0:00:02 > 0:00:05This programme contains scenes which some viewers may find upsetting.
0:00:05 > 0:00:08Do you think you are happier as Camille or Sebastian?
0:00:08 > 0:00:10Camille.
0:00:10 > 0:00:11How do we get this thing off?
0:00:11 > 0:00:13But Sebastian was happy too, wasn't he?
0:00:13 > 0:00:15- No.- You don't think so?
0:00:15 > 0:00:16No.
0:00:16 > 0:00:17Why not?
0:00:17 > 0:00:18He was not happy.
0:00:20 > 0:00:22What wasn't happy about him?
0:00:23 > 0:00:25He did not like...
0:00:25 > 0:00:29He wanted to be a girl and then he did not like his name
0:00:29 > 0:00:31so he changed his name.
0:00:32 > 0:00:36# Whoa-ah! #
0:00:39 > 0:00:43'For the last several months, I'd been meeting children who say
0:00:43 > 0:00:46'they were born into the wrong body.
0:00:46 > 0:00:47'San Francisco,
0:00:47 > 0:00:49'a leading light in gay rights,
0:00:49 > 0:00:53'is now blazing a trail for the transgender community,
0:00:53 > 0:00:57'helping boys and girls at ever younger ages to transition.'
0:00:57 > 0:00:59What is that little thing in there doing?
0:01:00 > 0:01:02Making it so I don't go through puberty.
0:01:02 > 0:01:04And why don't you want to go through puberty?
0:01:04 > 0:01:07Because I don't want to be a girl.
0:01:07 > 0:01:11'Intervening early allows them a chance to create the bodies
0:01:11 > 0:01:15'they feel they always should have had,
0:01:15 > 0:01:17'but it's also fraught with difficulties
0:01:17 > 0:01:21'and raises questions about how old a child should be
0:01:21 > 0:01:25'to make changes affecting his or her whole life.'
0:01:25 > 0:01:28She'll say that she wants a vagina.
0:01:28 > 0:01:29She uses the V word?
0:01:29 > 0:01:31- Yeah.- Yeah.
0:01:31 > 0:01:32And what do you say?
0:01:32 > 0:01:35Erm, I've just been telling her that when she's old enough
0:01:35 > 0:01:38and she's ready to make that decision
0:01:38 > 0:01:43that if she still wants one, erm, that she could have one.
0:01:57 > 0:01:59Smile.
0:02:00 > 0:02:04'I was with Casey and Eduardo and their child Camille...'
0:02:04 > 0:02:07Be careful. Stay out of the road, Camille. Come this way.
0:02:07 > 0:02:11'..who until recently had been called Sebastian.'
0:02:11 > 0:02:14Oh, my God, that was cool.
0:02:14 > 0:02:17'The family were about to have their first appointment with
0:02:17 > 0:02:19'Dr Diane Ehrensaft,
0:02:19 > 0:02:20'a clinical psychologist
0:02:20 > 0:02:23'specialising in transgender children.'
0:02:23 > 0:02:26And you can make a story in the sand tray of anything you want.
0:02:26 > 0:02:30It's kind of like having a dream or telling a story in your head,
0:02:30 > 0:02:33but you get to do it with all the things here,
0:02:33 > 0:02:35and then we'll take a picture of it.
0:02:38 > 0:02:40To put it simply, what brings you here today?
0:02:41 > 0:02:46Well, we have a child who has asked us
0:02:46 > 0:02:51if they can be a girl and we want to make sure that we're
0:02:51 > 0:02:54fostering the best approach to make it a smoother ride
0:02:54 > 0:02:56and to kind of know that we're doing the right thing.
0:02:56 > 0:02:59When did this request first come up?
0:02:59 > 0:03:04Not too long ago. Erm, we were just sitting on the couch
0:03:04 > 0:03:08and Sebastian asked me if...
0:03:08 > 0:03:10"How do I become a girl?"
0:03:11 > 0:03:16And we had pretty much... The process with us had started in October
0:03:16 > 0:03:22when Sebastian had requested an all-girls Halloween costume.
0:03:22 > 0:03:24Camille, did you want to tell us something?
0:03:24 > 0:03:29It was Monster High. Frankie's my favourite.
0:03:29 > 0:03:33Oh, OK. I'm going to spend a little time with Camille.
0:03:33 > 0:03:36The first thing we're going to do is draw, OK?
0:03:36 > 0:03:38Mm-hm.
0:03:38 > 0:03:41So, Camille, the first thing, I'm going to ask you just to draw
0:03:41 > 0:03:44a picture of a person.
0:03:44 > 0:03:47That's me. I can draw myself on here.
0:03:54 > 0:03:56That's me.
0:03:56 > 0:03:58So when you were born, a long time ago,
0:03:58 > 0:04:02your mummy and daddy thought they had a little boy named Sebastian.
0:04:02 > 0:04:05Right now, how would you describe yourself?
0:04:05 > 0:04:07A girl. Not a boy. I'm a girl.
0:04:08 > 0:04:13You're a boy and a girl but you'd like to be a girl and not a boy?
0:04:13 > 0:04:15Not a boy and a girl any more.
0:04:15 > 0:04:16Not a boy and a girl any more.
0:04:16 > 0:04:17Not transgender.
0:04:17 > 0:04:22And not transgender but, erm, so what shall we call it?
0:04:22 > 0:04:24Erm, girl.
0:04:24 > 0:04:25OK.
0:04:25 > 0:04:26Bye, Diane.
0:04:26 > 0:04:29Goodbye, Camille. I hope I'll see you again soon.
0:04:30 > 0:04:34How did that go, as far as you were concerned?
0:04:34 > 0:04:36As far as I was concerned, it went quite well.
0:04:36 > 0:04:43I mean, can you say at this point that she is transgender
0:04:43 > 0:04:46and was, as it were, born in the wrong body
0:04:46 > 0:04:49and will grow up to be a woman?
0:04:49 > 0:04:54I would say it lines up in that direction. So here's what I saw.
0:04:54 > 0:04:59This is a child who's been insistent and consistent and persistent
0:04:59 > 0:05:04since age 18 months about being gender non-conforming.
0:05:04 > 0:05:10But what is not there is a child who from age two,
0:05:10 > 0:05:13when then Sebastian, he developed language,
0:05:13 > 0:05:16was saying, "I am a girl."
0:05:16 > 0:05:18Do you sometimes see that?
0:05:18 > 0:05:23I sometimes see children as young as between age two and three
0:05:23 > 0:05:26saying things like...
0:05:26 > 0:05:30In response to, "Honey, such a good girl."
0:05:30 > 0:05:34"No, Mummy, boy," and it starts there, so the answer's yes.
0:05:36 > 0:05:40'Aged just five, Camille was on the cusp of a decision that could
0:05:40 > 0:05:42'change her entire life.'
0:05:46 > 0:05:48- Hello.- Hello.
0:05:48 > 0:05:50- Can I come in? - Come on in.
0:05:50 > 0:05:52A change of outfit! Look at that.
0:05:52 > 0:05:54Did we have a nap?
0:05:54 > 0:05:56- Did we have a little rest? - Yes.
0:05:56 > 0:05:58- A tiny one?- Tiny.
0:05:58 > 0:06:02What's striking looking around is all the photos of Camille
0:06:02 > 0:06:03as Sebastian.
0:06:03 > 0:06:04- Mm-hm.- Yeah.
0:06:04 > 0:06:06Looking very boyish.
0:06:06 > 0:06:08- Yeah.- Yeah.
0:06:08 > 0:06:12And how old... I mean, I guess it's a he in this.
0:06:12 > 0:06:16Is that right or do you read it back into the past and say,
0:06:16 > 0:06:18"Well, it was always a she, we just didn't realise"?
0:06:18 > 0:06:20Yeah.
0:06:20 > 0:06:22I think that's what... Where we're at now,
0:06:22 > 0:06:26is that it's always been a girl and we just didn't realise it until now.
0:06:26 > 0:06:27Uh-huh.
0:06:27 > 0:06:31And, to me, that one's a tough one because that was the last time
0:06:31 > 0:06:33we captured Sebastian.
0:06:33 > 0:06:36In honest opinion, that was the last time
0:06:36 > 0:06:41we saw that, you know, spiky little hair and the cute little clothes.
0:06:41 > 0:06:45I think it was really, for me, kind of saying goodbye.
0:06:45 > 0:06:48And I don't... And it's not a bad thing in my mind.
0:06:48 > 0:06:52It's kind of like, "Ah! That was a phase. We're done."
0:06:52 > 0:06:56What is going on? Camille, what are you doing?
0:06:56 > 0:06:57Putting lipstick on.
0:06:58 > 0:07:02For how long have you been using Camille
0:07:02 > 0:07:05and the she pronoun at home?
0:07:05 > 0:07:06- A month.- A month.
0:07:06 > 0:07:07- Just a month?- Yeah.
0:07:07 > 0:07:09So this is all really new to you, this.
0:07:09 > 0:07:12Very, very new. It's... We get confused quite often.
0:07:12 > 0:07:14How are you feeling about it?
0:07:16 > 0:07:17I'm fine.
0:07:17 > 0:07:22I... It's just hard getting used to going from one to the other.
0:07:22 > 0:07:24It's difficult. It's really difficult.
0:07:24 > 0:07:26It's not an easy thing to do.
0:07:26 > 0:07:28Do you find it confusing ever?
0:07:28 > 0:07:30- Yeah.- Yeah.
0:07:30 > 0:07:33Yeah, I think that's kind of par for the course sometimes,
0:07:33 > 0:07:37and I think it's that way with kids a lot but, erm,
0:07:37 > 0:07:40definitely with discovering who you are as a person.
0:07:40 > 0:07:44Trying to figure out what is solid and consistent and dependable
0:07:44 > 0:07:47and cater to that and support that.
0:07:47 > 0:07:50It is difficult and I'm not going to lie, it's not easy,
0:07:50 > 0:07:52this is not a very easy thing.
0:07:52 > 0:07:55We may have had not so bad of a time at this,
0:07:55 > 0:07:59but it's not an easy road to travel. You...
0:08:01 > 0:08:05It's gut-wrenching, honestly.
0:08:07 > 0:08:09It's a battle dance.
0:08:09 > 0:08:11A battle dance?
0:08:11 > 0:08:12Yes.
0:08:12 > 0:08:15You have... You have to dance as best that you can
0:08:15 > 0:08:17and you have to do this.
0:08:17 > 0:08:20I don't even know if I know what a battle dance is.
0:08:20 > 0:08:21Does that mean that...
0:08:21 > 0:08:22You have to dance the best.
0:08:22 > 0:08:23It's a competition?
0:08:23 > 0:08:24Yes.
0:08:24 > 0:08:28MUSIC: Bad Romance by Lady Gaga
0:09:03 > 0:09:06'There is a growing trend in America towards enabling trans kids
0:09:06 > 0:09:09'to transition as early as possible.
0:09:12 > 0:09:15'San Francisco's Benioff Children's Hospital is spearheading
0:09:15 > 0:09:19'the approach, under the direction of Dr Ehrensaft
0:09:19 > 0:09:21'and Dr Steve Rosenthal.'
0:09:21 > 0:09:24So do you prefer boy pronouns or...?
0:09:24 > 0:09:27Like "he" or girl pronouns like "she"?
0:09:27 > 0:09:29I just want to do it the way you want it.
0:09:29 > 0:09:33'Kids identified as trans can hold off puberty using blockers.
0:09:35 > 0:09:38'Later, by taking hormones, their bodies can
0:09:38 > 0:09:42'mature in the direction of the gender they feel they really are.
0:09:42 > 0:09:45'In some cases, the final step is surgery.'
0:09:45 > 0:09:49I think hopefully by... When I turn 18,
0:09:49 > 0:09:54I'll be fully transitioned, meaning, like, I'll have bottom surgery,
0:09:54 > 0:09:56- do you know what that means? - Uh-uh.
0:09:56 > 0:10:01So I'll have surgery that will, erm, change my penis into a vagina.
0:10:01 > 0:10:03Uh-huh.
0:10:03 > 0:10:04What's he doing?
0:10:06 > 0:10:08A month ago he had another implant put in.
0:10:08 > 0:10:11What do you mean by an implant?
0:10:11 > 0:10:14Erm, she is on a puberty blocker and he had...
0:10:14 > 0:10:16Hi, Shane. Louis.
0:10:16 > 0:10:17Can we see that, Shane?
0:10:17 > 0:10:19Yeah.
0:10:19 > 0:10:20It's under the skin there.
0:10:20 > 0:10:22There's some stitches dissolving.
0:10:22 > 0:10:26Shane, as you understand it, what is that little thing in there doing?
0:10:26 > 0:10:28Making it so I don't go through puberty.
0:10:28 > 0:10:30And why don't you want to go through puberty?
0:10:30 > 0:10:32Because I don't want to be a girl.
0:10:32 > 0:10:34- You don't want to?- No.
0:10:34 > 0:10:37Do you know what the next step is on the
0:10:37 > 0:10:39medical side of the journey?
0:10:39 > 0:10:43I want to go on T, or testosterone, but I have to wait until I'm
0:10:43 > 0:10:4714, so that's two years, and this should last for another two
0:10:47 > 0:10:52years, so hopefully I'll be able to just transition after that's done.
0:10:52 > 0:10:53Transition meaning?
0:10:53 > 0:10:55Get... Go on testosterone.
0:10:55 > 0:10:57And what would that do?
0:10:57 > 0:10:59It would make me go through guy puberty
0:10:59 > 0:11:02and my voice goes deeper and stuff.
0:11:02 > 0:11:04Hello, hello...
0:11:04 > 0:11:07'A 14-year-old trans girl had come in for a check-up.'
0:11:07 > 0:11:09- Good to see you again. - Nice to see you.
0:11:09 > 0:11:11I'm Louis.
0:11:11 > 0:11:12- Hi. Isabel.- Hi, Isabel.
0:11:12 > 0:11:14- Hi, Louis. Gerry.- Gerry.
0:11:14 > 0:11:15- Hi. Louis.- Hi.
0:11:15 > 0:11:16- What's your name?- Nikki.
0:11:16 > 0:11:18Nikki.
0:11:18 > 0:11:21At the last visit I saw her, I did increase her oestrogen dose
0:11:21 > 0:11:24and so she has, erm... She does have one breast bud,
0:11:24 > 0:11:27so she's had some response from that dose increase.
0:11:27 > 0:11:31When girls develop breasts, it very frequently starts
0:11:31 > 0:11:34on one side and then the other side, so this is normal.
0:11:34 > 0:11:35Yeah.
0:11:35 > 0:11:37Do you enjoy coming here, Nikki?
0:11:37 > 0:11:38Erm, yeah. Yes, I do.
0:11:38 > 0:11:40What do you like about it?
0:11:40 > 0:11:43Erm, that, like, every time I come here we're, like,
0:11:43 > 0:11:46making, like, a step forward, I guess.
0:11:46 > 0:11:50I guess, like, I'm just really excited about, like, the future...
0:11:50 > 0:11:55Like, you know, and erm...
0:11:55 > 0:11:57Yeah, I just can't wait.
0:11:57 > 0:11:59Ah, that's wonderful.
0:11:59 > 0:12:05'For the first 13 years of her life, Nikki had been Nick.
0:12:05 > 0:12:08'Last year, Nick had come home from school
0:12:08 > 0:12:11'and found his mum watching a TV programme about trans kids.'
0:12:12 > 0:12:16So Nikki had seen this TV show. Were you watching it with her?
0:12:16 > 0:12:19I was really debating... And I don't know if it's mother's intuition,
0:12:19 > 0:12:23I was really debating whether or not to allow her to watch this show
0:12:23 > 0:12:29because I guess I knew deep down inside what was going to happen next
0:12:29 > 0:12:35and within 15 minutes, you were like, "That's me," and I'm like...
0:12:35 > 0:12:36She said that out loud?
0:12:36 > 0:12:38- "That's me."- Yeah.
0:12:38 > 0:12:42And I'm like... Inside of me, I was like, "Oh."
0:12:42 > 0:12:44Nikki, for you, as soon as you saw the show you thought,
0:12:44 > 0:12:46"That's what I am. That's who I am"?
0:12:46 > 0:12:47Yes.
0:12:47 > 0:12:48Was it a...
0:12:48 > 0:12:52What made it important to you to do something straight away?
0:12:52 > 0:12:55Probably because, like, I was starting puberty.
0:12:55 > 0:12:57Like, my male puberty
0:12:57 > 0:13:00and I knew it was going to, like...
0:13:00 > 0:13:03Well, I knew it was going to get worse for me
0:13:03 > 0:13:06because I didn't want to start male puberty and it would be, like,
0:13:06 > 0:13:10really harder for me, like, to do, like, the treatments and I just
0:13:10 > 0:13:13wanted to make myself look like a girl and I just...
0:13:13 > 0:13:18Yeah, I just really didn't want any...
0:13:18 > 0:13:21I just really wanted to start with it fast.
0:13:21 > 0:13:23This has all happened quite quickly, hasn't it?
0:13:23 > 0:13:25Yes.
0:13:25 > 0:13:27There's two things you can do here. I mean, you can...
0:13:27 > 0:13:31As a parent, you can be in denial, which to some degree we were.
0:13:31 > 0:13:33You can say, "We can fight it." You know, we could say,
0:13:33 > 0:13:36"No, this is not the way you were born. You were born a boy,"
0:13:36 > 0:13:38and force that down that path.
0:13:38 > 0:13:41There's a good chance Nikki would have conformed to some degree,
0:13:41 > 0:13:42for a period of time.
0:13:42 > 0:13:44Nikki would have become an adult, and this happens
0:13:44 > 0:13:47all the time, right, where people become adults and really still
0:13:47 > 0:13:51feel this way and then they learn to transition when they're adults.
0:13:51 > 0:13:54Life is a lot harder, in my opinion,
0:13:54 > 0:13:57when, as parents, we fail to see that and I see it
0:13:57 > 0:14:01as protecting the life of my child, in a way, and taking that right
0:14:01 > 0:14:06fork and that's why I justify what I've done here, as a father.
0:14:16 > 0:14:18I guess what you're doing here that's a little
0:14:18 > 0:14:20different from some other
0:14:20 > 0:14:23comparable places is doing interventions relatively early.
0:14:23 > 0:14:27Is the risk there that, you know, they may get it wrong in some sense?
0:14:27 > 0:14:31The child may not... May think he or she knows who he or she
0:14:31 > 0:14:35really is but then five years, ten years on,
0:14:35 > 0:14:38having taken the intervention, may change his or her mind.
0:14:38 > 0:14:39Is it a risk?
0:14:39 > 0:14:43Let's call it a possibility, so with that possibility then we'd
0:14:43 > 0:14:48think the most important thing is the same exact idea -
0:14:48 > 0:14:51to find out who you are and make sure
0:14:51 > 0:14:55you get help facilitating being that person then.
0:14:55 > 0:14:58We have one risk we know about.
0:14:58 > 0:15:01The risk to youth when we hold them back.
0:15:01 > 0:15:02You don't...
0:15:02 > 0:15:07And hold back those interventions - depression, anxiety,
0:15:07 > 0:15:12suicide attempts, even successes, and if we can facilitate a better
0:15:12 > 0:15:17life by offering these interventions, I weigh that
0:15:17 > 0:15:22against there might be a possibility that they'll change later,
0:15:22 > 0:15:26but they will be alive to change, so that's how I weigh it on the scales.
0:15:32 > 0:15:36'I was with Casey on the way to picking up Camille.
0:15:36 > 0:15:39'It was the first day she'd been allowed to wear a dress to school.'
0:15:45 > 0:15:46Mummy!
0:15:51 > 0:15:53Hello there. How's it going?
0:15:53 > 0:15:55- Good.- High-five.
0:15:55 > 0:15:58Finally I got to see you.
0:15:58 > 0:15:59How did it go?
0:15:59 > 0:16:00Good.
0:16:02 > 0:16:05Look at you! What a nice dress.
0:16:09 > 0:16:11What would you want?
0:16:11 > 0:16:14I would like regular chocolate, please.
0:16:14 > 0:16:19Whoa! Oreos and sprinkles! I want those Oreos and...
0:16:20 > 0:16:24Was it any different wearing a dress than it is normally?
0:16:28 > 0:16:30It was actually easier getting her dressed today
0:16:30 > 0:16:33because it was something that she wanted to wear.
0:16:33 > 0:16:35Did it feel like a big step for you?
0:16:35 > 0:16:39It did. I was kind of worried about the reaction from
0:16:39 > 0:16:44other parents, cos I know people are going to be gawking
0:16:44 > 0:16:48and just looking at Camille a little bit different.
0:16:48 > 0:16:51I mean, you don't think Camille's still exploring?
0:16:52 > 0:16:54Trying different things?
0:16:54 > 0:16:56I don't know.
0:16:56 > 0:17:02Honestly, it's been such a quick journey in the last one year
0:17:02 > 0:17:07that we've been going through this that it doesn't feel like
0:17:07 > 0:17:12there's a lot of exploration left now.
0:17:12 > 0:17:14It's big leaps and bounds forward.
0:17:14 > 0:17:16I don't think there's any more exploring.
0:17:16 > 0:17:20I think this is... This is Camille and this is her coming-out party.
0:17:30 > 0:17:32'Casey had told me that
0:17:32 > 0:17:35'Camille's transition had caused a rift in the family.
0:17:37 > 0:17:40'Back at home I had some more questions.'
0:17:43 > 0:17:45You were saying that your father...
0:17:45 > 0:17:47Mm-hm.
0:17:47 > 0:17:51..is, erm, is a bit of a sceptic on all this.
0:17:51 > 0:17:56I think that they think that she's too young
0:17:56 > 0:17:59and that we should wait till she's older to make her decisions
0:17:59 > 0:18:01that could affect her life.
0:18:01 > 0:18:04He's OK with her wearing dresses around the house
0:18:04 > 0:18:05and stuff like that?
0:18:05 > 0:18:10Yeah, inside the house is fine but, you know,
0:18:10 > 0:18:13out in public where other people could see.
0:18:13 > 0:18:18And what about changing the name and changing the pronouns?
0:18:18 > 0:18:20They're not happy with that at all.
0:18:20 > 0:18:24They think that's a big step for
0:18:24 > 0:18:28a five-year-old to have to undertake.
0:18:30 > 0:18:32Does he call Camille Camille or Sebastian?
0:18:32 > 0:18:35Sebastian.
0:18:35 > 0:18:38Sebastian, him, he.
0:18:38 > 0:18:39Does that bother you?
0:18:39 > 0:18:43I don't...
0:18:43 > 0:18:44Yes and no.
0:18:44 > 0:18:49I mean, I know it's hard. Like, a lot of people can't...
0:18:49 > 0:18:51It's hard to remember to do it,
0:18:51 > 0:18:54but when you're blatantly ignoring the fact that, you know,
0:18:54 > 0:18:57we're making this transition and you're not listening
0:18:57 > 0:19:02to what we're saying, that's disrespectful and hurtful.
0:19:02 > 0:19:08So your dad's position is basically, it's Sebastian, it's a he,
0:19:08 > 0:19:13and just give it time and see where you get to.
0:19:13 > 0:19:17What I say is, it's very different day to day when you're at home with
0:19:17 > 0:19:21Camille, that it's not just...
0:19:22 > 0:19:25This is not us putting it on our child,
0:19:25 > 0:19:28putting so much responsibility on a five-year-old to decide what to do.
0:19:28 > 0:19:31All these big life-changing things.
0:19:31 > 0:19:35These are things that she's coming to me and saying.
0:19:35 > 0:19:40I'm not the one who's, "Are you a girl? Are you a boy?"
0:19:40 > 0:19:42No, this child's coming to me and saying,
0:19:42 > 0:19:44"I am a girl and I want to be a girl.
0:19:44 > 0:19:45"How do I become one?"
0:19:54 > 0:19:58'Some trans people become so unhappy with their bodies
0:19:58 > 0:20:02'they experience dysphoria, feelings of anxiety and depression.
0:20:03 > 0:20:08'For older kids and adults, there is the option of surgery.
0:20:08 > 0:20:12'Among the leading surgeons in the field is Dr Curtis Crane.
0:20:13 > 0:20:16'He offered to show me some of his handiwork.'
0:20:16 > 0:20:17Can I join you over there?
0:20:17 > 0:20:19Oh, please. Yes.
0:20:24 > 0:20:29This is a thigh as a donor site, giving quite a large phallus.
0:20:29 > 0:20:32That's about six and a half inches.
0:20:32 > 0:20:35Here's a forearm as a donor site,
0:20:35 > 0:20:39giving a five and a half inch phallus.
0:20:39 > 0:20:42I'd be hard pressed to see this patient walking around a
0:20:42 > 0:20:46locker room and find someone that wouldn't say, "That's not a male."
0:20:52 > 0:20:53Hello.
0:20:53 > 0:20:55'One of Dr Crane's patients,
0:20:55 > 0:20:58'17-year-old Amaya, had come by for a check-up.'
0:20:58 > 0:21:00- Hello. - Good to see you.
0:21:00 > 0:21:02Good to see you again.
0:21:02 > 0:21:05Well, very good. So it's been a while since your surgery.
0:21:05 > 0:21:06Almost a year, yeah.
0:21:06 > 0:21:08Almost a year and how have you healed?
0:21:08 > 0:21:11Pretty good. I haven't really been doing much for the scars themselves
0:21:11 > 0:21:14- but I mean, they're healing pretty well.- Yeah.
0:21:14 > 0:21:18The scars, you know, they take a little while to go away and
0:21:18 > 0:21:23they're going to get better whether you do anything for them or not.
0:21:23 > 0:21:26It's pretty amazing. All of our friends are saying it.
0:21:26 > 0:21:28Well, thank you. You look fantastic.
0:21:28 > 0:21:30- Pretty good.- Yeah, look at that.
0:21:30 > 0:21:34Like I said, they're still there, obviously, but...
0:21:34 > 0:21:35- No, they're fading very nicely. - Yeah.
0:21:35 > 0:21:37There's a little bit of redness under here.
0:21:37 > 0:21:39Yeah.
0:21:39 > 0:21:41And will that gradually fade, Dr Crane?
0:21:41 > 0:21:45Er, possibly. You know, a scar isn't totally mature for a year
0:21:45 > 0:21:47so we're just a little bit before that and then
0:21:47 > 0:21:49if it's not to Amaya's liking, there's options of
0:21:49 > 0:21:53getting a little bit of laser to take out some of that red.
0:21:53 > 0:21:55- Could do that? - Yeah, it's very easy.
0:21:55 > 0:21:58So is that it for you, surgery-wise
0:21:58 > 0:22:03or have you thought about or talked about bottom surgery?
0:22:03 > 0:22:07For now, that's it. I don't see myself going that route for
0:22:07 > 0:22:11a while and I don't know how I'll be in five, 10, 20 years.
0:22:11 > 0:22:14But for now, this is all I really needed.
0:22:14 > 0:22:18You don't have dysphoria to do with, er, downstairs?
0:22:18 > 0:22:20No.
0:22:20 > 0:22:23Definitely not as much as upstairs.
0:22:23 > 0:22:26How old were you when you changed pronouns?
0:22:26 > 0:22:28That was only in the last year or so.
0:22:28 > 0:22:30- In the last year or so? - Yeah.
0:22:30 > 0:22:33So were you... Before you grew breasts you weren't having
0:22:33 > 0:22:35dysphoria to do with your, erm...
0:22:35 > 0:22:37- Er, no. - ..your body?
0:22:37 > 0:22:41Not that I can remember, at least. It was really that, you know,
0:22:41 > 0:22:44sixth, seventh grade when I was 11 or 12 was really
0:22:44 > 0:22:48when I started to develop and when all of those dysphoric issues
0:22:48 > 0:22:51started to come up and then progressed from there.
0:22:51 > 0:22:53And what was that like?
0:22:53 > 0:22:59It was tough. It definitely kind of hurt my own mental health
0:22:59 > 0:23:01a little bit, I guess I could say.
0:23:01 > 0:23:03Why?
0:23:03 > 0:23:05It didn't make me want to be very social.
0:23:05 > 0:23:09It kind of gave me a little bit of an anxiety issue and
0:23:09 > 0:23:13it just didn't help anything in terms of me going out in public
0:23:13 > 0:23:16and having to deal with it.
0:23:16 > 0:23:19It definitely made me have a bit of a struggle, in that sense.
0:23:19 > 0:23:21It just didn't feel like it was you
0:23:21 > 0:23:23or you didn't like the way it felt or looked or...?
0:23:23 > 0:23:26I didn't like mainly the way other people were perceiving me
0:23:26 > 0:23:31and so it was a lot of how I was perceiving myself plus
0:23:31 > 0:23:34how others would see me just on the street, people that didn't
0:23:34 > 0:23:37know me necessarily and how they would think of me.
0:23:41 > 0:23:46'The path of transition, rarely easy, becomes even less clear
0:23:46 > 0:23:48'when parents don't see eye to eye.'
0:23:48 > 0:23:49Hello.
0:23:49 > 0:23:51CAT MIAOWS
0:23:52 > 0:23:54- Hi.- Hi.
0:23:54 > 0:23:57- Joy?- Yes.- Louis.
0:23:57 > 0:24:00'I was about to meet a child whose parents'
0:24:00 > 0:24:03'divorce had made her true gender a matter of dispute.'
0:24:07 > 0:24:09- You've got a daughter called Crystal.- Yes.
0:24:09 > 0:24:11Is that... Would you...?
0:24:11 > 0:24:12Well, she was born Cole.
0:24:12 > 0:24:16But she was born Cole, with male anatomy?
0:24:16 > 0:24:17Correct.
0:24:17 > 0:24:21At what point did you switch to using, erm, female pronouns?
0:24:21 > 0:24:25We go back and forth, and it's difficult because at school
0:24:25 > 0:24:29or in places where she's a he, we can trip over ourselves.
0:24:29 > 0:24:31At school it's he, it's Cole?
0:24:31 > 0:24:33Uh-huh.
0:24:33 > 0:24:35Er, and it's Cole and then at home...
0:24:35 > 0:24:36At home...
0:24:36 > 0:24:38- Here, it's...- She.
0:24:38 > 0:24:40- ..Crystal and she? - Er, yeah.
0:24:40 > 0:24:44Is there a reason you haven't transitioned at school?
0:24:44 > 0:24:47Because her father and I,
0:24:47 > 0:24:50I don't think see this from the same perspective.
0:24:50 > 0:24:56So Crystal or Cole hasn't expressed a clear preference, it sounds like.
0:24:56 > 0:25:02She has said, privately with her therapist, that she is a girl,
0:25:02 > 0:25:06erm, almost 100%.
0:25:06 > 0:25:10When I've sat down and had private conversations with her and said,
0:25:10 > 0:25:13"Would you ever be interested in hormones, blockers,
0:25:13 > 0:25:15"they need to be started soon, right?"
0:25:15 > 0:25:19So, erm, you know, I've had to have more serious conversations.
0:25:19 > 0:25:22"Do you... Let me explain to you how your body's going to change.
0:25:22 > 0:25:25"Do you want to stop that? How do you feel about it?"
0:25:25 > 0:25:29Erm, and her answer is,
0:25:29 > 0:25:34"I can't... I can't do that, Mummy.
0:25:34 > 0:25:36"I have to be a boy,"
0:25:36 > 0:25:40and I enquire further as to why and she says,
0:25:40 > 0:25:47"Because I'm Poppy's only son and it would destroy Poppy."
0:25:47 > 0:25:49How you doing? Can I say hello?
0:25:49 > 0:25:51Yeah.
0:25:51 > 0:25:52Louis. What's your name?
0:25:52 > 0:25:54Crystal.
0:25:54 > 0:25:58Crystal. But you've got another name. What's your other name?
0:25:58 > 0:25:59Cole.
0:25:59 > 0:26:01Do you have one that you like better?
0:26:01 > 0:26:02No.
0:26:02 > 0:26:04Your mummy was telling me that one is sort of for school,
0:26:04 > 0:26:06is that right?
0:26:06 > 0:26:09And one is what, more for home?
0:26:10 > 0:26:11So that's different.
0:26:11 > 0:26:13Is that fun having two names?
0:26:13 > 0:26:14Kind of.
0:26:14 > 0:26:19But what about maybe going outside and, erm... Do you like to pogo?
0:26:19 > 0:26:21OK. I'll just have to get on my shoes.
0:26:21 > 0:26:22OK.
0:26:29 > 0:26:32Hang on, no hands? Isn't that dangerous?
0:26:32 > 0:26:33No.
0:26:37 > 0:26:39Two hands, one leg. I like that.
0:26:40 > 0:26:42How many can you do?
0:26:42 > 0:26:44I have a small record.
0:26:44 > 0:26:46Go on, let's see you.
0:26:48 > 0:26:49I just fall off.
0:26:49 > 0:26:51So what do your sisters call you?
0:26:51 > 0:26:54Er, either Crystal or Cole.
0:26:54 > 0:26:56Either one? Maybe I should ask them. What's your name?
0:26:56 > 0:26:58Rebecca.
0:26:58 > 0:27:02I call Crystal Crystal
0:27:02 > 0:27:07and sometimes Cole when, erm,
0:27:07 > 0:27:10when she wants to be called Cole.
0:27:10 > 0:27:13Do you think of them as a boy or a girl?
0:27:13 > 0:27:19Cole usually is a boy and Crystal's a girl.
0:27:19 > 0:27:20Doesn't that get confusing?
0:27:20 > 0:27:22No.
0:27:22 > 0:27:23So how do you decide?
0:27:25 > 0:27:29I decide on what clothes I'm wearing, like, that day.
0:27:29 > 0:27:32Like, if I want to wear these kind of clothes, I'm a girl.
0:27:32 > 0:27:35If I want to wear, like, those kind of clothes, I'm a boy.
0:27:35 > 0:27:39Like, it depends on, like, what I feel like doing that day.
0:27:39 > 0:27:42And do you prefer one?
0:27:42 > 0:27:46No, I don't.
0:27:46 > 0:27:49And do you think at some point you'll decide one way or the other
0:27:49 > 0:27:53or do you think you might just keep kind of going back and forth?
0:27:53 > 0:27:56I'll just decide one day.
0:27:56 > 0:27:57You think you will?
0:28:12 > 0:28:16'I was making a follow-up visit to Nikki and her family.'
0:28:17 > 0:28:19- Hi, Gerry. - How are you?
0:28:19 > 0:28:21- Yeah, good. How are you doing? - Good to see you.
0:28:21 > 0:28:24- Bit of an early start.- Yes.
0:28:24 > 0:28:26'Since our first meeting, four months earlier,
0:28:26 > 0:28:29'I'd been curious about the progress of her transition
0:28:29 > 0:28:31'and its impact on the rest of the family.'
0:28:31 > 0:28:33Hi, Nikki. How are you doing? Nice to see you.
0:28:33 > 0:28:35I'm good.
0:28:35 > 0:28:37So you're allowed to wear make-up to school?
0:28:37 > 0:28:39Yeah, but I don't wear that much,
0:28:39 > 0:28:42cos I don't like wearing a lot of make-up,
0:28:42 > 0:28:46cos it's really, like... It takes for ever to put on a lot.
0:28:46 > 0:28:48Since I last saw you, your hormones were increased.
0:28:48 > 0:28:51Yeah, they have. Like, I'm starting to see a lot of changes
0:28:51 > 0:28:54and pretty much...
0:28:54 > 0:28:56Cos, er, last time when I saw you guys
0:28:56 > 0:28:59was when I just, like, started on it, I think.
0:28:59 > 0:29:00Yeah.
0:29:00 > 0:29:02Like, it was a month I started in on it,
0:29:02 > 0:29:04but I've been, like, seeing and, like,
0:29:04 > 0:29:06feeling a lot of changes to that.
0:29:06 > 0:29:07Go on.
0:29:07 > 0:29:11Erm, like, erm...
0:29:11 > 0:29:14Well, I've been, like, getting...
0:29:14 > 0:29:16Well, I've been getting a lot of mood changes.
0:29:16 > 0:29:19Because a mood's brought on by the hormones, do you think?
0:29:19 > 0:29:22Yeah, it brings you, like, certain feelings that you don't
0:29:22 > 0:29:25want to go out into the world because it's who you are
0:29:25 > 0:29:29and just get, like, so scared. I don't know.
0:29:29 > 0:29:32I started, like, feeling that when I started hormones.
0:29:32 > 0:29:37I started getting more, like, sad and emotional a lot of the times.
0:29:37 > 0:29:41And there are maybe things that...
0:29:41 > 0:29:42When you're in a mood that...
0:29:42 > 0:29:45that are bringing you down a little bit?
0:29:45 > 0:29:49I just want to, like, stay away from everyone.
0:29:49 > 0:29:50At school?
0:29:50 > 0:29:53Yeah, and sometimes I don't, like, really want go back to school.
0:29:53 > 0:29:55Like, they don't get it.
0:29:55 > 0:30:02They call me, like, faggot, like a fag and stuff and, erm, yeah.
0:30:06 > 0:30:09Do you like what you see when you look in the mirror?
0:30:09 > 0:30:11Yeah.
0:30:11 > 0:30:16I mean, I like it.
0:30:18 > 0:30:21Erm, I wouldn't exchange it for anything.
0:30:28 > 0:30:29This is Daniella.
0:30:29 > 0:30:31- Hi, Daniella. I'm Louis.- Hi.
0:30:31 > 0:30:32- How do you do?- Good.
0:30:32 > 0:30:34What's this been like for you?
0:30:34 > 0:30:36Erm, it's...
0:30:36 > 0:30:39It's been an experience.
0:30:39 > 0:30:41It was hard at first,
0:30:41 > 0:30:43erm, but then I really got used to it
0:30:43 > 0:30:47and then I just really learned to, like, love her.
0:30:47 > 0:30:50You had a brother, or thought you had a brother, called Nick.
0:30:50 > 0:30:51Yeah.
0:30:51 > 0:30:53Who you were quite fond of, I imagine.
0:30:53 > 0:30:56I didn't want to accept the fact that she was transitioning.
0:30:56 > 0:31:01I didn't. I just said, "No. Like, I'm not OK with this."
0:31:01 > 0:31:03Why not?
0:31:03 > 0:31:05Erm, because it was kind of like
0:31:05 > 0:31:07I was the only girl in this family and I wanted to be the first
0:31:07 > 0:31:12to wear make-up, the first to do all the girl stuff, erm,
0:31:12 > 0:31:17and now I wasn't going to be because she's older than me and she's going
0:31:17 > 0:31:20to be doing all that stuff first and I just...
0:31:20 > 0:31:23I've been living my whole life with Nick and I really...
0:31:23 > 0:31:25I didn't want anything to change.
0:31:25 > 0:31:27Did you know that she felt that?
0:31:27 > 0:31:29Yeah, I kind of did.
0:31:29 > 0:31:32Erm, it was really, like... She was really confused
0:31:32 > 0:31:34when my mum told her.
0:31:34 > 0:31:38- It feels quite normal now, does it? - Yeah.
0:31:38 > 0:31:43Yeah. It's just Nick is gone and I'm OK with that now
0:31:43 > 0:31:47and Nikki is, like... I don't know,
0:31:47 > 0:31:49I just feel like she was Nikki her whole life.
0:31:54 > 0:31:56- Bye, honey.- Bye.
0:32:02 > 0:32:04See you later.
0:32:04 > 0:32:05Bye.
0:32:07 > 0:32:10One thing that had come up when I was talking to Nikki was that,
0:32:10 > 0:32:14erm, some of the kids weren't fully accepting.
0:32:14 > 0:32:17A lot of her peers don't really get it.
0:32:17 > 0:32:20They don't really understand what transgender means.
0:32:20 > 0:32:22- They think she's gay.- Mm-hmm.
0:32:22 > 0:32:25Erm, and it's really hard for Nikki to explain that to them
0:32:25 > 0:32:27because she's so quiet
0:32:27 > 0:32:33and she doesn't like to create, like, problems or get into arguments
0:32:33 > 0:32:37or... Not that she would have to, but she'd rather just let it go.
0:32:37 > 0:32:39A lot of that will be alleviated moving forward
0:32:39 > 0:32:41because we have made movement.
0:32:41 > 0:32:43We've gone through the court to officially change Nikki's name.
0:32:43 > 0:32:45Did that feel like a big step?
0:32:45 > 0:32:48Yes, it was a big step for...
0:32:48 > 0:32:52I mean, for her too, she was very happy.
0:32:52 > 0:32:54I was... It was bittersweet for me
0:32:54 > 0:32:56but I know I'm doing the right thing.
0:32:56 > 0:32:57As a matter of fact, we just got her
0:32:57 > 0:33:00new birth certificate two days ago and the first thing
0:33:00 > 0:33:06she pointed out was her gender, and she was very happy.
0:33:07 > 0:33:10Bittersweet for you in what way?
0:33:10 > 0:33:13That I don't have my son any more.
0:33:14 > 0:33:16It's...it's hard sometimes.
0:33:19 > 0:33:23You know, I have to refer... I have to look... I'm sorry...
0:33:26 > 0:33:27There's always, you know,
0:33:27 > 0:33:31there will always be a sense of, erm, of grief. Even though
0:33:31 > 0:33:37it's not a total loss, you, erm, you go through that
0:33:37 > 0:33:40and you have a, erm, for ever memory, you know?
0:33:40 > 0:33:44Because anybody that has children, you had them as babies and you did
0:33:44 > 0:33:47things when they were little and you're not going to...you can't
0:33:47 > 0:33:51just erase those memories. And many times they were boy memories
0:33:51 > 0:33:56and erm, you know, that... You know, that's not going to go away.
0:33:56 > 0:33:59Isabel, how would you explain the sadness?
0:34:00 > 0:34:05I don't know, I guess just that I won't...
0:34:05 > 0:34:09You know, like, I often wonder, like, what would Nikki be as Nick
0:34:09 > 0:34:14as a teenager, you know? I know her life is going to be a little harder,
0:34:14 > 0:34:20you know, she will always have something that she has to overcome,
0:34:20 > 0:34:23you know, erm, and it...
0:34:23 > 0:34:26Her future scares me a little bit,
0:34:26 > 0:34:27I'll be honest.
0:34:41 > 0:34:46I was visiting the reconstructive surgeon Dr Crane again.
0:34:47 > 0:34:50This time I was hoping to find out about his more ambitious
0:34:50 > 0:34:53surgeries and also get a perspective on childhood
0:34:53 > 0:34:56transition from his older patients.
0:34:56 > 0:34:58- Good to see you.- Good to see you.
0:34:58 > 0:34:59Another day in the office.
0:34:59 > 0:35:00Yes, it is.
0:35:00 > 0:35:03You've got some candidates coming in.
0:35:03 > 0:35:05Yes, we've got a lot of patients today.
0:35:08 > 0:35:09- Louis.- Nice to meet you, Louis.
0:35:09 > 0:35:10- What's your name?- Ketch.
0:35:10 > 0:35:12- Ketch?- Yes.
0:35:12 > 0:35:15So tell me, erm, what brings you here today?
0:35:15 > 0:35:20I'm doing a pre-op appointment for, erm, I guess the final stage
0:35:20 > 0:35:26of my phalloplasty, doing testicular implants and glansplasty.
0:35:26 > 0:35:30So you've already had a... a shaft made?
0:35:30 > 0:35:31Yes.
0:35:31 > 0:35:32And how did that go?
0:35:32 > 0:35:34It went really well, actually.
0:35:35 > 0:35:38It was a lot different than I expected it to be,
0:35:38 > 0:35:40but, erm, the results are amazing.
0:35:40 > 0:35:45I'm very happy with it and it... it's, erm, what's the word?
0:35:45 > 0:35:46Useful.
0:35:48 > 0:35:50That's great. How old are you, Ketch?
0:35:50 > 0:35:53I am 36. I'll be 37 in five days.
0:35:53 > 0:35:57And you were assigned female at birth?
0:35:57 > 0:35:58Yes, yes.
0:35:58 > 0:36:01Which is hard to believe, looking at you.
0:36:01 > 0:36:02That's awesome.
0:36:02 > 0:36:04Which I guess is a good thing, right?
0:36:04 > 0:36:06It's a wonderful thing.
0:36:06 > 0:36:10I've been meeting kids mainly who are trans
0:36:10 > 0:36:14and in the process or figuring out whether they are trans,
0:36:14 > 0:36:18and some of them are transitioning as kids
0:36:18 > 0:36:21and taking pubertal blockers and cross-gender hormones.
0:36:21 > 0:36:23Uh-huh.
0:36:23 > 0:36:27Looking back, does it seem to you that that's something you wish,
0:36:27 > 0:36:28erm, you'd done earlier?
0:36:28 > 0:36:31- Oh, absolutely.- Really?- Absolutely.
0:36:31 > 0:36:35When I was a kid, I'm like...I felt that was a missing part of me.
0:36:35 > 0:36:38You know, erm, going to the bathroom and having to sit down or
0:36:38 > 0:36:40to stand up, that, you know, that really bothered me
0:36:40 > 0:36:44cos in pre-school, the kids would all go to the same bathroom.
0:36:44 > 0:36:47You know, you have the teachers there supervising and I'm like,
0:36:47 > 0:36:51"OK, so why's he standing? Why don't I...? I have to sit down," you know,
0:36:51 > 0:36:55and so I would for years and years and years find a way
0:36:55 > 0:36:58- to try to fix that, you know, so... - How?
0:36:58 > 0:37:03Erm, just try different devices to, you know, stand and pee.
0:37:03 > 0:37:06Correct me if I'm wrong, but it's more just the act of wanting to
0:37:06 > 0:37:11stand and pee maybe even more than...than the sexual side of it.
0:37:11 > 0:37:15Oh, it's definitely more than that because after I, erm,
0:37:15 > 0:37:19I had top surgery, it still... I still wasn't complete, you know?
0:37:19 > 0:37:22Going to the beach and, you know, feeling like
0:37:22 > 0:37:25somebody's looking at me like, "Oh, you know, you look like a guy
0:37:25 > 0:37:27- "but, you know..."- There's no bulge.
0:37:27 > 0:37:28Yeah, exactly.
0:37:28 > 0:37:32- Literally that? - Literally, yes. Yeah.
0:37:33 > 0:37:36I'm out at the beach and...
0:37:36 > 0:37:38Yeah.
0:37:38 > 0:37:41You've got...you know it's something that people,
0:37:41 > 0:37:43- if they're looking that way... - If they're looking.
0:37:43 > 0:37:45..there'll be something there.
0:37:45 > 0:37:49Yeah, definitely. It's functional, it's very functional, so...
0:37:49 > 0:37:50- It feels good?- Yes.
0:37:53 > 0:37:56Hello. Hi.
0:37:56 > 0:37:57- Hi. Louis. - Hi, hello, Minerva.
0:37:57 > 0:38:00- You must be Minerva. How're you doing?- It's good to meet you.
0:38:00 > 0:38:02- And, Tristian, yes.- Yes.
0:38:02 > 0:38:04- Nice to meet you. - Pleased to meet you.
0:38:04 > 0:38:05What kind of questions can I answer for you?
0:38:05 > 0:38:09Specifically, I mean, I've known for sure, like, I want an orchiectomy.
0:38:09 > 0:38:11I've been hearing things from a friend of mine
0:38:11 > 0:38:15who I think recently got done here, like, a kind of...
0:38:15 > 0:38:18She was calling it a no-depth vaginoplasty.
0:38:18 > 0:38:20An orchiectomy is the removal of the testicles
0:38:20 > 0:38:22and phallus as well?
0:38:22 > 0:38:23No, just testicles.
0:38:23 > 0:38:28And, erm... But I heard you say a no-depth vaginoplasty.
0:38:28 > 0:38:29- Uh-huh.- Meaning?
0:38:29 > 0:38:32It's essentially, erm, you construct a vulva
0:38:32 > 0:38:37and a clitoris, erm, but the vulva doesn't lead to anywhere.
0:38:37 > 0:38:39There's a lot of options. You know,
0:38:39 > 0:38:44I very much tailor the care of my patients to exactly what they want.
0:38:44 > 0:38:48I... Basically I'm a... I see my job as a counsellor
0:38:48 > 0:38:50and she can have anything.
0:38:50 > 0:38:53And so at this point... We said this at the beginning but you have
0:38:53 > 0:38:56a pretty clear idea of what you... what the destination is for you?
0:38:56 > 0:39:00Yeah. Financially, I think... I think I'm going to
0:39:00 > 0:39:02spring for the orchi, I think, right now.
0:39:02 > 0:39:07I'm not... Which is a, it's... It's a good middle ground, I think,
0:39:07 > 0:39:11because that is definitely something that I want and it doesn't preclude
0:39:11 > 0:39:15any other options if, you know, what I need changes as I grow older.
0:39:15 > 0:39:18So then you're in a kind of, sort of, erm, middle stage,
0:39:18 > 0:39:21- is that...? - I mean, I could, I could...
0:39:21 > 0:39:24I'm not going to, you know, make guesses
0:39:24 > 0:39:28as to what me in 20 or 30 years would want, but, erm,
0:39:28 > 0:39:31for now I would be absolutely happy with an orchiectomy.
0:39:31 > 0:39:34- And keep the phallus as is.- Yeah.
0:39:34 > 0:39:40There's no dysphoria around her phallus, so why surgically
0:39:40 > 0:39:47remove it, you know? We're trying to solve dysphoria, we're not
0:39:47 > 0:39:54trying to put everyone in a box that the rest of society believes in.
0:39:54 > 0:39:56Are you in a relationship, may I ask?
0:39:56 > 0:39:58Mm-hmm, this is my girlfriend.
0:39:58 > 0:40:00OK.
0:40:00 > 0:40:02- Nice to meet you. - Nice to meet you too.
0:40:02 > 0:40:07And so, Tristian, may I ask you, how do you self-identify?
0:40:07 > 0:40:09Well, I'm also a woman.
0:40:09 > 0:40:11And have you had any surgeries at all?
0:40:11 > 0:40:16Yeah, I did experience much more, erm, dysphoria and emotional pain
0:40:16 > 0:40:21around my genital configuration than Minerva does,
0:40:21 > 0:40:25erm, so I did have a...
0:40:25 > 0:40:30full reassignment or reconfiguration, erm, last summer.
0:40:30 > 0:40:31How's that working for you?
0:40:31 > 0:40:36It's, erm...it's working out pretty well.
0:40:36 > 0:40:38It's, erm,
0:40:38 > 0:40:42it's been a lot better, a lot better since.
0:40:51 > 0:40:52Feeling good.
0:40:52 > 0:40:55He's going to make it. Yep, you're going to make it.
0:40:55 > 0:40:57Oh, nice!
0:41:00 > 0:41:01I was back with Crystal.
0:41:02 > 0:41:06Unlike her mum, her dad Erik has been reluctant to embrace
0:41:06 > 0:41:10Crystal's female identity and so this was a Cole day.
0:41:12 > 0:41:14Oh, too much.
0:41:14 > 0:41:16That one's going in. There you go.
0:41:16 > 0:41:18Well played.
0:41:18 > 0:41:20So now you can try and get a hole in one.
0:41:20 > 0:41:21Yeah, free game.
0:41:25 > 0:41:30So we met Joy and we talked to her a little bit about Cole
0:41:30 > 0:41:33and she sort of has a point of view on that,
0:41:33 > 0:41:35is that the best way of putting it?
0:41:35 > 0:41:37Yeah, I look at it a little bit different.
0:41:37 > 0:41:39I might be a little bit more conservative
0:41:39 > 0:41:44and approach things as, you know, Cole or any of my kids,
0:41:44 > 0:41:48you know, might want to have... are going to have certain things
0:41:48 > 0:41:52that they want to do and, you know, I have limitations on that.
0:41:52 > 0:41:57Do you feel you're putting up a little bit of resistance?
0:41:57 > 0:42:01You know, in the sense that, are there times when Cole might say,
0:42:01 > 0:42:05you know, "I'd like to buy some make-up," or do this and that,
0:42:05 > 0:42:08and you might say, "Well, I don't think that's such a great idea."
0:42:08 > 0:42:11I think he's clear, kind of, on what he can
0:42:11 > 0:42:14and can't do at his mum's and kind of what,
0:42:14 > 0:42:18how he...what he can and can't do when he's with me. Erm, I mean...
0:42:18 > 0:42:22But I've had the conversations with him that, you know,
0:42:22 > 0:42:25"I don't want to prevent you from being who you are,
0:42:25 > 0:42:28"I just feel there's a time and a place for who you want to be
0:42:28 > 0:42:30"and how you want to express that."
0:42:30 > 0:42:34If he truly were transgender, if you thought you
0:42:34 > 0:42:37were seeing that, would you...? What would be your view then?
0:42:37 > 0:42:41I don't want to be in the position where I've made a decision
0:42:41 > 0:42:45and then a few years later, it's like, it was something
0:42:45 > 0:42:50that he may not have wanted to do. Or at least that his mind-set,
0:42:50 > 0:42:54when he's 18, 20 or whatever, you know, "I didn't want this."
0:42:55 > 0:42:57And I don't want to have to carry
0:42:57 > 0:43:00that burden that I made that choice for him and then he changed it.
0:43:05 > 0:43:06Whoa, and it just floats?
0:43:07 > 0:43:11'Back at Mum's house, I was hanging out with Cole-slash-Crystal.'
0:43:13 > 0:43:14Oh, my God.
0:43:14 > 0:43:17We didn't really talk about what I should call you, either.
0:43:17 > 0:43:18Crystal.
0:43:18 > 0:43:20- Crystal.- Mm-hmm.
0:43:20 > 0:43:21So, is this your area?
0:43:21 > 0:43:23- Yes.- Talk me through what you have in here.
0:43:23 > 0:43:28OK, so, this is practically my light and it has, like, little things,
0:43:28 > 0:43:29thingamajiggers in here.
0:43:29 > 0:43:32This is my perfume. I don't know where the top went.
0:43:32 > 0:43:34This is one of my favourite movies.
0:43:34 > 0:43:35- Spirited Away.- Yeah.
0:43:35 > 0:43:37Oh, yeah, that's a Japanese animation.
0:43:37 > 0:43:42Yeah, it's by Miyazaki and then... I'm really into Japan too and
0:43:42 > 0:43:46so this is my kimono and it's really pretty.
0:43:46 > 0:43:50- And it's really silky too, so... - Does that feel nice?
0:43:50 > 0:43:54It feels very nice and sometimes I sleep in it. And then this is
0:43:54 > 0:43:58my very, very special dress, and it's really good
0:43:58 > 0:43:59and I really like it.
0:44:01 > 0:44:03When do you wear that one?
0:44:03 > 0:44:06Well, I just got it, so I haven't had the chance to wear it yet.
0:44:06 > 0:44:09And how do you see yourself in that way?
0:44:09 > 0:44:10I don't know.
0:44:10 > 0:44:14I mean, cos most people would say I'm either a boy or a girl,
0:44:14 > 0:44:16some say they're somewhere in between.
0:44:16 > 0:44:18I'm somewhere in between.
0:44:18 > 0:44:21Do you feel pretty happy? Are you happy?
0:44:21 > 0:44:22Do you think you feel like you're happy?
0:44:22 > 0:44:24Yeah, I'm happy, I have a fine life.
0:44:27 > 0:44:29And as far as... Because, you know, we met your mum.
0:44:29 > 0:44:33- It's Joy, isn't it?- Uh-huh. - And then your dad is Erik.- Uh-huh.
0:44:33 > 0:44:36And I get... From meeting both of them, I get the impression
0:44:36 > 0:44:40that you do more of the girl type things when you're with your mum
0:44:40 > 0:44:44and you do less of them when you're with your dad.
0:44:44 > 0:44:48I would do, like, things that, like, are, erm,
0:44:48 > 0:44:53something that a boy could do and a girl could do too.
0:44:53 > 0:44:55Do you have any sense of whether when you're grown up
0:44:55 > 0:44:59you'd like to be Crystal full time?
0:44:59 > 0:45:03Actually, when I grow up, I'm thinking of being Cole.
0:45:03 > 0:45:07So not like Crystal, like this. This is, like, practically till
0:45:07 > 0:45:13I'm, like, out... When I'm practically out of high school.
0:45:13 > 0:45:16When you think of yourself as a grown-up,
0:45:16 > 0:45:19do you think of yourself as more of a man or more of a woman?
0:45:19 > 0:45:21- A man.- You do?
0:45:21 > 0:45:24Uh-huh, and that's... I think about life like...
0:45:24 > 0:45:27Oh, well, I don't know why,
0:45:27 > 0:45:30but I think of having a wife and two children
0:45:30 > 0:45:34and like this... Like, you know how in Japan there are
0:45:34 > 0:45:39these really weird houses, like with the pointy-end roofs?
0:45:39 > 0:45:42I want a house like that because I'm really into Japan now.
0:45:42 > 0:45:45I love their clothing and their style and everything and I love...
0:45:45 > 0:45:46Silk?
0:45:46 > 0:45:49Yes. Well, silk actually came from China.
0:45:49 > 0:45:50Good point.
0:45:53 > 0:45:57So, how have you been doing vis-a-vis Cole-slash-Crystal?
0:45:57 > 0:46:02Feeling like we don't need to make any decisions right now
0:46:02 > 0:46:07and that, erm, we're not - at this time, anyway -
0:46:07 > 0:46:12going to really pursue any kind of hormone,
0:46:12 > 0:46:14hormone blockers
0:46:14 > 0:46:17or anything like that.
0:46:17 > 0:46:20Do you think it's possible you were wrong before about
0:46:20 > 0:46:21what your child wanted?
0:46:23 > 0:46:25I don't think...
0:46:25 > 0:46:28I don't...I don't think I was wrong about what she wanted.
0:46:28 > 0:46:35I think what's changing is being able to be who she is as Cole
0:46:35 > 0:46:37and being accepted that way.
0:46:37 > 0:46:43She's Cole and when she's Cole - a boy at school, right? -
0:46:43 > 0:46:46she can still have her mannerisms
0:46:46 > 0:46:52and her likes and her dislikes and all of these things,
0:46:52 > 0:46:58and she has friends who love that in her and, erm,
0:46:58 > 0:47:05she's happy and doesn't have to take on the role of a female
0:47:05 > 0:47:06to be who she is.
0:47:06 > 0:47:10In her bedroom just now, she, erm...
0:47:10 > 0:47:17she or he was saying that he intends to be a man when he grows up.
0:47:17 > 0:47:21I think that he, being Cole, isn't all that miserable
0:47:21 > 0:47:25and quite honestly, that's the easy road and I hate to say that,
0:47:25 > 0:47:26but that's the easier road.
0:47:26 > 0:47:30So if she can be happy in that skin as a boy...
0:47:32 > 0:47:33..erm...
0:47:34 > 0:47:40..that's the preferred route for, you know, safety.
0:47:40 > 0:47:45And socially, unfortunately, it's still that way, so I support that.
0:47:49 > 0:47:51Having spent time with both Cole
0:47:51 > 0:47:56and Crystal, I was still unsure as to which was the truer identity...
0:47:58 > 0:48:01..whether she'd had her true nature repressed
0:48:01 > 0:48:04or had never been trans in the first place.
0:48:09 > 0:48:11At the Benioff Children's Hospital,
0:48:11 > 0:48:14Nikki and her family were back for her check-up.
0:48:14 > 0:48:16For me, it was a last chance to see Nikki
0:48:16 > 0:48:19and get a sense of how she was faring in her transition.
0:48:19 > 0:48:21- Hi, Gerry, hi, Isabel.- Hi.
0:48:21 > 0:48:23How you doing, Nikki? Nice to see you.
0:48:23 > 0:48:27I have some questions because I just want to pick up
0:48:27 > 0:48:29- the first time we ever met...- Yeah.
0:48:29 > 0:48:34..until today, cos I want to just find out that space in between.
0:48:34 > 0:48:37I don't know, I've been feeling more excited about all these,
0:48:37 > 0:48:42like, medication and everything. I'm more happier, definitely,
0:48:42 > 0:48:47than I used to be. I can be, like, different, like, emotions.
0:48:47 > 0:48:50Do you two see the same thing?
0:48:50 > 0:48:54She does get emotional. You know, sometimes we have very
0:48:54 > 0:49:00good days and some days she gets sad because she finds it a little hard.
0:49:01 > 0:49:03In what way, would you say?
0:49:03 > 0:49:06The fact that she has to take her medicines, she has to come here,
0:49:06 > 0:49:12you know, and do the doctor thing every three months.
0:49:12 > 0:49:18So I think that kind of makes her feel...
0:49:18 > 0:49:20sad, you know,
0:49:20 > 0:49:24in knowing that this is going to be pretty much the rest of her life.
0:49:24 > 0:49:28So the notion you have to kind of medicate to be who you are,
0:49:28 > 0:49:29- like that?- Yeah.- Yeah.
0:49:29 > 0:49:33Is there anything else, do you think, that we should touch on
0:49:33 > 0:49:37in terms of things that could make your life better right now?
0:49:37 > 0:49:44Erm, maybe, like, having God with me because I don't feel that
0:49:44 > 0:49:47he is always with me and I've been, like, losing hope.
0:49:47 > 0:49:51And, like, I'm losing faith because, erm...
0:49:52 > 0:49:56I don't...I don't see it like how my parents do
0:49:56 > 0:50:02or anything because I just feel that he, erm, he's never there.
0:50:02 > 0:50:07She feels that she's a mistake and I tell her, you know,
0:50:07 > 0:50:10"God doesn't make the mistakes - you were born to be who you are..."
0:50:10 > 0:50:12Uh-huh.
0:50:12 > 0:50:17..you know, and, "We love you." And I know she also worries
0:50:17 > 0:50:22about finding someone and being married and being a mum.
0:50:22 > 0:50:24Those are...those are worries that she has as well.
0:50:24 > 0:50:26- Uh-huh.- And, erm...
0:50:28 > 0:50:31You know, all I tell her is
0:50:31 > 0:50:34it is going to get better, it is going to be OK.
0:50:35 > 0:50:39But I think right now she just doesn't believe it.
0:50:39 > 0:50:42Right, Nikki?
0:50:42 > 0:50:46Well, no, not really. I don't see any, like...
0:50:46 > 0:50:49- I don't, like, see my future yet, I guess.- Yeah.
0:50:49 > 0:50:51It almost sounds like you're 14, you know?
0:50:51 > 0:50:54Just what life is going to be like in high school
0:50:54 > 0:50:56and what life is going to be like in college and having...
0:50:56 > 0:51:01If you're going to find that right person and I'm hearing a...you know,
0:51:01 > 0:51:04some things that I hear from a lot of 14-year-olds too.
0:51:04 > 0:51:07- Did I get that right, or...? - Yeah.
0:51:07 > 0:51:09- Yeah. - I think, yeah, that's right.
0:51:12 > 0:51:15That felt, erm...
0:51:15 > 0:51:16quite emotional, didn't it?
0:51:16 > 0:51:20I think Nikki's, erm, struggling a little bit.
0:51:20 > 0:51:25The kids that I work with who know before they go into puberty that
0:51:25 > 0:51:28they're transgender, and that many of them have already
0:51:28 > 0:51:31socially transitioned and they're looking like
0:51:31 > 0:51:33they're having a good time, they're happy,
0:51:33 > 0:51:37they hit this age - 12, 13, 14 -
0:51:37 > 0:51:39when everybody's bodies are changing
0:51:39 > 0:51:42and when you do start to think about your future a little bit,
0:51:42 > 0:51:46and they don't tank, but they slow down, and I just saw it in Nikki.
0:51:46 > 0:51:48What is it, do you think?
0:51:48 > 0:51:52When you get to this age, you start being able to think abstractly,
0:51:52 > 0:51:55you can think in larger constructs,
0:51:55 > 0:51:57you have a different sense therefore of yourself.
0:51:57 > 0:52:01You have to deal with reality and you understand what reality means
0:52:01 > 0:52:04so in this case, we have a girl who doesn't have a uterus
0:52:04 > 0:52:06who wants to be a mummy.
0:52:06 > 0:52:10We have a girl who will grow breasts but she hasn't gotten them
0:52:10 > 0:52:14yet and she has to do them by coming here to a clinic,
0:52:14 > 0:52:16and the reality of that has set in.
0:52:16 > 0:52:18And you start thinking about your romantic self -
0:52:18 > 0:52:19"Who's going to want me?"
0:52:19 > 0:52:21You know, in this case -
0:52:21 > 0:52:24"I'm a girl with a penis. How am I going to do that?"
0:52:24 > 0:52:28So all of that, I saw right there in Nikki's
0:52:28 > 0:52:30kind of almost tearfulness.
0:52:30 > 0:52:34I'm not surprised. I was a little sad myself to see
0:52:34 > 0:52:39Nikki in that slope down, and I do think that what Meredith said
0:52:39 > 0:52:42was right, it will get better, and I think she knows that as well.
0:52:51 > 0:52:55Nikki, do you feel any better after that upstairs?
0:52:55 > 0:52:57- I do, yeah.- You do?- Yeah.
0:52:57 > 0:52:59Good. And what about you, Isabel?
0:52:59 > 0:53:01How did that go for you?
0:53:01 > 0:53:02You seemed quite concerned in there.
0:53:02 > 0:53:07I just, you know... because I see her when she's up
0:53:07 > 0:53:10and I see her when she's down and I just want to make sure
0:53:10 > 0:53:14we're doing the right thing and, you know, being there for her and...
0:53:14 > 0:53:18When I was up there, I was thinking about how, when I was 14 and
0:53:18 > 0:53:22turning 15, that was probably the hardest year of my life.
0:53:22 > 0:53:23Yeah.
0:53:23 > 0:53:24It really was.
0:53:24 > 0:53:26It's hard, yeah.
0:53:26 > 0:53:28Cos you're thinking about, how do I fit in?
0:53:28 > 0:53:31Yeah, yeah.
0:53:32 > 0:53:34And you're not a child but you're not a grown-up
0:53:34 > 0:53:37and it's a very confusing...
0:53:37 > 0:53:40- it's a very confusing and lonely time sometimes.- Yeah.
0:53:40 > 0:53:42- Is that how you feel?- Yes, exactly.
0:53:44 > 0:53:47Do you feel you're on the right path?
0:53:47 > 0:53:48Yeah.
0:53:48 > 0:53:52Yeah, I guess mostly, yeah, I do.
0:53:56 > 0:53:59I said goodbye to Nikki with a feeling of trepidation
0:53:59 > 0:54:02for the difficult journey she was embarked upon
0:54:02 > 0:54:06but also confident that with her family's love and support,
0:54:06 > 0:54:09she'd have the best chance of making her transition
0:54:09 > 0:54:11as painless as possible.
0:54:16 > 0:54:17I had one last appointment.
0:54:18 > 0:54:21When I'd first met Casey, Eduardo and Camille,
0:54:21 > 0:54:25they'd just started their journey towards transition.
0:54:25 > 0:54:29Four months on, I wondered how it was going.
0:54:29 > 0:54:31Will you come and pour me some tea?
0:54:36 > 0:54:38Oh, wow, lovely.
0:54:41 > 0:54:42That tastes delicious.
0:54:46 > 0:54:49Do you remember why we're making this TV programme about you?
0:54:51 > 0:54:53Transgender.
0:54:53 > 0:54:56I get everything.
0:54:56 > 0:54:59Are you one of those transgender people, do you think?
0:55:02 > 0:55:04Uh-huh, yes.
0:55:04 > 0:55:07How do you know?
0:55:07 > 0:55:09Because I'm turning into a girl.
0:55:11 > 0:55:15Do you think you were always trans...transgender?
0:55:15 > 0:55:16Yes.
0:55:16 > 0:55:17How did you realise it?
0:55:20 > 0:55:22Because of myself.
0:55:25 > 0:55:28Because being myself turning into a girl.
0:55:28 > 0:55:30And do you think someone who turns into a girl
0:55:30 > 0:55:32can turn back into a boy?
0:55:32 > 0:55:34No.
0:55:34 > 0:55:37I would never do that.
0:55:37 > 0:55:39You're going to stay girl, is that what you're saying?
0:55:39 > 0:55:41Yes.
0:55:43 > 0:55:47Is that because it's more fun being a girl?
0:55:47 > 0:55:49Yes.
0:55:49 > 0:55:52And you also feel that that's who you really are, is that right?
0:55:52 > 0:55:53Yes.
0:55:53 > 0:55:56And do you think you were always a girl
0:55:56 > 0:55:58or that you are turning into a girl?
0:55:58 > 0:56:01Always a girl. I will always be a girl for ever.
0:56:05 > 0:56:06(My hair!)
0:56:07 > 0:56:09How confident are you that, erm,
0:56:09 > 0:56:15this is how it will be from now on, you know, for the rest of her life?
0:56:15 > 0:56:18Every single day, it reinforces it for me.
0:56:18 > 0:56:23I'm...I would say I'm 99% sure this is where we're at.
0:56:23 > 0:56:24I'm 100.
0:56:25 > 0:56:28I mean, I don't care either way if something does change
0:56:28 > 0:56:32- in a few years.- You'd be OK with that?- Totally OK.- Uh-huh.
0:56:32 > 0:56:34I think the biggest thing is, she's taught me
0:56:34 > 0:56:37personally how to be more authentically myself.
0:56:37 > 0:56:40It's something that I never... I mean, I've always thought,
0:56:40 > 0:56:43you know, just be yourself, but that's different when you have
0:56:43 > 0:56:47a child that's telling you, "Well, I was born a certain way,
0:56:47 > 0:56:52"but this is really who I am," and you kind of re-evaluate yourself too.
0:56:52 > 0:56:56So if that means in five years she's Sebastian,
0:56:56 > 0:56:59well, what do I care?
0:56:59 > 0:57:02So you wouldn't mind, it wouldn't be an issue for you were it ever
0:57:02 > 0:57:06to come to that, that she wanted to be Sebastian again?
0:57:06 > 0:57:07- No.- Nope.
0:57:11 > 0:57:15To me, it's the same as if she's Camille.
0:57:15 > 0:57:17It's the same thing.
0:57:17 > 0:57:21Why would it matter going the other way, if that was the case?
0:57:21 > 0:57:22- So...- Mm-hmm.
0:57:22 > 0:57:27I think we've been through a lot and we can pretty much handle...
0:57:27 > 0:57:31- handle most changes at this point. - Mm-hmm.
0:57:34 > 0:57:38There's a sale going on, Camille. Lucky you.
0:57:40 > 0:57:43- Look at that. - Is that too cute or what?
0:57:43 > 0:57:44Yes, that's too cute!
0:57:45 > 0:57:48In our time together, I'd been moved by Casey
0:57:48 > 0:57:53and Eduardo's readiness to support their child's choices but also
0:57:53 > 0:57:57aware of the heavy responsibility of the decision they were making.
0:57:57 > 0:57:58These are too cute.
0:58:00 > 0:58:03The choice to transition involves the possibility of social
0:58:03 > 0:58:09rejection and a lifetime commitment to medication,
0:58:09 > 0:58:13but it is also a chance to exercise the most fundamental right
0:58:13 > 0:58:15we have - the right to be ourselves.
0:58:17 > 0:58:21In the end, the hardest part of the challenge may be knowing
0:58:21 > 0:58:23who it is we really are.
0:58:25 > 0:58:27- This one's your favourite?- Yes.
0:58:27 > 0:58:28Why's that?
0:58:29 > 0:58:32Pink and purple.
0:58:32 > 0:58:33It does look great on you.