hairdressers or in the theatre.”  Her face turned sad, “it was so hard for them.”  While a gay hairdresser is not the same thing, her grandmother goes on to say, “we are who we are, dear.  We are who we are.”

Some relatives said my child was not a girl at all, just spoiled, as if becoming a girl was like getting a pony.  Everyone complains about pronouns.  “I knew that they weren’t being deliberately cruel.  They just found it…weird.  It was weird.”  She describes feeling as if aliens had landed in her garden, but nobody knew it or believed it.  “Nobody seemed to understand how momentous this story was, and that there really was a unicorn in the garden…”

Step 4: Prepare

She describes what she learns from other parents in the support group.  She lives in a liberal US state, one with progressive, left-leaning politicians.  She describes families who leave everything behind to move to her State.  “Children who say they wish they had never been born.  Children who get caught naked in the bathroom with scissors attempting to correct ‘God’s mistake’.  Children who stuff socks into their pants to make it look right.  Children who shave their heads.  Children who want a do-over.

They move because her State is one of the few that has enshrined protections of transgender people into law.  They call them “gender refugees”.

“It was from them that I learned how fortunate I was, and how rare this was.  I happened to live in one of the handful of US states with any legal protection at all for transgender people, let alone community support or resources like [the support group she attended].  The gender refugees told us how their businesses had been boycotted, their longtime friends no longer answering their calls, the doors of their churches shut to them, their kids ejected from schools and banned from play-groups, and death threats—against them and their children—left on their voicemail.

“But not all horror stories are imported across State lines.  ‘Kids here are excluded and bullied here, too,’ the local parents warned.  ‘And the worst bullies are often the other parents.  Or the teachers.’  One child’s tormentor was the school nurse.”

The group facilitator noted that most of the experts, the doctors, the politicians, the psychologists, the educators, “still don’t believe that your kids really exist.”

“No kidding,” said one parent, “this hospital [where the group meetings were being held] won’t even treat our kids.”

“You are pioneers,” the facilitator went on, “All of you are pioneers.  And revolutionaries.  You and your kids are changing the world.”

“Everyone is obsessed with bathrooms,” the facilitator warned.  “When I do presentations at schools, that’s all they want to talk about.  As if your children go in there to do anything other than use the toilet!”

They learn about things like “blockers”, medicines that press the pause button on puberty [and something which was not available or understood when I was growing up].  They talk about Thailand as an inexpensive place to make physical operations.  “For trans girls like mine, it was all about layers, and skirts were your best friend—worn over leggings, sewn onto swimsuits.  For boys, one of our moms would modify their underpants for you, sewing a soft bulge into the crotch.

They talk about the idea of a “Safe Folder”—a collection of documents we should all gather and keep readily accessible at home: a doctor’s letter confirming your child’s diagnosis, and the same from a psychologist, for backup.  Letters attesting to your parenting abilities, written by reputable people in your life: work colleagues, your child’s teachers, your church pastor.  Photos of your child exhibiting unconventional gender expression from a young age.  It is a good idea to include art too, self-portraits they have drawn of themselves in their true gender.”

“But why, what’s it for?” one parent asked.

“In case Child Protection Services knocks on your door.  If someone calls them and reports anything, they are required by law to investigate.  The neighbours could report you, or some acquaintance.  It could be anyone.  It can happen anywhere.”

“But can they actually take away our kids for this?” I asked.  Everyone was silent.  We turned to the facilitator.

“It’s best to be prepared,” he said, “just in case.”

“That night she looked at a painting her child had made of a girl holding a flock of yellow butterflies, as if they were balloons, or a flying bouquet of flowers.  It was a joyful picture.  They were pet butterflies.  She imagined putting this picture in the ‘Safe Folder.’  Surely the girl with the butterfly bouquet said everything that needed to be said.  Why should joy have to build a case for itself?”

“A feminist friend chastised me for allowing Barbies in the house.  I realised that it had not once occurred to me that I would need to school my daughter in the perils of sexism.  And recently I had come across a baby photo, one of my favourites, a close up of my child’s smiling little face—those big blue eyes starting right into the camera.  I swooned and pined for the chubby heft of this delicious child in my arms.

I showed M.  “Look, this is you!”

She was delighted, too.  “She is so cute!” She said of her younger self.  


We were looking at the same photo but not seeing the same person…And if I did miss my ‘boy’, what did that even mean?  Why should love have a gender?”

She confides to a friend who also has a transgender daughter that she misses her ‘son’ and wonders how we can be truly sure that we actually had daughters?

Her friend tells her that her daughter is a tomboy: “she’s into sci-fi and chess, and she hates clothing and everything traditionally girly.  It’s confusing.”


“But I think that because our daughters are not so into traditionally ‘girly’ stuff actually makes a stronger case for them being transgender.”

“How so?”

“Well, we know they don’t want to be girls just so they can do girl stuff and wear girl clothes.  They like a lot of boy stuff, so you’d think it would be easier for them to just be boys.  But they aren’t picking that easier route, because they simply can’t.  Their gender runs deeper than that.”

“But that’s the thing that gets me,” I said.  “What is gender?  I just don’t know if I believe in gender anymore…If a girl can have any type of job, or wear any type of clothing, and even have a penis, what is a girl?  The words boy and girlstill mean something to other people that they don’t mean for me anymore.”

“I told her how a group of women at my office were going out for ‘ladies night’ recently and I just kept thinking: ‘why ladies’ night?  Don’t you see how meaningless these categories are?  And don’t you ever wonder if our kids might just be cool with being just, well, kids, if the world wasn’t so hell-bent on stuffing them into categories.

“Why go to so much trouble to be a girl when you had to fight the whole world to be seen as one?  Wouldn’t just going with the ‘boy thing’ be a whole lot easier, if you could swing it?  Unless you just couldn’t.

Step 5: Learn

“I had never felt uncomfortable with my identity as a girl, nor as a woman.  This apparently fundamental component of my daughter’s inner reality was something I could only imagine, like a food I had never tasted.  So I tried to bridge the gap by reading.  I read Conundrum by Jan Morris.  The first sentence was printed on the front cover: ‘I was three or four when I realised that I had been born into the wrong body and should really be a girl.  It is the earliest memory of my life.’

“Next I read, She’s Not There by Jennifer Finney Boylan, who described a childhood game played alone in the woods called ‘girl planet’.  “I was an astronaut who had crashed on an uninhabited world,” wrote Boylan.  “The thing was, though, that anybody who breathed the air on this planet turned into a girl.”

Neither Morris nor Boylan shared their thoughts with those around them, keeping them private well into adulthood.  “Over time, the ‘crushing burden,’ as Boylan called it, “only grew heaver, and heavier, and heavier.”  She described an ‘almost inexpressible degree of private grief,’ and ‘the nearly constant sense that I was the wrong person.”

“I still didn’t understand what it felt like to find yourself living a mislabeled life, wearing a body that felt like a betrayal, but these books had given me my best glimpse so far into the imagined inner world of my child.  She was still only give…she could not describe for me the ‘crushing burden’ she carried, but these grown up transgender women could—and they did.  My gratitude for this gift is hard to overstate.”

She apologizes to her daughter for not realising sooner that she was a girl, of thinking that she was a boy at first.  But then she remembers how sure she was when she was pregnant that she was carrying a girl. 

“You knew I was a girl when I was in your tummy?” She said.

“I guess I did, yes.”

A triumphant smile flashed across her face, and then vanished.  “Why did you forget”

Oh, my heart.

Not so long ago, the only trans heroes we had to look to were Christine Jorgensen, Sonja Henie, Renée Richards…and since the 1950’s not all that much has changed with respect to the transgender predicament—it is equally lonely, bewildering, and lacking in discernible signposts.

“People living cross-gender lives have been found in the pre-historic grave sites of Europe, in the temple records of Ancient Mesopotamia, in traditional cultures of Africa, in 3,000 year old Hindu texts, in the shocked accounts of early European exlporers who described fluid gender expression in the native cultures from Alaska to Brazil, where a band of women warriors attacked the invading Spaniards and inspired the naming of the Amazon river.  Someone like my daughter had been an Emperor of Ancient Rome.  And an eighteenth-century French spy in the Russian imperial court.  And a soldier for the Union Army in the American Civil War.

“At this very moment, people like her were living openly in Polynesia, where they are called mahu or fa’afafine.  In Thailand, they are the katoey, or “ladyboys”.  In India they are called hijra and carry out spiritual functions, including the blessing of newborns.  There is no time or place where transgender people have not existed.  But today, we talk about them as if they are aliens.  Where do they come from, what do they want?  Have they been living secretly among us for years?

“One’s gender identity is very resistant, if not immutable, to any type of environmental intervention.”

American Psychological Association.  Gender diversity and transgender identity in children.

Chapter 6: Find Your Tribe

“In June, a little girl just like mine was all over the news.  A Colorado school district had barred transgender six-year-old Coy Mathis from using the girls’ bathroom.  Her family fought back, sued the district, and won…At around the same time, Barbara Walters profiled another transgender girl, eleven-year-old Jazz Jennings, on 20/20.  In August, California passed a law mandating that transgender school students of all ages be allowed to access the bathrooms, locker rooms, and sports teams that aligned with their gender identities…’Is society really getting around to addressing transgender civil rights just in the nick of time to save my child from the hell endured by previous generations of trans folks?’”

She begins to make transgender friends in the community, for herself and for her child, to act as role models.  She finds it immensely reassuring for both of them, immensely positive.  She attends transgender support groups.

“I thought about all the grim statistics I had been hearing about transgender people.  People like my daughter endured sky-high rates of just about every form of statistically measurable suffering: homelessness, unemployment, violence and abuse, mental illness, and drug addiction.  These were the results of living in a society that barely recognised your existence, let alone your humanity…but until very recently, if I had met someone like [X], with her low-pitched voice and stubbly chin, I would have thought she was weird.”

“In 2011, the National Transgender Discrimination Survey published the sobering results of their survey of more than 6,000 transgender people.  The report found a pervasive pattern of discrimination against trans people in every arena of their lives: in childhood homes and schools, in “harsh and exclusionary workplaces, at the grocery store, the hotel front desk, in doctors’ offices and emergency rooms, before judges and at the hands of landlords, police officers…[and] health care workers.”

78% of those surveyed report having been harassed in school, and 98% were harassed at work.  25% lost their jobs because of their gender identity.  They were four times as likely as the general population to be living in extreme poverty and twice as likely to have been homeless.  57% had experienced significant family rejection.  A heart-breaking 41% of those surveyed reported attempting suicide, with ‘African-American transgender respondents faring far worse than all others in most areas examined.”

Injustice at Every Turn: A Report of the National Transgender Discrimination Survey, a survey of 6,450 transgender people, published in 2011.

She starts a blog, writing under the nom-de-plume “gendermom”.  These are snippets of some of the comments from readers she receives:

  • “My career as a high school teacher, a life with my children and my grandchildren (my daughters have never let me meet my eight grandchildren).  I miss them so!  I live underground now.  Even my boyfriend of 7 years doesn not know about my past.  Reading about your daughter made me cry, and deeply so.  How I wish I began this life at a later time and place.  Oh, how I wish I could begin again.”
  • “I first realised I was a woman on the inside when I was seven.  Like most transsexual people born when I was, I transitioned late in life—at the age of 48.  If only I could have stopped all the raging testosterone that turned me into Sasquatch.  I am 6’5” and hairy as a caveman with a very deep voice.  There is no fixing me.”

She attends a conference in her hometown called Gender Odyssey, sharing stories and survival tips with other parents.  

  • “A young dad told us how kids at school were bullying his nine-year old trans daughter.  ‘They call her a He-She,’ he said, his voice breaking.  “How can they do that to my little girl?  Why won’t the teachers stop them.”
  • “Our doctor refused to let my teenage daughter get a blocker,” a mother said, “and her voice dropped.  So now she refuses to speak in public.”
  • “Who will love my child?” another mother lamented, “What if he gets rejected when his girlfriend finds out he’s not a ‘real man’?  Who will love him?”

“Bullying is a virtual given.  “It’s going to happen.  You have to prepare your kids for how they are going to respond.”  A social worker warned that our children’s schools would invariably attempt to sidestep the ‘bathroom issue’ by suggesting that our kids use the nurse’s bathroom.  “Don’t fall for this ‘solution,’ she said.  “It singles out your child and it never works.”  They end up holding it all day, she said, to avoid drawing attention to themselves.  “I can’t tell you how many of these girls get urinary tract infections from refusing to pee at school.”

“There has never been a case published where a child has transitioned socially and then decided that they were going to roll with their birth gender, and was harmed by it.  It never gets addressed in the clinical literature because it never happens.  Some kids have said, ‘Yeah, it was kind of awkward to tell my parents that I’d changed my mind,’ but they never say, ‘My life was ruined and I couldn’t go to college.”

Dr Johanna Olson-Kennedy, Medical Director, Center for Transyouth Health and Development at Children’s Hospital Los Angeles, August 2015, Gender Odyssey Conference, Seattle, Washington.

“Research going back to the 1970’s shows that gender constancy is intact by three to five years old.  But there are plenty of kids who didn’t freak out about their gender, or get their parents’ attention until the full weight of puberty hit them.  ‘Thirteen-year old trans boys who get their periods are not happy campers.’  Kids came to her clinic wanting to die rather than going through the wrong puberty.  Those who claim that these are just spoiled teens or that they will grow out of it need to wake up and smell the science.  Kids are dying.  Blockers constitute a life-saving medical intervention.”

The irony is that puberty blockers are the same medicines given to middle-aged men to prevent or stop prostate cancer—any insurer will likely cover it.  But not for gender issues.  Same drug, different application.  Equally bad outcomes.

She finds herself at the conference wondering about people who transition later in life.  “What was it like when they were my daughter’s age?  How did they find the courage to transition later in life, in a world like this?  Did they see themselves in my daughter?  I wanted to tell them that I saw the little girls they once were.  That I thought they were beautiful, because I did.”

She describes a “teen panel” at the conference where a dozen teenagers tell parents of their experiences:

  • “A nonbinary teen broke down crying.  ‘I just wish my dad would see me.’  A roomful of parents leaned forward helplessly in our seats.”
  • “A leggy trans teen girl with Barbie-blond hair told us she wanted a family someday.  “I can’t wait to be a mom,” she said.  She had just started estrogen and was excited about growing breasts.  But not a soul at her school knew she was transgender.  “Not even your best friends?” someone in the audience called out.  “Are you kidding?” she laughed, “its junior high!  If I tell even one of them, the whole school will know by the next day.”
  • She meets a mother of a trans boy, and they laugh and compare notes, imagining that each other’s challenges are greater.  But then they both agreed that the non-binary kids were the most intimidating.  “My mind was just beginning to wrap itself around the idea that you could toggle between the two genders I had grown up with.  But a third gender?”

Step Seven: Secure the Perimeter

She puts her child in a gender-friendly private kindergarten.

Step Eight: Believe in Love

She learns from her ex-husband how he came to terms with their daughter’s gender.  He said that it was one evening when attending the trans support group and, “he looked around the room and realised that there were two camps: the fearful parents and the calm ones.  Like him, the fearful parents were new to the group and were ‘swimming in agony’.  The calm ones had been coming to the group for months, some for years.  His voice began to quiver, ‘And they spoke about their kids with joy and love.’

‘And their kids were doing okay, right?’ I asked.

He took a long, slow breath.  ‘They weren’t going to die,’ my child’s father said.  ‘Part of me thought my kid was going to die because she was transgender.’

After the meeting, he said, he went straight home and got down on his knees so could be eye to eye with our child.  ‘You get to decide,’ he told her, ‘I don’t get to decide.’

And our child looked into his eyes and relaxed, transforming before him, ‘like the opening of a flower.’  And from that moment on, their whole relationship changed.  Before, everything was a fight.  After, it was peace.”

Step Nine: Find a Role Model

She meets a retired transgender woman who transitioned via Stanford in the 1970’s.  In those days you had to pass extensive psychiatric evaluations and then live two years to prove you could pass and make a living before you could even start.

“I wrote to her and told her I thought she was incredibly courageous.”

“That’s very kind of you to say,” the woman writes back, “but I don’t think I’m courageous.  I simply did what I had to do.  I can’t even imagine what kind of courage it would have required from me to try to live my life as a male.”

On June 9, 2014, the cover of Time magazine announced a “Transgender Tipping Point: America’s Next Civil Rights Frontier.”  Transgender actress Laverne Cox, a star from the hit Netflix Series Orange is the New Black, is on the cover.  She laments about how she can share the good news to her young child without also sharing the bad.  “Someone like you has never been on the cover of a major magazine before.  The magazine says that people like you might finally have rights soon.  Maybe.  I could not bring myself to say these things to my six-year-old.  How do you dole out the news to a young child that her identity has landed her far down on society’s pecking order?  How do you explain that she is part of a group that needs a civil rights movement because people like her currently possess almost no legal rights?”

[When she sets out to answer her own question, she resorts to parallels with the African-American struggle for civil rights.  When I read this I thought of how often we default to the gay rights movement, Stonewall, and how important that was.  But in truth, there are not only more parallels between trans rights and overcoming racism, but also, the debt for the trailblazers is due to the African-American who not only fought and died to literally shake off the bonds of slavery, but who are still living the consequences of discrimination in their daily lives, and in the statistics.  And I do not mean to downplay the rough road that gay people face, the stigma, etc…but the difference is that generally, if a gay person wishes to be in the closet, nobody will ever know, whereas a trans person is visually identifiable, just as the colour of our skin.  It should not surprise me at all why African-Americans have consistently been my greatest allies and supporters in my own public forays…they are truly living it all the time].

She shares some stats on intersex people.  These are cases where biological sex didn’t align neatly the gender binary either.  These are people who might appear female, but have XY chromosomes, or with hormonal imbalances that let to them having reproductive systems of both genders, or in part.  Nearly 2% of all people are born with some level of intersex conditions, which is twice as high as the number of people thought to be transgender.  Intersex is more common than being a redhead.  It isn’t just gender that lives on a spectrum, so does biological sex.

“Gender is not sane.  It’s not sane to call a rainbow black and white.”

Kate Bernstein, Gender Outlaw: On Men, Women, and the Rest of Us.

She organises a meet-up group for trans youth in her area, and finds many interested people.  But only one boy shows up.  She discusses with another mother.  

“There are always more girls at this age,” she commiserates.

“I guess that makes sense.  If you’re a young girl who likes boy stuff, everyone just thinks you have a tomboy.”

“Right!  But if you’re a boy who likes dresses…”

“Your parents freak out and call a psychiatrist!”

“There will be more boys later,” the mom predicted.  “When the kids get older and the parents realise they don’t have a tomboy.  They have a boy.”

She looks to find a babysitter, an older trans girl who can be a friend and mentor to her daughter, and does find one.  It proves a fruitful match.

Step Ten: Question Everything

“That Winter, Leelah Acorn killed herself.  She was seventeen when she posted her suicide note on social media and stepped in front of a lorry on the motorway.  ‘I decided I’ve had enough,’ Leelah wrote.  When she had told her parents she was a girl, they had sent her to conversion therapy to fix her.  They told her that God didn’t make mistakes, and that she would always be their son.  ‘Please don’t tell this to your kids,’ Leelah wrote.  ‘That won’t do anything but make them hate themselves.  That’s exactly what it did to me.’

“Leelah’s suicide note went viral and made national headlines, along with selfies she had taken posing in the mirror.  I could hardly bear to look at them.  Some said her suicide vindicated parents like me.  That it proved we were doing the right thing, because at least our children were still breathing.  They blamed Leelah’s parents for her death and said they should be prosecuted for causing it.  Some questioned whether they had even loved their child.

“I was sure they did love her.  I failed to see them as monsters.  I did think they were tragically mistaken, but what parent gets it all right?  I had stumbled and doubted every step of the way since my own child’s first terrifying announcement, and more stumbling and doubting was sure to come.

“Parents like me were staking everything on what people were starting to call the ‘gender affirming’ model, allowing our kids to live in the gender they said they were.  But there were plenty of people who weren’t on board with this model.  Leelah’s parents would have had no shortage of authority figures telling them that I was the one who was mistaken…And they also had the law on their side: at the time, in 2014, conversion therapy—therapy intended to change someone’s sexual orientation or gender identify—was completely legal in all but two US states.  [Still today, this is true of most of the US, particularly outside of the liberal pockets of the West Coast and New England.  See this map for where it is illegal.]

US Map of States where conversion therapy is legal

The author goes on to recount a story of a prominent radio host regarded as an “Expert” in the field, who ran a very large clinic for transgender youth in Canada, NPR called him a “leader in the field” and he led the work on “Sexual and Identity Disorders” for the American Psychiatric Association’s most recent addition of the DSM (Diagnostic and Statistical Manual of Mental Disorders).  The DSM is the resource consulted by medical health professionals all over the US to diagnose their clients.  This guy had literally written the book on transgender kids.

“And he said that everything I was doing was wrong.  Gender in young children was malleable, he said.  Parents should take this into account and exert their influence and act before it was too late.  He advocated what he called ‘limit setting’ on cross-gender behaviour in young children.  He told parents to prohibit activities and interests that didn’t match ones associated with the child’s biological sex.

“It made sense.  It sounded reasonable.  And I had tried a version of this myself, as had most of the parents I knew with kids like mine.  Maybe we just hadn’t tried hard enough.  Or maybe we didn’t do it right.  He said close to 90% of the kids in his clinic were ‘cured’ of their gender affliction.  Under his care they had been spared a transgender life, which was this doctor’s stated goal.

“I decided to learn more about this doctor and the research behind his theories…His writings were full of case studies…and these case studies included a great deal about their mothers, especially ones like me with kids like mine, whom he referred to as ‘boys with gender identity disorder.’  Apparently mothers like myself had serious problems.

“A ‘substantial percentage’ of us, the doctor wrote, were ‘emotionally or psychologically impaired.’  His book is packed with detailed accounts of our mental disorders: borderline personality, anxiety disorder, depression, impaired social adaptation, insecure attachment.  It was his opinion that these impairments explained our inability to set ‘appropriate limits’ on our children’s inappropriate behaviours, including “cross-gender behaviour in boys.’

“It seemed impossible for mothers like me to get it right.  In one case study, the problem was identified as ‘maternal unavailability.’  In another, the doctor blamed an ‘inordinate amount of time’ spent with the mother.  Which was it?  Was I too close to my child or not close enough?  The book didn’t say.  In other cases, the explanation for gender confusion in our “sons” was more straightforward: we hated men.

“All this mother blaming felt tired and outdated.  It also begged the question: Why did blame need to be assigned at all?  What crime were we really being blamed for?  The crime of having children who were different?  Was it actually pathological to be a boy who loved dresses?  Or to be a boy who was really a girl?  Or was something else to blame?  Were our kids sick or was something else sick?

“I thought of Leelah Acorn, and of the final words of her suicide note, ‘My death needs to mean something,’ she had written.  ‘Fix society, please.’

“The gender affirmative model is grounded in the evidence-based idea that attempting to change or contort a person’s gender does harm.  Psychological interventions should aim to help children understand that their gender identity and gender expressions are not a problem.  Providers should aim to non-judgementally accept the child’s gender presentation and help children build resilience and become more comfortable with themselves, without attempting to change or eliminate cross-gender behaviour.  Children who experience affirming and supportive responses to their gender identity are more likely to have improved mental health outcomes.  Gender identity is resistant, if not impervious to environmental manipulation.  Moreover, attempts to change a child’s gender may have a negative impact on the child’s well-being.”

American Psychological Assocation, Gender Diversity and Transgender Identity in Children

Her podcast began to attract comments like these:

  • Dear Gendermom: I’m 14 years old and I know I’m a girl like your daughter.  My parents say it’s a phase.  That I’ll grow out of it.  But I know they are wrong.  I can’t go on like this.  If I can’t be a girl, I don’t want to live.

She was also receiving notes like this (and many worse):

  • Dear Gendermom: I am sure you mean well, but I think you have taken this way too far.  When I was a kid, I wanted to be a dog.  That didn’t make me one.

She writes, “Whether I was up against skeptical relatives, psychologists with fancy titles and mommy issues, or random readers of my blog, at the end of the day, my best evidence was my seven-year-old herself—and the fact that she was happy in the completest possible sense: content, unworried, playful, loving, curious and excited about the possibilities of each new day. And so were the other transgender children I had met, once they were heard and seen for who they said they were.

“What is the life of a kid who as a young child identifies as transgender going to look like?  And how will a parent’s or an environment’s decisions influence what that outcome will be?…This is the first generation of kids who are having the option of living as their gender identity in everyday life.  They are totally historic, they are paving the way, and we just know so little of what life will look like for them.”

Dr Katrina Olson, professor of Psychology, Princeton University, and founder of the TransYouth Project.

“According to Dr. Olson, there is solid scientific evidence that my child saying she was a girl was not the same thing as her wanting to be a dog.”  She describes the methodology of the test used to assess this.  And then goes on.  “What they found was that transgender girls had test results indistinguishable from those of the cisgender girls…about how they see their own gender identity.”

Dr. Olson was the first social scientist to be awarded the National Science Foundation’s Alan T. Waterman award, which comes with a $1m research grant.  In the same year she was honoured with a MacArthur Foundation Fellowship, commonly known as a ‘genius grant’, in recognition of her contributions to ‘advancing the scientific understanding of gender.’

“Remember honey, transgender is beautiful.”

Laverne Cox, transgender star of Orange is the New Black. What she says to the author’s child when they meet at a talk on transgender life and issues.

[But there are a lot of people out there who don’t feel that way.  Violence against transgender people for just being themselves runs high.  Trans women of colour, in particular, are at grave risk.  Consider this: the average life expectancy of a non-white transgender woman is just 31 years of age compared to their cis sisters of 71.  Why?  It seems so senseless.  Attacked and killed for being ourselves—is the male ego so fragile?]

In 2016, the Canadian doctor referred to above was stripped of his license, his clinic was shut down, and an investigation into his practice was launched by the Canadian authorities.  But the ugliness continues.  Bathroom bills.  Being outed.  Violence.  Denial of rights by the health system, the legal system.

Step Eleven: Make a Plan

Her daughter starts at a new school, and already a few days in, has told her ‘best’ friend that she is transgender.  “Don’t worry Mama.  Lucy promised she won’t tell anyone.”

“I realised I had just sent my daughter into the lion’s den, alone and unarmed.  What if she told the wrong kid, who had the kind of parents who wouldn’t be OK with a little girl with a penis in the bathroom?  My child had no idea how badly this could go for her.  She also didn’t understand that you couldn’t tell little kids to keep secrets from their parents these days.  Especially about anything that could be interpreted as sexual, because that’s what perverts and pedophiles do.

She tells her daughter that, “if you want to tell another friend at school, then please tell me first.”  That way, she reasoned, she could talk to the parents first, and if they said it was OK, then she could tell the friend.  It made her daughter angry.  “What’s the matter?’

‘I didn’t think they needed to know anything about it.’

‘The other parents?’


“She had a point.  Did these other parents really need to know?  Did they have a right to know?  Maybe all this focus on privacy is a mistake.  Maybe secrets really were toxic.  Maybe it would just be better to be totally open about it.

‘Maybe it would be better if everyone knew, so we wouldn’t have to worry about people finding out.  ‘Does that make sense sweetheart’?’

‘No sense at all.’

“A few days later, my daughter told me that if anyone besides Lucy found out what she was transgender, she was going to have to switch schools.  She said that if the other kids found out she was transgender, something really bad would happen.

‘What bad thing would happen?’

‘I’m afraid they will kill me.’

Step Twelve: Fight Back

“Up until this point, transgender kids had been virtually invisible.  I had struggled to convince people that someone like my child even existed.  Now the world was paying attention, finally acknowledging people like my daughter, and it seemed to think that they were dangerous.  All of a sudden, everyone on the news was talking about where transgender people should—and shouldn’t—pee.”

Bathroom bills were cropping up all over the country, asking people to use the bathroom of the sex indicated on their birth certificates, or at least which matched the “parts” in your pants, or that aligned with your DNA.  “Opponents of the bathroom bills argued that this was baseless fearmongering, and that the people most likely to be assaulted in restrooms were transgender people themselves.”

“I could see why the arguments for the other side [also] seemed compelling.  If a bunch of ill-intentioned men were indeed sneaking into women’s locker rooms under the cover of laws intended to protect transgender rights, that would be a scary scenario.  I didn’t want those men in the bathroom with me either, and certainly not with my precious little girl.  But it all turned out to be a red herring; there just wasn’t any evidence that men posing as transgender women were infiltrating changing rooms and bathrooms.  When I found out that the national organizations backing these laws were the same right-wing groups that had fought against legalizing same-sex marriage, I realized this fight probably had nothing at all to do with ensuring the safety of women while we pee.”

“There was good news too.  The University of Washington tracking transgender children, including my daughter, published its first set of findings.  Young transgender children like mine, who were allowed to live in their preferred gender, appeared to be psychologically healthy, with scores on mental health measures indistinguishable from their cis peers.  These results contrasted sharply with studies of children who had not been able to socially transition.  Those kids exhibited sky-high rates of depression and anxiety, triple that of healthy kids like mine.”

“Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group.”

Kristina R. Olson, PhD, et al, “Mental Health of Transgender Children Who are Supported in their Identities,” Pediatrics, March 2016

In 2016, President Obama’s justice department joined the education department and noted that Title IX, which forbids sex discrimination in public education would be interpreted as equally applying to transgender students.  “This meant that my daughter now had the right to be a girl at school and when she peed and when she played sports and when she changed for gym class.”

That didn’t stop discriminatory bills.  At the time of publication of this book, nearly 100 anti-trans bills were up for vote. Many of them would allow for punitive damages—financial fines for having exposed someone to the fact that a child is transgender.

“How was I going to tell my daughter that one day she might be the only girl in her school who wouldn’t be allowed to use the girl’s bathroom?”

Step Thirteen: Let Go

The author reaches out to the parents of her daughter’s friends at school to ask them if they would please reinforce the message not to share her daughter’s secret.  The responses varied.  

“My child’s fate is now in the hands of a bunch of eight-year-old girls whose parents think I’m either crazy or some sort of sexual pervert,” she lamented to the support group.  Hers was not the only story:

  • A nonbinary kid was being bullied in the school bathroom and told their parents they wanted to die.  
  • A transgender girl was quarantined to a section of the school playground after another parent hired an attorney and got a restraining order against her.  She was nine years old.  The parents were going to switch schools, cities, and not tell anyone.

“Don’t forget that your kids are resilient,” the facilitator said.  “They are amazing people.  They are the most courageous, resilient people you are likely to meet, of any age, anywhere.”

“How many of us would have the nerve to take on the world, as our children have done?  How many of us would risk everything, including perhaps our own parents’ love, in order to craft an outside that matched our insides?  How many would defy a system that society had declared immutable…to trust some inner drumbeat of self…and would summon the courage to give voice to that drumbeat and be in the world in ways that most of us have never seen or imagined?”

“I thought of my child at 4 years old.  How she had worked on me, day after day, week after week…”

An adult transgender pen pal writes to her.  “Each day is a gift.  I will always consider myself saved from a life of unknown misery and sadness.  Your daughter will face some troubling times.  But one day she will understand what her place in this world is, and that who she is and what she stands for is difficult for many people to grasp.  This is where she has to be brave.  But it’s worth it.  Life is grand!”


Written five years later.  “Did I ever see my daughter waver?  Not for a moment.”  A friend asked her about the decision to take the step of medical intervention.  “There never was a decision because decisions are made when there is more than one viable option.  Thirteen-year-old girls don’t choose to become women.  They simply do, because it’s who they are.

[This is kind of how I have felt when people in my life have told me I was courageous.  Courage is not what it is.  It is survival.]

“[We don’t talk much anymore} about the fact she is transgender; we’re too busy just living our lives.  This normalcy is a rare gift.  I know that she is living a life that would not be possible in the vast majority of places on this planet, where transgender people are invisible, exploited, outlawed, and too often killed or driven to take their own lives.  My daughter’s access to a loving, supportive community, and to legal, safe, and affordable medical care places her in a tiny and privileged category.  Only the random accident of geography and timing has spared us from tragedy.

“While bathroom bills now, blessedly, seem to be a thing of the past, anti-trans politicians are finding new avenues to discriminate and exclude.  More than 100 anti-trans laws have been introduced so far this year [July 2021], and many of them specifically target the rights of transgender youth.  Nine US states have banned girls like mine from playing on girls’ sports teams at school.  Arkansas became the first state to make it a crime for doctors to prescribe puberty blockers for trans youth.  Fourteen other states have introduced legislation to follow suit.”

My own comments

I loved this book.  I cried a lot reading it.  It is very poignant to see the trans experience from a mother who is trying to cope and understand.  We can’t do our lives again and bless the youth of today who are growing up in a more tolerant environment.  Bless the enlightened parents of today who are helping them be true to themselves.  These feelings are bittersweet.  So much pain in my life growing up lies in this landscape.  But also, so much beauty.  That which I treasure most about myself came from this.  We cannot take the good without the bad.  It is the pain that makes the good taste better, through which character was forged.

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