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I still have my male anatomy, but I embrace femininity on my own terms. I don't desire to have a vagina or be like other women. I simply want to express myself in a feminine way.

If someone desires female anatomy but does not have it, there is a surgical option available. This procedure involves inverting the penis to create a vagina.

I offer support to find gender affirming care for youth, even if they need to go out of state. If parents are unsupportive, some kids choose to get emancipated at 16 to make their own medical decisions. Dealing with transphobic parents can be tough, especially if they are very right-leaning. It's important to find a chosen family of friends who accept you. I can send you a binder discreetly if needed.

A politician introduces a video clip of a surgeon who identifies as the "queer surgeon" and performs gender affirming surgeries. The politician expresses concern over experimental and irreversible procedures being performed on children. In the clip, the surgeon states that 80% of their practice is gender affirming surgery, with a focus on genital surgeries like vaginoplasty and phalloplasty. They acknowledge an increase in adolescents seeking surgical intervention, which presents unique challenges, especially for those who have undergone puberty suppression. The surgeon admits that there is a lack of published research on genital surgeries for pubertally suppressed adolescents and that they are "just kind of learning and figuring out what works." They explain that puberty suppression affects the amount of tissue available for vaginoplasty, requiring alternative techniques like using peritoneum to line the vaginal canal. The surgeon notes that they will know more about the outcomes in 5-10 years and that it will be fascinating to see how these kids turn out. The politician then condemns these procedures as "barbarism" and "mutilation of children" that should be illegal. They claim that children lack the capacity to make such life-altering decisions and that sex is an immutable characteristic.

Dr. Olsen decides to start Josie on blockers and promises to give her estrogen in two years. Josie receives the blockers as an arm implant and holds on tight as she prepares for the next chapter of her life. The speaker reflects on how just 20 years ago, they wouldn't have been able to provide blockers, and Josie would have had to go through male puberty, which terrifies them. They express uncertainty about whether Josie would have survived male puberty.

Max, who identifies as a boy, is visiting the doctor to discuss hormone blockers to prevent puberty. He has started experiencing some breast growth and feels uncomfortable. His parent expresses concern about medical interventions and their effects on bone health and psychosocial development. The doctor explains that hormone blockers can halt puberty progression and reassures that if Max changes his mind, he can still go through female puberty later. The procedure involves inserting a small implant in Max's arm, which will last about 14 to 18 months. The entire process is quick, taking only about 10 to 15 minutes.

The reaction to having two trans kids is often one of shock. Before transitioning, I felt incomplete and was nervous about telling my parents. Being trans means feeling different from the gender assigned at birth. Recently, I started hormone blockers to prevent menstruation and breast development, which can be mentally challenging. People often question if I'm too young to know I'm trans, but I wonder if they are too young to know they're cis. Olivia identified as transgender from age 4 and socially transitioned at 5. Some think younger kids mimic older siblings, which made us hesitant about her transition, but this is who she is. Initially, I felt defensive about Olivia transitioning, thinking it was my experience, but I now see her as a girl, and she always will be.

"For someone who is assigned male at birth and if they've already been through puberty, they could produce a semen specimen and have it frozen." "If someone is assigned female at birth and they are also all the way through puberty, you can do egg banking, which entails a little bit more." "Typically, you have to take some additional hormone injections and it's a procedure to go in and retrieve the eggs." "We think someone has to be probably in mid male puberty to produce semen." "There have been some case reports of transgender men who were assigned female at birth who weren't completely through puberty and have been able to do fertility preservation, but we don't know if that applies to everybody." "We definitely counsel all of our patients about fertility preservation." "Usually from their first visit, we're starting to talk about it."

There is not one surgery that every transgender person wants. Many transgender people have no interest in having surgery. For other people, they undergo medical transition involving use of gender affirming hormone treatments. And for others, they may have one or more surgeries. They may have top surgery, which is surgery on the chest or breasts. They may have bottom surgery, surgery on the genitals. They may have facial feminization. Trans women may have a tracheal shave to reduce their Adam's apple. No two trans people have the same needs to resolve their gender dysphoria. So you can never make an assumption that any trans person wants any particular surgery or any surgery at all.

I will be hanging out with the daughters of my mom's friend while they have a meeting. Jazz is an inspiration as a transgender role model. She shared her surgery experience honestly. Charlie plans to have surgery after high school due to bullying. I recently had surgery with complications, but now I feel great. Stitches came apart a week after surgery, causing pain and distress.

Clementine, a detransitioner, shares her experience with another person also named Clementine. She began puberty blockers at 12, testosterone at 13, and had a double mastectomy at 14. Testosterone caused her to experience psychosis, so she stopped taking it around age 17. Now 20, she detransitioned earlier this year and is undergoing reconstructive surgery. She notes that getting approval for reconstructive surgery has been more difficult than getting the initial double mastectomy. She expresses disbelief that people question the experiences of detransitioners.

Most trans kids know they're trans between ages two and seven, with the speaker's daughter knowing around two and a half. The speaker emphasizes that children know things that adults don't, and these are the things to which adults should listen. The speaker states their child is not mentally ill. To begin gender affirming care, the speaker had to consult with numerous healthcare professionals.

Here's my transgender daughter, Bella. She was assigned male at birth but now uses she/her pronouns. We're working on getting her medication to block male hormones. Bella is 14 and doing well in her transition. Being trapped in the wrong body affected her mental health, but with medication, we'll get through it together. We also received a grant to cover her transition costs, which is a huge relief. She can finally be who she truly is, which is all she's wanted for years, and we're so happy for her.

A child will often know that they are transgender from the moment that they have any ability to express themselves, and parents will often tell us this. We have parents who tell us that their kids, they knew from the minute they were born practically, and actions like refusing to get a haircut or standing to urinate, trying on siblings' clothing, playing with the quote opposite gender toys, things like that. There is more and more a group of adolescents that we are seeing that really are coming to the realization that they might be trans or gender diverse a little bit later on in their life. So what we're seeing from them is that they always sort of knew something was maybe off and didn't have the understanding to know that they might be trans or have a different gender identity than the one they had been assigned. So that is a growing population that we are seeing and that's being recognized as being trans and able to be treated.

I prefer male pronouns and presenting as male. I want to either have no genitalia through nullification surgery or have female genitalia. Even if I don't have testicles, I would still take testosterone. My husband and I haven't decided on surgery, but I have started tucking and binding my genitals, which has been life-changing for me.

"The eligibility for getting gender affirming surgeries at Boston Children's Hospital is basically the same as it would be for most other hospitals or surgeons in The United States." "And that's the case because we all follow the World Professional Association for Transgender Health or WPATH standards of care." "For top surgery, you are requested, but not required to have been on gender affirming hormones for at least a year." "If you're a trans woman, it's really encouraged that you be on estrogen for at least a year because you want to maximize your natural breast growth." "Many surgical centers require you to be 18." "At Boston Children's Hospital for top surgeries, we'll see people as young as age 15 if they've been affirmed in their gender for a long period of time and don't really have any other life complications that make surgery inappropriate."

"Hi, I'm Maria. I use pronouns she, her, hers, and you're gonna meet a lot of folks, and don't be overwhelmed." "It's very much a two way conversation." "After that, Doctor. Ghanour and myself will come in to wrap up the consult, go over surgery in detail." "At that time, we'll ask you to change to do an exam that's very quick, have you change back into your normal clothes to then sit down and discuss everything with or without your parents, depending on your age and what your family desires." "We tell you to write down all your questions, to email anytime, to call anytime." "It can be very overwhelming and we give you a lot of information, but that first visit is mostly informational with one exam."

The speaker discusses the standards applied to children and the potential benefits of going on blockers. They mention that blockers can prevent the development of a deep voice, Adam's apple, and facial hair. The speaker shares their personal experience of spending $5,000 on facial hair removal and $25,000 on facial feminization surgery. They believe that blockers can prevent the need for such procedures and alleviate stress.

Admiral Rachel Levine, a pediatrician and the assistant secretary for the Department of Health and Human Services, addresses concerns about children transitioning before 18. She emphasizes the challenges of adolescence, particularly for those experiencing gender dysphoria. If a child feels female but is undergoing male puberty, it can be distressing. Critics argue that children are too young to make such decisions. Levine clarifies that for prepubertal children, no medical procedures are performed; instead, they are supported through therapy to explore their feelings.

Doctor Olsen faced a decision regarding Josie's treatment. She advised starting hormone blockers around age 13, ensuring Josie wouldn't have to wait until 16 to begin. Josie received the blockers as an implant in her arm, showing great bravery as she embraced this new chapter in her life. The doctor reflected on how, just twenty years ago, such treatment wouldn't have been possible, and Josie would have faced male puberty, which was a terrifying thought. The doctor expressed relief that they could provide this support now, emphasizing the importance of the decision for Josie's well-being.

This boy just had top surgery, and I want to share our journey. After the surgery, I was called to the Recovery Room. The surgeon was working on him, and there was a lot of blood coming from his scars. They informed me that they needed to take him back for more surgery because a blood vessel had popped. Unfortunately, we lost his right armpit hair during the process, but the left one remained untouched.

A breakthrough in surgery is the ability to harvest the peritoneal lining. Jazz, a medical case, presents a challenge as her puberty was effectively blocked, preventing normal genital growth. This makes it difficult for surgeons to use a conventional approach. They are using the peritoneum tissue to create what can be described as a patchwork or Franken vagina.

Here's my transgender daughter, Bella. She was assigned male at birth but now uses she/her pronouns. We're working on getting her medication to block male hormones. Bella is 14 and doing great in her true body. Being trapped in the wrong body really affected her mental health, but with the right medication, we'll get through this together. We even received a grant to cover all the transition costs, which is a huge relief. All she's wanted for years is to finally be herself, and we're so happy for her.

We're here to support our child, Violet, and her right to access necessary medical care. It's important for her to be herself, and we won't let anyone silence her. We're from Arizona and are concerned about how this case might impact our state. We've even discussed the possibility of moving, but Violet's needs come first. Violet has known she is trans since she was one and a half years old; she has expressed this since she could speak.

Véronique and Martine discuss the process of gender reassignment surgery and the challenges of reintegrating into society. Véronique believes that the surgery is not a transformation but rather a necessary step to align her physical appearance with her feminine identity. She emphasizes that the integration is smooth on an individual level but faces legal complications in terms of societal acceptance. Martine adds that it is difficult for trans individuals to find employment due to the uniqueness of their civil life. She shares her personal experience of struggling to secure a job in the electronics field.