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Live updates, parents speak out about the ‘rush’ to reassign the gender of their kids.

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Single mom Bri was visiting the pediatrician’s office with her 15-year-old, a child struggling with anxiety, when the doctor said: “If you don’t affirm your daughter’s gender identity, or get her the help she needs, and she kills herself, you’re going to feel awfully guilty.”

Bri, who asked The Post to publish only her nickname for fear of being branded a bigot and doxxed by transgender-rights activists, was horrified — not only by the insinuation her teen would commit suicide if she didn’t transition, but also the fact that the general practitioner issued the warning in front of them both.

Activists are increasingly pushing for laws that allow children to make their own decisions to transition without parental approval, insisting that going through puberty is traumatic for those who feel misgendered. 

But some experts now question the threat that they say is commonly used by medical professionals. They believe many doctors are so scared of the label “transphobe” that they automatically present skeptical parents with a doomsday scenario: “Would you rather have a dead son or a living daughter?” or vice versa.

Critics of the blunt proposition include pediatric endocrinologist Dr. Paul Hruz, of the Washington University School of Medicine in St Louis. He told The Post: “In these circumstances, I would advise parents to ask, ‘On what evidence are you making this claim?'”

His concerns focus on the widely accepted belief that sex-reassignment treatment prevents emotionally damaged kids from ending their lives. He questions the theory, pointing out that its supporting studies are variously limited or skewed. According to the physician, fundamental problems with the research include large numbers of self-selected subjects, a lack of control groups and inadequate reviews by peers.

By contrast, a 2011 study spanning three decades by the respected Karolinska Institute in Sweden found that people who underwent sex reassignment were 19 times more likely to die by suicide than the general population . In the US, a yearlong survey by the National Center for Transgender Equality concluded that those who had transitioned were more likely to have attempted suicide than trans people who had not had medical or surgical treatments.

Hruz’s views are also backed by a study published in 2019 in the American Journal of Psychiatry, which concludes that when it comes to the mental health of those diagnosed with gender dysphoria, there is “no advantage of [reassignment] surgery.”

His take on the issue is explored in the newly released film “Trans Mission: What’s the Rush To Reassign Gender? ” Produced by the Center for Bioethics and Culture Network , the documentary is streaming on YouTube and Vimeo, and arrived a month after a similar investigation by “60 Minutes. “

Lesley Stahl’s exposé highlighted the surge in unregulated, money-spinning transgender clinics serving kids and young adults in the US. The Human Rights Campaign currently lists more than 40 “clinical care programs for transgender and gender-expansive youth” on its Web site.

Only one such institution existed in America in 2007.

In the “60 Minutes” segment, chronically depressed young woman Grace Lidinsky-Smith describes how, in her early 20s, she believed transitioning would make her feel “free.” She tells Stahl that a gender therapist she found on the Internet “didn’t go into what my gender dysphoria might have been stemming from.”

She was hastily prescribed testosterone and, just four months later, was approved for so-called top surgery, trans speak for a double mastectomy. But, instead of experiencing relief after the drastic operation, she felt traumatized. “I started to have a disturbing sense that a part of my life was missing — almost a ghost-limb feeling,” Lidinsky-Smith, now 27, reveals on camera. She de-transitioned by coming off testosterone, and says she complained to the unnamed clinic about its agenda-driven methods.

Meanwhile, according to 39-year-old Bri, her daughter, who aims to become a boy, has comorbid psychological issues because of a traumatic childhood, partly caused by the difficult divorce of her parents. The Baltimore-based mom remains convinced her child has been duped by peer pressure, social media — which seems to champion transgenderism among young people without question — and the “grass is greener” trope that men have an “easier” lot in life.

“It has to be a safe and careful process for both parents and kids to move forward wherever their gender exploration goes. It doesn’t work that a child says, ‘I’m trans, give me hormones,’ and then gets a shot.” Dr. Michelle Forcier, a professor of pediatrics who supports early “gender care” that “helps kids express their authentic identity”

“There was no indication between her birth and the age of 13 that she felt she was in the wrong body,” said Bri, who sadly believes the catalyst was her girl being lusted after and shamed by boys. “As they started taking an interest in her — she told me how a classmate had repeatedly touched her inappropriately — she began to bind her breasts and became introverted and round-shouldered, as if she was trying to disguise the fact she was a woman.”

Following several rounds of counseling — which, Bri claims, only accelerated her desire to transition — she contemplated top surgery at only 14. This operation is frequently followed by bottom surgery, a k a an elective hysterectomy.

Bri said, “I felt the need to safeguard my daughter before she allowed her body to be harmed.” By then, without the mom’s knowledge or consent, teachers at the eighth-grader’s school were exclusively calling their student by her boy name.

“I felt completely marginalized — like the odd one out,” said Bri, whose state does not require parental permission for anyone 16 and older to either take cross-sex hormones or fully transition.

Hruz has become increasingly worried about the way kids are allowed to make these life-changing decisions on their own. In the state of Washington, for example, a child as young as 13 can defy the wishes of their parents by transitioning via medical treatments. Moreover, that same seventh-grader is legally entitled to use their family’s health insurance to cover gender-affirming procedures such as tracheal shaves, or Adam’s apple reductions.

“There’s well-established literature on the inherent tendency of adolescents to be impulsive and not fully able to appreciate long-term consequences,” Hruz said. “It’s the whole basis for society limiting their autonomy on things like drinking alcohol, purchasing cigarettes and even voting until a certain age.

“The concept that gender reassignment is an exception needs to be challenged.”

Concerned about enduring health effects of medical and surgical interventions such as puberty blockers, sustained hormone therapy and the removal of intimate body parts, he added: “These issues are so under researched. We don’t have the long-term data on the relative risks and benefits of this approach.”

Californian Abigail Shrier, who wrote the 2020 book “Irreversible Damage: The Transgender Craze Seducing Our Daughters,” is horrified by the way children — particularly girls — have easier access to hormones and surgeries.

“Most of these girls seeking interventions don’t have typical gender dysphoria at all, and there is no evidence they will be helped by any of the treatments they are getting with almost no medical oversight,” Shrier told The Post. “It’s a crisis in the making.”

She’s argued that “peer contagion” may play a part, an idea that’s supported by a 2019 study from Brown University that found that parents of children experiencing gender dysphoria observed their teens feeling pressure to fit in with their friend group.

Brenton Netz, 49, of Marquette, Mich., feels his parental concerns over the medical treatment of his child, Miles Gewirtz, have been ignored. Appearing in “Trans Mission,” he expresses his opposition to his 11-year-old, who has autism, taking puberty blockers. He fears the boy will be considered for gender-reassignment surgery when he reaches his mid to late teens.

“Miles is very impressionable,” Netz told The Post. Netz has joint custody with Miles’ mother, Sarah Gewirtz, and feels the tween has been unduly influenced by “overzealous” clinicians who diagnosed him with gender dysphoria at age 8.

“My son has said he’s going to drink a magic potion to keep him young forever,” he said. “It demonstrates his limited capacity to understand his feelings about something as important as gender.”

Netz, who launched an online campaign called Save Miles to generate publicity for his cause, recently won a significant victory in a lengthy legal battle. The judge’s ruling prevents Miles’ mother from pursuing medical interventions at a gender and sexuality clinic in St. Cloud, Minn.

“Miles’ autism makes him particularly vulnerable,” said Netz, explaining that the disorder has already made his son feel lonely and isolated, leaving him with an overwhelming “need to please and fit in.”

Not everyone is so distrusting. Dr. Michelle Forcier, professor of pediatrics at Brown’s Warren Alpert Medical School, who is featured in “Trans Mission” as a supporter of early “gender care,” describes the practice of gender intervention at a young age as “beautiful and inclusive,” since it “helps kids express their authentic identity.”

She says in the film, “We’re telling parents to love your child, no matter their gender trajectory, because every kid is better if they are loved for who they are and feels safe, respected and valued at home.”

Forcier insists that the process is not rushed; consideration and balance are employed before puberty blockers and other hormone treatments are administered to children.

“It has to be a safe and careful process for both parents and kids to move forward wherever their gender exploration goes,” adds the doctor. “It doesn’t work that a child says, ‘I’m trans, give me hormones,’ and then gets a shot of testosterone.”

However, she stressed that the practice of “watchful waiting” — where parents and clinicians resolve to delay intervention until the child gets older — can be harmful, since they may miss the “window” when treatments are most effective.

Addressing the prevalence of autistic children such as Miles who are diagnosed with gender dysphoria — the Tavistock Centre , the only gender identity clinic in the UK for under-18s, has reported some 35 percent of its referrals are kids on the spectrum — Forcier offers a controversial explanation.

“They are neuro diverse, and might also be gender diverse,” she says. “With their wiring and their hormones, they are not necessarily going to fit in this square hole. They’re going to need a different fit.”

She adds: “If you are not super attentive to social cues — and you’re not, ‘Oh, God, what will people think of me?’ — you may be more willing to think, ‘My gender isn’t this clear cut.’ ”

As for Bri, the staunch feminist hopes to persuade her daughter to first tackle her mental-health issues before making an informed choice about a possible transition. As she says in the documentary: “It’s because I love her so much [that] I’m willing to take on this whole ideology just to protect her.”

Nonetheless, she told The Post she would never turn her back on her child, whichever road she eventually chooses.

The mom concluded: “I’ve said that — even though I don’t agree with it — if you feel lousy after hormonal treatments or surgical interventions, I will still make chicken soup for you.”

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‘Born to Be’ Review: Intimate Portrait of Transgender Surgery Pioneer Gets It Right

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“Not every patient wants to have a surgical transition. Transition can take many forms,” says Dr. Jess Ting in an early interview in “ Born to Be ,” a poignant and finely tuned documentary about his work as head surgeon at Mt. Sinai’s Center for Transgender Medicine and Surgery. Ting’s thoughtful, measured, and sensitive approach to the transgender population are just part of what make him such a satisfying documentary subject. (His sense of humor and background as a Juilliard-trained classical musician does the rest.) Dr. Ting brings a level of care and humanity to his work that is, unfortunately, not always the norm for the community he serves. Taking a page out of his book, filmmaker Tania Cypriano treats her tireless subject with utmost sensitivity, which is apparent throughout the 92 minutes of her intimate and highly compelling film.

“Born to Be” follows Dr. Ting as he makes his daily rounds, consulting patients on everything from top surgery and facial feminization to vaginoplasty and phalloplasty. While trans audiences may — and rightly so — be wary of a film that zeroes in so definitively on transitional surgery, it is precisely that laser focus that helps “Born to Be” avoid the many pitfalls for which trans films have been criticized. (Many trans films have irked the trans community by dwelling on the particulars of medical transition, continuing the long and painful history of the fascination with and objectification of the trans body.)

“You don’t have to have surgery,” continues Dr. Ting, allaying any fears that “Born to Be” sees medical transition as the end-all and be-all of trans identity. “I see a subset of the transgender population. Only those patients who desire transitional surgery.”

For those who do wish to medically transition, Dr. Ting has his work cut out for him. Despite the rise in trans visibility, there are still too few doctors trained in surgical transition. There is currently a two-year waiting list just for a consultation with him.

“Essentially they just asked everyone and everyone else said ‘no,’ except for me,” Dr. Ting, who is cisgender, says of how he got into the field. “Everyone thought I was nuts. But whatever.” Learning the disproportionately high suicide rates in the transgender population changed his understanding of what his patients go through, and quickly became his raison dêtre .

Though Dr. Ting is the film’s central figure, “Born to Be” uses an eclectic range of patients to highlight the significance of the care he provides. There’s Devin (who now goes by Garnet), a 21-year-old woman who could have a career as a model; Cashmere, an old timer who was friends with transgender pioneer Marsha P. Johnson; and Jordan, the good-humored recipient of Dr. Ting’s very first phalloplasty — the most complicated of the transitional surgeries. Together, they represent a balanced spectrum of the trans community, infusing the clinical setting with wit, warmth, and humanity to spare.

Cashmere’s presence in particular carries a lot of weight — as a black trans woman of a certain age, she is a vital reminder that the relative acceptance trans people enjoy today was hard-won. “Believe me, there’s not too many older queens like me around to talk,” she says, gingerly thumbing a photo of her late friend Marsha. “They’re all dead.”

One entertaining scene shows Cashmere revisiting her old haunts in New York’s meatpacking district. “This is my favorite corner,” she says of 14th Street and 9th Avenue, leaning against the glass doors of the Apple Store that now resides there. “This is where we used to stand. Thats how I got the Johns.”

Devin’s story adds another disheartening but crucial perspective to the film — the reality that medical transition isn’t always a magical cure to years of body and gender dysphoria. When she attempts suicide after recovering from multiple surgeries, Dr. Ting is clearly shaken; perhaps his life-saving justification for all the long hours and shunning from colleagues is not as solid a foundation as he thought. When another patient tells him he never thought he’d make it to 30, and Dr. Ting is the reason he is alive, the relief radiates from his kind eyes.

Cypriano expertly arranges these key scenes to land the biggest emotional impact. Exactly one hour into the film, the shit hits the fan, and we see the toll that running a groundbreaking medical practice can take. The camera follows Dr. Ting on a ceaseless churn of making the rounds as he knocks on doors, gets lost in hallways, and pounds gummy bears for energy. Insurance companies are denying claims, the waiting list keeps growing, and a frustrated patient posts a viral rant online. These patients don’t see the kind-hearted single father who left Juilliard for medical school and risked it all on this work — they’re just trying to survive.

“Born to Be” follows on the heels of the recent swell of quality trans documentaries that includes “Man Made,” “Changing the Game,” “Transmilitary,” and “Growing Up Coy.” Like television, non-fiction film is quickly surpassing narrative film at crafting a robust trans cinema. With its cinematic eye, compelling subjects, and elegant awareness of the issues, “Born to Be” was conceived just in time.

“Born to Be” world premiered at the 2019 New York Film Festival. It is currently seeking distribution.

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• GENDER REVOLUTION

In the Operating Room During Gender Reassignment Surgery

Behind the scenes with identical twin Emmie Smith during her medical transition.

Before August 30, 2016, getting stitches at age seven was the most time Emmie Smith had ever spent in a hospital.

That morning, she swapped her plaid shirt and jean shorts for a gown, tucked her hair into a cap, and prepared for surgery to conform her anatomy to the gender she already identified with: woman. In the operating room with her was National Geographic photographer Lynn Johnson. She and Emmie hoped they could demystify the procedure by documenting it, close-up and unflinching. “It was stressful and scary at times, but it almost created a mission other than just recovery,” Emmie says. “We were making something together.”

It had been a year and a half since Emmie had first come out as a transgender woman on Facebook. Telling her family and friends had been an enormous relief. “I’m not sure I could have taken another few years of being closeted,” she says.

Still, it was a challenging time for her family. Her mother, Reverend Kate Malin, is a prominent figure in their Massachusetts town, and her identical twin sons Caleb and Walker were familiar fixtures at her Episcopal church. A month after Walker came out as Emmie, Malin stepped out from behind her pulpit and walked into the aisle. Halfway through her sermon she decided it was time to address the change in her family.

“As most of you know, Bruce and I have three children,” she began. “Caleb and Walker, who are 17, and 13-year-old Owen. Walker’s new name is Emerson, and she prefers Emmie or Em. She’s wearing feminine clothing and makeup and will likely continue to move in the direction of a more feminized body.”

Follow Emmie's transition in pictures

Kate nervously revealed her struggle to the attentive New England crowd. “I feel broken much of the time,” she confessed. “I’ve wanted to run away, and I’ve prayed for this child that I would gladly die for, guilty for how much I miss the person I thought was Walker and everything I thought might be.”

After the sermon, the congregation engulfed her in a hug. Then they moved to offer words of support to the sandy-haired 17-year-old sitting in the pews. In the first of many awkward mistakes the family would later laugh about, it was Caleb—Emmie’s identical twin.

After that sermon, a “new normal” set in. On a Saturday night soon after, they had their first “out” outing. Kate took Emmie—whose hair was still short and chest was flat—to buy a prom dress at David’s Bridal. She feared someone would point or laugh, but the crowds of brides and bridesmaids in the dressing room offered only compliments.

Though she hadn’t initially considered surgery, after a couple of months Emmie had grown frustrated by the tucking and taping required to fit into women’s clothes. That fall, her senior year of high school, she decided to do it.

But waking up after the operation, Emmie felt none of the immediate relief she’d expected. In the recovery room her earbuds played a soothing loop of Bon Iver and Simon and Garfunkel, but it didn’t drown out her disappointment and fear. In retrospect, she thought, hadn’t life before been OK?

It wasn’t until months later, when she was home and could walk and sit again, that Emmie knew she’d made the right choice. “If you’re not living freely that’s time wasted, and I felt my time was wasted pretending to be a boy,” she says. “It was the best decision in my life.”

Now, halfway through a gap year, she’s applying to college theater programs. It’s strange, she says, knowing that her future classmates may watch Johnson’s film and learn the most intimate details of her life. She’s hopeful that her participation will evolve the public’s understanding of gender reassignment surgery. “It’s not science fiction or mythology,” Emmie says. “It’s what happens to women just trying to be at peace with themselves and their bodies.”

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• Entertainment
• Inside HBO’s <i>Transhood</i>, Which Follows Four Transgender Kids Over Five Crucial Years

Inside HBO’s Transhood , Which Follows Four Transgender Kids Over Five Crucial Years

H air is important to 18-year-old Jay, from Kansas City, Mo. Before the age of 12, he was severely bullied in school for having long hair and wearing clothing typically marketed to boys. “Cutting my hair was one of the biggest things that happened to me through the transition because it made me feel like I am me,” he says. “I am Jay.”

The new HBO documentary Transhood , out Nov. 12, follows four transgender children and their families over the course of five years. In the film, viewers see how Jay expresses his identity, particularly in two scenes with his barber, who is also a trans man. It’s these scenes that help to normalize, for viewers, the transition process for children and young people, emphasizing that it is a social process first, during which they may alter their hairstyle, clothing or pronoun preference before considering medical changes.

The four young people director Sharon Liese followed in her hometown between 2014 and 2019 show different facets of what it can mean to be trans or gender fluid. Viewers follow Leena, 15 when filming began, and her family as they navigate her later adolescence, the disappointments of her first relationship and her goal to have gender confirmation surgery when she turns 19. Liese also follows Avery, who was 7 when filming began, as she sits for a portrait for the cover of National Geographic’s 2017 “ Gender Revolution ” issue and faces the pressure that comes with media attention. And in the story of Phoenix, who was 4 when Liese started filming, we see how children’s relationships with their gender identity are not always clear-cut. Phoenix initially says they are a “girl-boy” and later identifies as a girl, before identifying as male at age 7, and Transhood follows Phoenix’s parents as they respond to their child’s evolving identity.

“It’s not unusual that kids know [that they are trans] when they are young,” says Liese. “People ask me, how do kids know when they are four years old? I quickly realized that is not the question. The question is, how do you not believe them?” This was true for Jay, who says he understands why people might have these questions, but who knew that he was trans when he was 5. “It’s not something you just decide. It’s something you discover about yourself,” he says.

“These stories really weren’t being told”

As a Kansas City native, Liese knows the midwestern city well and was able to deeply embed with the four families she followed. The location was also a backdrop for the shifting attitudes around and support networks for trans people. While the Midwest, broadly speaking, is a more politically and religiously conservative part of the U.S., Kansas City, like many urban areas, is more progressive, and is also home to the Transgender Institute , an organization that provides resources and support for transgender people and their families.

Through the Institute, Liese met Jay and his mother Bryce, as well as Avery and her mother Debi, who was raised as a Southern Baptist conservative and never expected to become an advocate for LGBTQ rights. “I just realized that these stories really weren’t being told and there wasn’t that kind of trans representation, over time, about kids,” says Liese. While depictions of transgender people onscreen appear to be evolving for the better , with more transgender people both in front of and behind the camera in critically acclaimed films and series including Orange Is the New Black , A Fantastic Woman and Pose , they largely focus on transgender adults.

Following the families over several years allowed Liese to see the young people as they grew up and experienced different triumphs and challenges. A pivotal moment in the film shows Jay and Bryce on the phone to Jay’s girlfriend Mildred, after photographs of Jay pre-transition circulate on social media. The storyline shows the difficult decisions trans people often make about disclosing their identities. “A lot of trans people do hide. That’s our natural thing to do, because we are so scared,” says Jay. “It is definitely hard to come out to someone that you care about. You wonder if they are going to run or stay.” Although Jay and Mildred, who was one of Jay’s first relationships, part ways after that scene in the film, Jay says Mildred contacted him after recently watching the film and told him how much she enjoyed it. “It was definitely the hardest thing I think, to come out to her during the film, and that was the first person I ever told,” he says.

Liese says that this scene with Jay was “such a pivotal and huge moment for the film, because it can represent what can happen, and what happens frequently” when trans people disclose their identities. “There’s no good guidelines other than ‘when you want to’ when it comes to disclosure. It’s not cut and dry,” she says.

“You can never go wrong by affirming your child”

As well as hoping that more trans and non-binary youth see themselves represented onscreen in Transhood , Liese also wants the film to show parents and others how to be allies and support people through transition. Jay agrees, leaning into the relationship he has with his mom, and hoping that the film can show parents of trans children that it’s important to check in with them and ensure that they are heard. Through Phoenix’s story, Liese shows that every journey is unique when it comes to gender. Although Phoenix’s parents eventually divorce and have different views on parenting Phoenix, Liese says that the message from that story “is that you really just need to love your kids, and let them lead, and that you can never go wrong by affirming your child.”

As is the case with children who identify as a different gender than the one they were assigned at birth, Phoenix had a social transition before puberty, changing aspects of his identity like pronouns and clothing. Some older children make the decision along with parents and doctors, like Jay did when he was 12, to take hormone blockers to delay puberty. These hormones effectively suspend puberty, and their effects are reversible if a person decides to stop taking them ; if a person goes through puberty, physical developments like breast and hair growth are more difficult to reverse. According to the U.S. Centers for Disease Control and Prevention , one in three transgender youth has experienced a suicide attempt. A study published earlier this year indicated that that if transgender youth have access to puberty blockers, their chances of suicide and mental health issues in both the immediate and long-term decline significantly. Toward the end of the documentary, Leena, who was 19 when filming ended, discusses future plans for gender confirmation surgery with her parents and gender affirmation surgeon Dr. Marci Bowers.

For the parents featured in Transhood , navigating their child’s transition as a family is often uncharted territory. “When we started with Avery and her transition, we didn’t feel like there was anywhere to turn to, we didn’t know who to talk to or where to go, and we felt desperately lost,” says Tom, Avery’s dad, during the film. A landmark study by Dr Kristina Olson in 2019 showed that gender-nonconforming kids who go on to transition already have a strong sense of their true identity—one that differs from their assigned gender. The findings of Olson’s study emphasize the importance of affirmative models of care recommended by both the American Academy of Pediatrics and the American Academy of Family Physicians, which are focused on understanding and appreciating a young person’s gender experience in a non-judgemental way. These organizations also stress the importance of supportive parenting and social environments, as Leena and Jay experienced, when making decisions about their healthcare from their families and medical professionals. Transgender Institute also runs support groups, therapy and mentoring for its young trans community in Kansas City.

A call to action at a critical moment

Ultimately, the film is as much a call to action to advocate for legislation protecting trans rights as it is a portrayal of the complexity of transgender lives. During President Donald Trump’s tenure, various levels of government have enacted major changes impacting the rights of transgender people and LGBTQ people more broadly, including a declaration that requires schools in Connecticut to ban transgender students from participating in school sports and the rollback of an Obama-era federal rule that protected transgender people from discrimination by homeless shelters and other housing services.

Looking back on the film now, a year since filming ended, Jay feels he has changed a lot. He now feels more outgoing, and more open to talking about the documentary. He sees the film as a broader coming out, where more of the people he went to community college and graduated with will learn that he is trans and understand more about his experience. “I’m excited, and now I have the mindset that if people don’t like it, that’s O.K.,” he says. He also sees it as vital to show different aspects of what it means to be trans, and dispel some of the intolerance and misperceptions about trans people. “I can’t make everyone like me and understand, but at least they can watch this film, and hopefully they can see that [being trans] is O.K. and they don’t need to judge me for it,” he says. “I hope that the documentary opens people’s eyes and opens people’s minds.”

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‘Always Jane’ Is Part of a New Generation of Trans Documentaries

For decades, films about transgender people tended to be sensationalistic. A newer crop is more celebratory — and opening doors for its young subjects.

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By Robert Ito

In the first part of the documentary series “Always Jane,” Jane Noury, a high school student in suburban New Jersey, hangs out with friends, contemplates college — maybe the School of Visual Arts? — and works at the local Panera. She dreams of being a director. Near the end of Part 1, Jane also learns that she will have to miss commencement; it falls on the same day as her gender confirmation surgery.

There’s talk of anti-transgender bullying, but not a lot. In that episode, she also shops for a prom dress and plans a trip to Los Angeles, where she is to compete in an international competition for transgender models — the first of its kind.

“I’m not saying it was all happy rainbows and everything,” Jane said in a recent video interview. But she believed the series’s director, Jonathan Hyde, “really wanted to tell a story where a family just shows their love and acceptance of their trans child.”

Premiering Friday on Amazon Prime Video, the four-part series is among a crop of recent TV documentaries that skew toward the celebratory over the sensational, featuring younger transgender subjects who, unlike their predecessors of decades past, have the terminology and understanding to describe what they’re going through, and are growing up at a time when more viewers have been exposed to transgender people and the issues they face.

The documentaries, which include films like “Transhood” (about four transgender children growing up in Kansas City) and “Little Girl” (a portrait of an 8-year-old transgender French girl), both from 2020, reflect a changing culture that allows for deeper and more nuanced explorations of their subjects — even as the films themselves contribute to those cultural changes.

“When you look at the history of trans documentaries, it started with this subculture perspective on trans people, like, ‘Look at this weird corner of the world nobody knows about,’” said TJ Billard, a communications professor at Northwestern and the founding executive director of the Center for Applied Transgender Studies, in Chicago. “Then it moved into highly medicalized documentaries about the ‘scientific wonders of gender conversion.’”

And now? More and more of them, like “Always Jane,” tell stories of determined and immensely likable transgender children or teens who face adversity — from bullying to bathroom wars — and beat the odds. Many of the documentaries, some filmed nearly a decade ago when their subjects were very young, have created opportunities for their subjects since.

“Hollywood is much more willing to take a risk on somebody with a public profile,” Billard said. “So I think this pivot is, in some ways, a way for trans people who do emerge into the public eye through this documentary form to capitalize on it.”

“Always Jane” got its start in early 2020, when Hyde was thinking about creating a short film centered on the transgender modeling contest in which Jane was set to compete. After meeting Jane and her mother in the run-up to the event, however, Hyde decided to put the focus squarely on the Nourys.

“I remember my mom was crying a lot, and then I started crying,” Jane said. “It was a very emotional first meeting.”

Over the course of the series, we see Jane finish a senior year upended by the pandemic and make friends with other contestants in Los Angeles. (“I didn’t have a lot of trans friends in Sparta,” she said of her hometown.) Otherwise, much of the series is filled with scenes of a loving family, including Jane’s father, David; her older sister, Emma, who is an intensely protective Coast Guard cadet; and her younger sister, Mae, who is struggling with the thought of having Jane leave home for college. Many scenes were filmed, diary-style, by Jane on a hand-held camera.

Documentaries about the transgender experience weren’t always this way. Early examples include “Queens at Heart” (1967), an exploitation film complete with creepy, leering interviewer, and “Let Me Die a Woman” (1978), which promised viewers “all true! all real!” scenes of sex reassignment surgery. In these early films, the subjects were, not surprisingly, often anonymous.

Today’s subjects are often anything but anonymous, and many have moved beyond the documentaries they appeared in to pursue opportunities as actors, writers and activists.

Jazz Jennings, who at 11 was the subject of the 2011 documentary “I Am Jazz,” went on to write a children’s book and a memoir and currently stars in a TLC reality series, also titled “I Am Jazz.” Avery Jackson, who began filming “Transhood” in 2014, when she was 7, became the first transgender person to appear on the cover of National Geographic in 2016 and wrote a children’s book, “It’s Okay to Sparkle,” the next year.

Since appearing in the 2016 HBO documentary “The Trans List,” Nicole Maines, now 24, has done a TEDx Talk, starred in a vampire film (“Bit”), and in 2018 debuted in the CW series “Supergirl,” which wrapped up its six-season run on Nov. 9. Maines played Nia Nal, also known as Dreamer, the first transgender superhero on TV.

“The first of anything is special,” she said, adding that she was “consumed by this character. I have a relationship with her that borders on the unhealthy.”

Zoey Luna, who appeared in the HBO documentaries “Raising Zoey” (2016) and “15: A Quinceañera Story” (2017), went on to land roles in “Pose” (2018-21), “The Craft: Legacy” (2020), and in September, the film version of “Dear Evan Hansen.” She said she viewed the documentary experience — being on set, working in front of cameras — as valuable job training.

“Being in the documentaries was definitely an avenue for me to accomplish that goal of becoming an actress,” she said. “I knew that they would create some visibility for me, and they definitely helped me feel like my dreams were achievable.”

“I do feel like there are more opportunities for transgender actresses now,” she added. “And I feel like the opportunities are going to be endless within a matter of years.”

The documentaries don’t sugarcoat the experiences of their subjects, even as the films celebrate their victories and families. In “The Trans List,” Maines recalls having staffers at her middle school assigned to keep her from using the girl’s bathroom. In “Raising Zoey,” Luna and her mother describe how Luna was bullied by classmates who would pull her hair and call her names.

In “Always Jane,” Jane recalls being outed at a school assembly by a student who thought that transitioning was a sin. Her sister Emma, who was also at the assembly, wasn’t having it — and said so. For the film, Jane went back to the auditorium to recount the story.

“I thought I was over what happened, but psychologically it was a lot for me to be back in that situation,” she said. “I’m just really grateful I had Emma there to be my advocate, and to just be there for me.”

Since graduating high school, Jane has expanded her horizons and community. She has appeared in fashion magazines and walked the runway at Rihanna’s Savage X Fenty fashion show, in Los Angeles.

Currently a student at the School of Visual Arts, in Manhattan, Jane is studying film and hopes to try some acting. (“I’d love to do a horror film,” she said, “maybe playing a psycho killer or something.”) She also hopes to do more modeling. Her mother, Laura, hopes she will, too.

“She’s a beautiful model,” Laura said. “And she struts her stuff down the runway. It’s amazing to watch the confidence that’s in her, because I look back and I remember the scared boy who wouldn’t come out of his room.”

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Journey from steven to susan captured in new documentary.

Editor's note: Follow Steven Stanton's transition to a woman on "Her Name was Steven" on CNN Saturday 8 p.m. and 11 p.m. ET

(CNN) -- Susan Stanton doesn't seem much different than any other woman: She struggles with her weight, she tries to balance her career with being a parent, and she worries about her teenage son who is just learning to drive.

But Stanton has been a woman for only about two years.

In 2007, Largo, Florida, City Manager Steven Stanton, announced he planned to become a woman.

Stanton -- who knew very little about the transgender community -- practically became the poster child for the transgender rights movement.

Today, her name is linked more closely with budget concerns in Lake Worth, Florida. That relative anonymity has allowed Stanton to finally achieve her goals: to live her life as a woman, resume her career as a city manager, and continue to raise her son.

Stanton's transition from man to woman is intimately chronicled in the CNN documentary, "Her Name was Steven," which airs this Saturday at 8 p.m. and 11 p.m. ET.

Stanton agreed to participate in the documentary to "put a human face on [something] people still have a profound misunderstanding of," she says.

Are you transgendered? Share your message

Stanton's 2007 announcement came as a shock to the city of Largo, Florida, who had known Steven Stanton as their city manager for 14 years.

The city manager was promptly terminated and Stanton's marriage ended. After transitioning to Susan, she became a pariah in the transgender community for her wavering position on whether all transgender people should be federally protected, as well as her decision not to sue the city of Largo for her termination.

But her relationship with her son, Travis, never wavered. Travis' acceptance of his father is a central part of the CNN documentary.

Read Travis' essay about his father

The most stinging criticism for Stanton is that the gender transition would harm Travis.

"They perceive [that] when you go through this process, you're going to become some sort of monster," she said. "This story clearly documents the love of a child to a dad because the dad never changed -- maybe the outside changes."

Stanton underwent gender reassignment surgery in 2008. Travis still calls Stanton "Dad," which Stanton says does not bother her, even when Travis says it in front of other people.

"I'm his dad, I'll always be his dad," she says. "I'm not his mom."

Starting over

It has been nearly a year since Stanton was hired as Lake Worth's city manager. She says her main concern today is getting Lake Worth through the difficult economic challenges that nearly every small U.S. city is facing.

She has the unique position of knowing what it's like to serve as a city manager as both a man and a woman.

"You don't realize how difficult it is to lead people as a woman because you don't get the deference as a woman," Stanton says.

"As a guy, when I'm talking, people would stop. But now, sometimes I find myself saying, 'Excuse me, stop interrupting me.' "

Looking back

Like many transgender people, Stanton struggled with serious depression and suicidal thoughts during her transition.

The loss of her job and her marriage were the two most difficult side effects of the process.

"I did not want to leave angry at my city, the person who wound up divorcing me and the people who wound up getting off my train," she said.

She credits her faith with helping her not internalize anger after losing so much during the transition process.

"So many people who go through this process, they don't do that," she said. "And they're justified in their emotion, but it becomes incapacitating."

Stanton speaks fondly of both the city of Largo and of her ex-wife, Donna.

"I am still wearing my wedding band. ... We speak frequently, I still love her as much as I did before," Stanton says.

"I love Largo, I still love Largo, I walked away with a sense of loss that not only did I lose my friends in the city, but the relationship with a community that I dearly loved.

"You just don't discard that so easily."

She said her job keeps her so busy that she doesn't have time to worry much about her personal life.

"I haven't started [dating] yet," she says. "Psychologically, I'm not there yet."

She also doesn't think about "Option C" anymore, which she defined in the documentary as suicide.

"I don't worry, like I was at that point in the documentary, because I'm gainfully employed," Stanton said. "I'm not at that place. But I also know, given the nature of my type of work, I could be back in that spot someday."

Stanton walked away from being a spokesperson for the transgender community, but says she still represents the community "because of the prominence of my story."

"Today my focus is being a city manager, not being a transgender advocate," Stanton says. "I promised people in that community [transgender community] two years ago when I walked off the stage -- I was gone."

Stanton says her journey to become a woman does not mean she wants to forget about her life as a man.

"For the most part -- most things I do in my life -- the fact that Susan used to be Steven is totally irrelevant," Stanton says. "But it's very much part of who I am. I don't think you can ever deny your human story."

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A List of 38 Transgender Documentaries

We love a good documentary, especially an LGBTQ focused one. More transgender documentaries are popping up in recent years which explores newer surgical and hormonal treatments and options available.

We also found some retro gold from the likes of the BBC and coverage from CNN.

Grab a bucket of popcorn and enjoy our diverse collection of trans documentaries.

GAME FACE shows the quest to self-realization of LGBTQ athletes and the acceptance in society.

This documentary tells the parallel story of Fallon Fox, MMA’s first transgender pro fighter.

Watch the trailer on YouTube here .

A transgender documentary filmed in Hawaii focusing on a transgender Hawaiian teacher who inspires a girl to lead the school’s male hula troupe.

Watch the trailer here .

Watch on YouTube movies .

Southern Comfort

Kate Davis’s award-winning documentary chronicles the final four seasons in the life of Robert Eads, a female-to-male transsexual dying of ovarian cancer in rural Georgia.

Striking a balance between Robert’s biological family — mother, father, sons and grandson — and his “chosen” family of transge nder friends including Maxwell, Cas and Lola Cola, his male-to-female transsexual partner, Davis documents Eads’s final days at the Southern Comfort Conference, a national transgender gathering.

Watch the full documentary on YouTube here .

Raising Zoey

Raising Zoe presents a year in the life of trans Latina teenager, Zoey Luna, as she struggles for acceptance at her middle school and faces the challenges of being a teenager in a conservative heteronormative world.

Watch the trailer on Vimeo .

Tranny Fag (Bixa Travesty)

A documentary that follows Mc Linn Da Quebrada, a black trans woman, performer and activist living in impoverished São Paulo.

Her electrifying performances (with plenty of nudity) brazenly take on Brazil’s hetero-normative machismo.

Watch the exciting trailer on YouTube here .

Screaming Queens

A documentary about transgender women and drag queens who fought police harassment at Compton’s Cafeteria in San Francisco’s Tenderloin in 1966, three years before the famous riot at Stonewall Inn bar in NYC.

Watch the full documentary on YouTube .

The Trans List

The Trans List explores the range of experiences lived by Americans who identify as transgender (an umbrella term for people whose gender identity does not conform to that typically associated with the sex they were assigned at birth). No two experiences of trans people are exactly alike.

Transgender, transsexual, gender-queer, bi-gender, and non-binary are just a few of the multitude of self-identifiers in the trans community. This film gives a platform to a diverse group of eleven individuals to tell their stories in their own words of their experience with identity, family, career, love, struggle and accomplishment.

I Want My Sex Back

Detransitioned transgender people who regretted changing sex speak out. Billy, Rene and Walt were born male, but they all felt uncomfortable with their sex.

So they underwent sex reassignment surgery, believing it would end their distressing condition, which is known as gender dysphoria – feeling uncomfortable with your birth sex. However, becoming female only brought problems, disappointment and regret.

Transgender Kids

In this shocking yet touching film, Transgender Kids follows the lives of four transgender children to discover what it is like to realize you were born in the wrong body so young.

We will find out how young children change their apparent gender and how families cope with having a transgender child.

Real Boy is an intimate story of a family in transition. As 19-year-old Bennett Wallace navigates early sobriety, late adolescence, and the evolution of his gender identity, his mother makes her own transformation from resistance to acceptance of her trans son.

Along the way, both mother and son find support in their communities, reminding us that families are not only given but chosen.

Watch the trailer on Vimeo here .

The Death and Life of Marsha P. Johnson

Filmmakers re-examine the 1992 death of transgender legend Marsha P. Johnson, who was found floating in the Hudson River. Originally ruled a suicide, many in the community believe she was murdered.

Watch the official trailer on YouTube ,

Watch on Netflix .

Documentary: Big Open Closet – Transgender in Russia

A documentary film about being transgender in St Petersburg in Russia, presented by Owl and Fox Fisher.

This is the first specifically trans-related documentary film on day to day trans life and the specific issues that trans women, trans men, and non-binary people are facing in Russia.

Sundance Selects will release the documentary KIKI, a dynamic coming of age story about resilience and the transformative art form that is voguing.

KIKI offers riveting and complex insight into the daily lives of a group of LGBTQ youth-of-color who comprise the “Kiki” scene, a vibrant, safe space for performance created and governed by these activists.

Watch the trailer on YouTube .

Visit the Official KIKI website here .

Becoming More Visible

Challenged by how to identify since early childhood, four fearless transgender young adults defy societal norms to be their true selves and  to become more visible.

Visit the official website here .

My Prarie Home

My Prairie Home is a 2013 Canadian documentary film about transgender singer/songwriter Rae Spoon, directed by Chelsea McMullan.

It features musical performances and interviews about Spoon’s troubled childhood, raised by Pentecostal parents obsessed with the Rapture and an abusive father, as well as Spoon’s past experiences with gender confusion.

Mala Mala is a feature-length documentary about the power of transformation told through the eyes of 9 trans-identifying individuals in Puerto Rico.

She’s a Boy I Knew

She’s a Boy I Knew is a Canadian documentary film by Gwen Haworth, released in 2007.

The film documents Haworth’s process of coming out as transgender and undergoing gender transition, using a combination of interviews, home video footage, short animation clips and interviews with her friends and family about its impact on them.

My Dad is a Woman

A trans documentary that gains intimate access to the lives of two fathers undergoing extraordinary sex-change operations and family upheaval as they fulfill their desire to become the women they have always wanted to be.

Transsexual surgeon Dr. Marci Bowers and two of her patients work to transform their small Colorado town into a haven for individuals seeking gender-reassignment surgery.

Transgender Teens (BBC)

Hundreds of young people across Northern Ireland identify as transgender. Two teenagers share their experiences and the BBC examines the debate over medical intervention.

Watch the f ull documentary on YouTube here .

Growing Up Coy

Growing Up Coy follows a landmark transgender rights case in Colorado where a 6-year-old transgender girl named Coy has been banned from the girls’ bathroom at her school.

Coy’s parents hire a lawyer to pursue a civil rights case of discrimination, and the family is thrust into the international media spotlight, causing their lives to change forever. A timely topic as states across the US battle with this particular civil rights issue. The film also asks a universal question that every parent may face: How far would you go to fight for your child’s rights?

Watch the full documentary on Netflix .

MAJOR! explores the life and campaigns of Miss Major Griffin-Gracy, a formerly incarcerated Black transgender elder and activist who has been fighting for the rights of trans women of color for over 40 years.

​ Miss Major is a veteran of the Stonewall Rebellion and a survivor of Attica State Prison, a former sex worker, an elder, and a community leader and human rights activist. She is simply “Mama” to many in her community. Her personal story and activism for transgender civil rights intersect LGBT struggles for justice and equality from the 1960s to today. At the center of her activism is her fierce advocacy for her girls, trans women of color who have survived police brutality and incarceration in men’s jails and prisons.

Gender Revolution

A Journey with Katie Couric is a 2017 documentary film about gender identity, produced by Katie Couric, National Geographic, and World of Wonder.

It originally aired on the American network National Geographic on February 6, 2017.

Made in Bangkok

Following a transgender opera singer as she travels from Mexico to Bangkok to undergo sex reassignment surgery and claim the identity she’s fought for.

The Brandon Teena Story

The true story behind trans movie ‘Boys Don’t Cry’. This documentary follows the tragic tale of a transgender man from rural Nebraska who was murdered after two locals discovered his female origins, director Susan Muska delves into the story of Brandon Teena — born Teena Brandon — through a number of revealing sources.

News footage and documents from the time o f the murder lay out the facts of the case, while Muska conducts interviews with those closest to Teena, including several ex-girlfriends, to piece together a life and a crime.

Paper Dolls

After Israel closes its borders to Palestinian workers, people from other countries emigrate there to find jobs. Among them are several individuals from the Philippines.

The men, who consider themselves female, get jobs as caregivers for elderly Orthodox Jewish men. On their nights off they perform  in a drag ensemble called “Paper Dolls.”

Beautiful Darling

Beautiful Darling: The Life and Times of Candy Darling is a 2010 feature-length documentary film about Candy Darling, the transsexual pioneer, actress and Andy Warhol superstar.

Paris is Burning

One of the most popular transgender documentaries, Paris is Burning focuses on drag queens living in New York City and their “house” culture, which provides a sense of community and support for the flamboyant and often socially shunned performers.

Groups from each house compete in elaborate balls that take cues from the world of fashion. Also touchi ng on issues of racism and poverty, the film features interviews with a number of renowned drag queens, including Willi Ninja, Pepper LaBeija and Dorian Corey.

Watch Paris is Burning on YouTube .

Watch Paris is Burning on Netflix here .

The Pearl of Africa

The Pearl of Africa is a trans documentary that captures an intimate’s struggle for the right to love.

Following a Ugandan transgender girl, forced to leave her country.

Age 8 and Wanting a Sex Change

Eight-year-old Josie was born a boy but has been living as a girl for two years since revealing the full extent of his feelings about his identity to his mother. Kyla is also eight.

She was born a boy but loves anything pink and sparkly, has grown his hair and is preparing to return for school after summer dressed as a girl for the first time. They have both been diagnosed with gender dysphoria. Sixteen-year-old Chris, who was born a girl, started testosterone treatment at 14. He now has a deep voice and plentiful body hair and shaves regularly. These children and their parents reveal what it is like to face life-changing questions, giving a frank insight into a subject most people never have to consider.

Kyle Dean was a misfit in her North Carolina school. She was called “Creature” because she was a boy who knew she was a girl in part of the country where such things were not understood or tolerated.

As soon as she could she left North Carolina for Hollywood where she felt that she’d stand more of a chance of becoming who she wanted to be. Now as Stacey she’s going back to visit with Mom and Pop.

Lady Valor: The Kristin Beck Story

In “Lady Valor”, former U.S. Navy SEAL Christopher Beck embarks on a new mission as Kristin Beck as she lives her life truthfully as a transgender woman. In 2011, after 20 years of service on SEAL Team 1, she retired from service though continued to hide her true identity while working for the United States Government and the Pentagon.

In 2013, a year and a half after retirement, Kristin came out publicly through LinkedIn and confirmed her true identity on CNN’s Anderson Cooper 360 taking many friends and family by surprise. While many people have been supportive, some in some in the public have expressed more bigotry than she ever expected. After a lifetime of service, Kristin has learned that her fight for life, liberty, and the pursuit of happiness did not end on the battlefield.

Red Without Blue

The intimate bond between two identical twin brothers is challenged when one decides to transition from male to female; this is the story of their evolving relationship and the resurrection of their family from a darker past.

You Don’t Know Dick: Courageous Hearts of Transsexual Men

In this bold documentary, six female-to-male transsexuals tell their courageous stories of transformation, struggle, and acceptance. Their lives are wildly diverse — one works as a mechanic and loves to lift weights; one previously birthed three children.

In candid conversations, they discuss their  painful pasts, their relationships, and the surgeries and hormone therapies that brought on their physical changes, bringing a unique perspective to a subject rarely approached in the cinema.

Watch the on Amazon Prime .

Prodigal Sons

When filmmaker Kimberly Reed left her small Montana hometown, she was a man. Returning years later for her high school reunion, Reed is a transgendered woman.

She seeks to reconnect with her estranged adopted brother, Marc McKerrow, who was permanently disabled in a car crash and might be related t o Orson Welles and Rita Hayworth. Exploring identities, rivalries, and family, Reed embarks on a personal journey that begins with her hometown and leads all the way to Croatia.

Passing Ellenville

This documentary follows two transgender youths in a small, economically-depressed town in the Catskills mountains of New York and their struggles during the gender transition process. James, female-to-male, comes from a history of abuse and a string of family problems.

Ashlee, male-to-female, struggles to align her orthodox Jewish faith with her transgender identity. The film exposes a side of transgender youth we have not seen in the national news media. These are transgender youth at the margins of society living in Any Town, USA, barely surviving on government assistance and food stamps and facing tremendous prejudice and hate. However, the film also shows how each of the subjects, including their older and wiser transgender mentor, find their own pockets of happiness in their life journey.

Gendernauts: A Journey Through Shifting Identities

Monika Treut explores the worlds and thoughts of several trans-gendered individuals. As with Treuts first film, Jungfrauenmaschine, Gendernauts, enters a minority sector of San Fransisco culture.

The individuals in this film are people whose (genetically) assigned gender does not match their social gender identity. The subject is pinpointed in the film independent of sexual orientation. Leave your conservative hats at the door, this is going to need your special attention.

Watch Gendernauts on Vimeo here .

Behind the Bombshell

Bonnie Bombshell, a transgender YouTuber, worked on this documentary for 6 months.

Behind The Bombshell is a self-edited documentary-type mini-series that reveal parts of her life that have never been discussed publicly. With the help of Century Films, she is able to relive major steps towards the beginning of her physical transition.

Watch the full documentary On Bonnie’s YouTube channel here .

Like our ‘List of Transgender Documentaries’? Pin it!

Did we miss something from our list of Transgender Documentaries? Let us know in the comments below.

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I would highly recommend the classic musical-turned-film Hedwig and the Angry Inch! Another favorite is Tangerine, which was filmed entirely on an iPhone, I believe 🙂 Much love, and blessings from the UK

Oops, these are films with fictional characters, instead of documentaries. My mistake, still recommend!

Why is thecseries called ladyboys on sky 1 not here. It was fantastic.

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Model Andreja Pejic Shares Her Gender Transition in New Documentary

The film aims to show a glimpse of gender reassignment surgery

It’s one of the final steps in her transition – from androgynous male model Andrej to the woman she has always wanted to be, Andreja.

In an clip exclusive to PEOPLE from Andrej(a) – The Documentary , Andreja Pejic is in her hospital bed, still recovering from sex reassignment surgery . Chatting on her cell phone, she tells a friend that she has been “optioned” – the fashion term for being put on hold – for a Donna Karan fashion show.

“I might [still] have a catheter,” Pejic says. But having walked runways for Marc Jacobs and Jean-Paul Gaultier, the 23-year-old knows that when fashion calls, she’d better answer. Ever the optimist, Pejic says of her possible medical accessory, “That could be a look.”

The film, which depicts Pejic’s physical, emotional and professional journey from man to woman, is directed by Eric Miclette and partially funded by a Kickstarter campaign which has raised more than $24,000 so far. Actor Jared Leto has also shown support for the film.

“I wanted to show the whole experience,” explains Pejic, who says she not only hopes to demystify the trans process but also help “young kids out there who are going through similar struggles.”

That’s why she gave filmmaker Miclette full access, allowing him to document nearly every aspect of her journey. “I was there the whole time,” says Miclette, who adds that there were moments when he struggled with not setting down his camera to comfort Pejic.

The film, which Miclette started as a passion project more than a year ago, shows some of those sad moments, but plenty of uplifting ones as well. Viewers eventually learn that Pejic did end up walking in the DKNY show, but she hasn’t yet had her first official post-op photo shoot.

“I still haven’t been shot as a woman,” Pejic told PEOPLE exclusively. “With fashion, it’s all about timing and holding out for the right thing.”

In the meantime, she’s busy going to castings and having meetings. When asked about her personal life and dating, she hesitates. “That’s the thing,” she says. “I haven’t really had the time.”

But the model has made time for her family since the surgery. In the past few months, she’s traveled to Europe to catch up with her mother and see her grandmother. “We had lots to talk about,” says Pejic of reuniting with her mom. “We had mother-daughter conversations for the first time. It was lovely.”

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A documentary portrait of the late John Wojtowicz, whose attempted robbery of a Brooklyn bank to finance his lover's gender-reassignment surgery was the real-life inspiration for Dog Day Aft... Read all A documentary portrait of the late John Wojtowicz, whose attempted robbery of a Brooklyn bank to finance his lover's gender-reassignment surgery was the real-life inspiration for Dog Day Afternoon (1975). A documentary portrait of the late John Wojtowicz, whose attempted robbery of a Brooklyn bank to finance his lover's gender-reassignment surgery was the real-life inspiration for Dog Day Afternoon (1975).

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• Jeremy Bowker
• 15 User reviews
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• 76 Metascore
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Young Children Do Not Receive Medical Gender Transition Treatment

By Kate Yandell

Posted on May 22, 2023

SciCheck Digest

Families seeking information from a health care provider about a young child’s gender identity may have their questions answered or receive counseling. Some posts share a misleading claim that toddlers are being “transitioned.” To be clear, prepubescent children are not offered transition surgery or drugs.

Some children  identify  with a gender that does not match their sex assigned at birth. These children are referred to as transgender, gender-diverse or gender-expansive. Doctors will listen to children and their family members, offer information, and in some cases connect them with mental health care, if needed.

But for children who have not yet started puberty, there are  no recommended  drugs, surgeries or other gender-transition treatments.

Recent social media  posts   shared  the misleading  claim  that medical institutions in North Carolina are “transitioning toddlers,” which they called an “experimental treatment.” The posts referenced a  blog post  published by the Education First Alliance, a conservative nonprofit in North Carolina that says  many schools are engaging in “ideological indoctrination” of children and need to be reformed.

The group has advocated the passage of a North Carolina bill  to restrict medical gender-transition treatment before age 18. There are now  18 states  that have taken action to restrict  medical transition treatments  for  minors .

A widely shared  article  from the Epoch Times citing the blog post bore the false headline: “‘Transgender’ Toddlers as Young as 2 Undergoing Mutilation/Sterilization by NC Medical System, Journalist Alleges.” The Epoch Times has a history of publishing misleading or false claims. The article on transgender toddlers then disappeared from the website, and the Epoch Times published a new  article  clarifying that young children are not receiving hormone blockers, cross-sex hormones or surgery. 

Representatives from all three North Carolina institutions referenced in the social media posts told us via emailed statements that they do not offer surgeries or other transition treatments to toddlers.

East Carolina University, May 5: ECU Health does not offer gender affirming surgery to minors nor does the health system offer gender affirming transition care to toddlers.

ECU Health elaborated that it does not offer puberty blockers and only offers hormone therapy after puberty “in limited cases,” as recommended in national guidelines and with parental or guardian consent. It also said that it offers interdisciplinary gender-affirming primary care for LGBTQ+ patients, including access to services such as mental health care, nutrition and social work.

“These primary care services are available to any LGBTQ+ patient who needs care. ECU Health does not provide gender-related care to patients 2 to 4 years old or any toddler period,” ECU said.

University of North Carolina, May 12: To be clear: UNC Health does not offer any gender-transitioning care for toddlers. We do not perform any gender care surgical procedures or medical interventions on toddlers. Also, we are not conducting any gender care research or clinical trials involving children. If a toddler’s parent(s) has concerns or questions about their child’s gender, a primary care provider would certainly listen to them, but would never recommend gender treatment for a toddler. Gender surgery can be performed on anyone 18 years old or older .

Duke Health, May 12: Duke Health has provided high-quality, compassionate, and evidence-based gender care to both adolescents and adults for many years. Care decisions are made by patients, families and their providers and are both age-appropriate and adherent to national and international guidelines. Under these professional guidelines and in accordance with accepted medical standards, hormone therapies are explicitly not provided to children prior to puberty and gender-affirming surgeries are, except in exceedingly rare circumstances, only performed after age 18.

Duke and UNC both called the claims that they offer gender-transition care to toddlers false, and ECU referred to the “intentional spreading of dangerous misinformation online.”

Nor do other medical institutions offer gender-affirming drug treatment or surgery to toddlers, clinical psychologist  Christy Olezeski , director of the Yale Pediatric Gender Program, told us, although some may offer support to families of young children or connect them with mental health care. 

The Education First Alliance post also states that a doctor “can see a 2-year-old girl play with a toy truck, and then begin treatment for gender dysphoria.” But simply playing with a certain toy would not meet the criteria for a diagnosis of gender dysphoria, according to the medical diagnostic manual used by health professionals.

“With all kids, we want them to feel comfortable and confident in who they are. We want them to feel comfortable and confident in how they like to express themselves. We want them to be safe,” Olezeski said. “So all of these tenets are taken into consideration when providing care for children. There is no medical care that happens prior to puberty.”

Medical Transition Starts During Adolescence or Later 

The Education First Alliance blog post does not clearly state what it means when it says North Carolina institutions are “transitioning toddlers.” It refers to treatment and hormone therapy without clarifying the age at which it is offered. 

Only in the final section of the piece does it include a quote from a doctor correctly stating that children are not offered surgery or drugs before puberty.

To spell out the reality of the situation: The North Carolina institutions are not providing surgeries or hormone therapy to prepubescent children, nor is this standard practice in any part of the country.

Programs and physicians will have different policies, but widely referenced guidance from the  World Professional Association for Transgender Health  and the  Endocrine Society  lays out recommended care at different ages. 

Drugs that suppress puberty are the first medical treatment that may be offered to a transgender minor, the guidelines say. Children may be offered drugs to suppress puberty beginning when breast buds appear or testicles increase to a certain volume, typically happening between ages 8 to 13 or 9 to 14, respectively.

Generally, someone may start gender-affirming hormone therapy in early adolescence or later, the American Academy for Pediatrics  explains . The Endocrine Society says that adolescents typically have the mental capacity to participate in making an informed decision about gender-affirming hormone therapy by age 16.

Older adolescents who want flat chests may sometimes be able to get surgery to remove their breasts, also known as top surgery, Olezeski said. They sometimes desire to do this before college. Guidelines  do not offer  a  specific age  during adolescence when this type of surgery may be appropriate. Instead, they explain how a care team can assess adolescents on a case-by-case basis.

A previous  version  of the WPATH guidelines did not recommend genital surgery until adulthood, but the most recent version, published in September 2022, is  less specific  about an age limit. Rather, it explains various criteria to determine whether someone who desires surgery should be offered it, including a person’s emotional and cognitive maturity level and whether they have been on hormone therapy for at least a year.

The Endocrine Society similarly offers criteria for when someone might be ready for genital surgery, but specifies that surgeries involving removing the testicles, ovaries or uterus should not happen before age 18.

“Typically any sort of genital-affirming surgeries still are happening at 18 or later,” Olezeski said.

There are no comprehensive statistics on the number of gender-affirming surgeries performed in the U.S., but according to an insurance claims  analysis  from Reuters and Komodo Health Inc., 776 minors with a diagnosis of gender dysphoria had breast removal surgeries and 56 had genital surgeries from 2019 to 2021.

Research Shows Benefits of Affirming Gender Identity

Young children do not get medical transition treatment, but they do have feelings about their gender and can benefit from support from those around them. “Children start to have a sense of their own gender identity between the ages of 2 1/2 to 3 years old,” Olezeski said.

Programs vary in what age groups they serve, she said, but some do support families of preschool-aged children by answering questions or providing mental health care.

Transgender children are at increased risk of some mental health problems, including anxiety and depression. According to the WPATH guidelines, affirming a child’s gender through day-to-day changes — also known as social transition — may have a positive impact on a child’s mental health. Social transition “may look different for every individual,” Olezeski said. Changes could include going by a different name or pronouns or altering one’s attire or hair style.

Two studies of socially transitioned children — including one with kids as young as 3 — have found minimal or no difference in anxiety and depression compared with non-transgender siblings or other children of similar ages.

“Research substantiates that children who are prepubertal and assert an identity of [transgender and gender diverse] know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender and benefit from the same level of social acceptance,” the AAP  guidelines  say, adding that differences in how children identify and express their gender are normal.

Social transitions largely take place outside of medical institutions, led by the child and supported by their family members and others around them. However, a family with questions about their child’s gender or social transition may be able to get information from their pediatrician or another medical provider, Olezeski said.

Although not available everywhere, specialized programs may be particularly prepared to offer care to a gender-diverse child and their family, she said. A child may get a referral to one of these programs from a pediatrician, another specialty physician, a mental health care professional or their school, or a parent may seek out one of these programs.

“We have created a space where parents can come with their youth when they’re young to ask questions about how to best support their child: what to do if they have questions, how to get support, what do we know about the best research in terms of how to allow kids space to explore their identity, to explore how they like to express themselves, and then if they do identify as trans or nonbinary, how to support the parents and the youth in that,” Olezeski said of specialized programs. Parents benefit from the support, and then the children also benefit from support from their parents. 

WPATH  says  that the child should be the one to initiate a social transition by expressing a “strong desire or need” for it after consistently articulating an identity that does not match their sex assigned at birth. A health care provider can then help the family explore benefits and risks. A child simply playing with certain toys, dressing a certain way or enjoying certain activities is not a sign they would benefit from a social transition, the guidelines state.

Previously, assertions children made about their gender were seen as “possibly true” and support was often withheld until an age when identity was believed to become fixed, the AAP guidelines explain. But “more robust and current research suggests that, rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family,” the guidelines say.

Mental Health Care Benefits

A gender-diverse child or their family members may benefit from a referral to a psychologist or other mental health professional. However, being transgender or gender-diverse is not in itself a mental health disorder, according to the  American Psychological Association ,  WPATH and other expert groups . These organizations also note that people who are transgender or gender-diverse do not all experience mental health problems or distress about their gender. 

Psychological therapy is not meant to change a child’s gender identity, the WPATH guidelines  say . 

The form of therapy a child or a family might receive will depend on their particular needs, Olezeski said. For instance, a young child might receive play-based therapy, since play is how children “work out different things in their life,” she said. A parent might work on strategies to better support their child.

One mental health diagnosis that some gender-diverse people may receive is  gender dysphoria . There is  disagreement  about how useful such a diagnosis is, and receiving such a diagnosis does not necessarily mean someone will decide to undergo a transition, whether social or medical.

UNC Health told us in an email that a gender dysphoria diagnosis “is rarely used” for children.

Very few gender-expansive kids have dysphoria, the spokesperson said. “ Gender expansion in childhood is not Gender Dysphoria ,” UNC added, attributing the explanation to psychiatric staff (emphasis is UNC’s). “The psychiatric team’s goal is to provide good mental health care and manage safety—this means trying to protect against abuse and bullying and to support families.”

Social media posts incorrectly claim that toddlers are being diagnosed with gender dysphoria based on what toys they play with. One post  said : “Three medical schools in North Carolina are diagnosing TODDLERS who play with stereotypically opposite gender toys as having GENDER DYSPHORIA and are beginning to transition them!!”

There are separate criteria for diagnosing gender dysphoria in adults and adolescents versus children, according to the Diagnostic and Statistical Manual of Mental Disorders. For children to receive this diagnosis, they must meet six of eight criteria for a six-month period and experience “clinically significant distress” or impairment in functioning, according to the diagnostic manual. 

A “strong preference for the toys, games or activities stereotypically used or engaged in by the other gender” is one criterion, but children must also meet other criteria, and expressing a strong desire to be another gender or insisting that they are another gender is required.

“People liking to play with different things or liking to wear a diverse set of clothes does not mean that somebody has gender dysphoria,” Olezeski said. “That just means that kids have a breadth of things that they can play with and ways that they can act and things that they can wear . ”

Editor’s note: SciCheck’s articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.

Rafferty, Jason. “ Gender-Diverse & Transgender Children .” HealthyChildren.org. Updated 8 Jun 2022.

Coleman, E. et al. “ Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 .” International Journal of Transgender Health. 15 Sep 2022.

Rachmuth, Sloan. “ Transgender Toddlers Treated at Duke, UNC, and ECU .” Education First Alliance. 1 May 2023.

North Carolina General Assembly. “ Senate Bill 639, Youth Health Protection Act .” (as introduced 5 Apr 2023).

Putka, Sophie et al. “ These States Have Banned Youth Gender-Affirming Care .” Medpage Today. Updated 17 May 2023.

Davis, Elliott Jr. “ States That Have Restricted Gender-Affirming Care for Trans Youth in 2023 .” U.S. News & World Report. Updated 17 May 2023.

Montgomery, David and Goodman, J. David. “ Texas Legislature Bans Transgender Medical Care for Children .” New York Times. 17 May 2023.

Ji, Sayer. ‘ Transgender’ Toddlers as Young as 2 Undergoing Mutilation/Sterilization by NC Medical System, Journalist Alleges .” Epoch Times. Internet Archive, Wayback Machine. Archived 6 May 2023.

McDonald, Jessica. “ COVID-19 Vaccines Reduce, Not Increase, Risk of Stillbirth .” FactCheck.org. 9 Nov 2022.

Jaramillo, Catalina. “ Posts Distort Questionable Study on COVID-19 Vaccination and EMS Calls .” FactCheck.org. 15 June 2022.

Spencer, Saranac Hale. “ Social Media Posts Misrepresent FDA’s COVID-19 Vaccine Safety Research .” FactCheck.org. 23 Dec 2022.

Jaramillo, Catalina. “ WHO ‘Pandemic Treaty’ Draft Reaffirms Nations’ Sovereignty to Dictate Health Policy .” FactCheck.org. 2 Mar 2023.

McCormick Sanchez, Darlene. “ IN-DEPTH: North Carolina Medical Schools See Children as Young as Toddlers for Gender Dysphoria .” The Epoch Times. 8 May 2023.

ECU health spokesperson. Emails with FactCheck.org. 12 May 2023 and 19 May 2023.

UNC Health spokesperson. Emails with FactCheck.org. 12 May 2023 and 19 May 2023.

Duke Health spokesperson. Email with FactCheck.org. 12 May 2023.

Olezeski, Christy. Interview with FactCheck.org. 16 May 2023.

Hembree, Wylie C. et al. “ Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline .” The Journal of Clinical Endocrinology and Metabolism. 1 Nov 2017.

Emmanuel, Mickey and Bokor, Brooke R. “ Tanner Stages .” StatPearls. Updated 11 Dec 2022.

Rafferty, Jason et al. “ Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents .” Pediatrics. 17 Sep 2018.

Coleman, E. et al. “ Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7 .” International Journal of Transgenderism. 27 Aug 2012.

Durwood, Lily et al. “ Mental Health and Self-Worth in Socially Transitioned Transgender Youth .” Journal of the American Academy of Child and Adolescent Psychiatry. 27 Nov 2016.

Olson, Kristina R. et al. “ Mental Health of Transgender Children Who Are Supported in Their Identities .” Pediatrics. 26 Feb 2016.

“ Answers to Your Questions about Transgender People, Gender Identity, and Gender Expression .” American Psychological Association website. 9 Mar 2023.

“ What is Gender Dysphoria ?” American Psychiatric Association website. Updated Aug 2022.

Vanessa Marie | Truth Seeker (indivisible.mama). “ Three medical schools in North Carolina are diagnosing TODDLERS who play with stereotypically opposite gender toys as having GENDER DYSPHORIA and are beginning to transition them!! … ” Instagram. 7 May 2023.

State health plans must cover gender-affirming surgery, US appeals court rules

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SC Senate to debate bill about banning transgender youth medical care, what to know

Just days before the legislative session ends on May 9, the South Carolina State Senate is expected to debate a bill that would ban medical care for transgender youth on Tuesday, May 30.

Passed by the House of Representatives after being introduced in the first week of the new legislative session in January, the bill bars anyone under the age of 18 from receiving gender reassignment surgery or any form of puberty-blocking or hormone therapy for transgender youth. If passed by the Senate, it would also make it a felony for doctors who perform gender assignment surgery on those under the age of 18.

Dr. Elizabeth Mack, president of the South Carolina Chapter of the American Academy of Pediatrics, testified against the bill during a Senate Medical Affairs Subcommittee on Feb. 14.

"We have less than 2,000 trans kids in the state, as far as we know, some never seeking medical care, and less than 1% are regretting their transition," she said.

While those in favor of the bill tout it intends to protect children, others point to studies that show transgender and non-binary youth who use hormones and puberty blockers show lowered signs of depression and anxiety .

Gender-affirming care: SC House Republicans go after gender-affirming care in first week of legislative session

SC legislators mirror debate happening around the state

In February, Greenville County Libraries Board of Trustees unanimously voted to relocate children's materials depicting transgender minors from the children's section to the parenting section, where only adults or minors with library cards allowing them to check out books from any section can access them, as previously reported by the Greenville News.

More recently, South Carolina's Superintendent of Education Ellen Weaver instructed school districts not to implement new federal regulations unveiled by President Joe Biden that seek to protect vulnerable students, including LGBTQ+ students. The latest changes to Title IX, which will take place in August, add protections from discrimination based on gender identity. Title IX is a federal civil rights law banning sex-based discrimination for students and employees attending federally funded schools.

"By redefining the class of people that Title IX intends to protect, the Biden administration’s rule seeks to change the meaning and purpose of the underlying law, thus compelling the speech of students and teachers related to preferred pronoun use, upending biology-based protections for females in athletics, bathrooms, locker rooms, overnight accommodations, and other sex-separate spaces and activities; placing massive legal uncertaintyand compliance costs on districts; and creating chaos and confusion for teachers, students, and parents," Weaver wrote in a memo for district superintendents and South Carolina school board members.

Savannah Moss covers Greenville County politics and growth/development. Reach her at [email protected] or follow her on X @Savmoss.

Veto override fails, keeping gender-affirming care legal for transgender youths in Kansas

Gender-affirming care for transgender youths won't be banned this year after Kansas lawmakers narrowly failed to override Gov. Laura Kelly's veto.

Senate Bill 233 would have banned gender-affirming surgeries and hormone therapy for transgender youths, and some people also interpreted the language to effectively prohibit social transitioning .

While the Senate on Monday got the two-thirds majority it needed to override with a 27-13 vote, the House fell two votes short, 82-43. House Minority Leader Vic Miller, D-Topeka, then made a procedural move to officially kill the bill.

"I am glad that bipartisan members of the legislature have stood firm in saying that divisive bills like House Substitute for Senate Bill 233 have no place in Kansas," Kelly said in a statement. "The legislature's decision to sustain my veto is a win for parental rights, Kansas families, and families looking to call our state home."

The bill's failure came after two House Republicans flipped: Rep. Jesse Borjon, R-Topeka, and Rep. Susan Concannon, R-Beloit.

"I strongly support prohibiting gender reassignment surgery and limiting the use of hormone blockers for minors," Borjon said. "Senate Bill 233 goes too far in restricting mental and behavioral health care for children, which is so desperately needed in these cases. No other state has prohibited providers' speech, and consideration must be given to children currently undergoing treatment."

Borjon said he would support future legislation targeting surgery "without further compromising the care they receive."

Concannon said she likewise has concerns with gender-affirming surgery, but "this bill is vague beyond the surgery."

"We're not listening to the impacted youth," she said. "Government involvement is not the answer."

House Republican caucus meeting showed signs of trouble

Heading into veto session, Republicans appeared poised to override Kelly's veto after failing to do so last session. Several Republicans had flipped this year, though Kelly said she was hoping "some of those legislators who did flip their votes realize that they've made a mistake."

Signs of trouble emerged before the Monday evening vote, which was delayed by GOP leadership for roughly 45 minutes. Earlier in the afternoon, during a House GOP caucus meeting, several representatives urged anyone with cold feet to stick with their previous support of the bill.

Some Republicans suggested that colleagues may have been swayed by concerns that the bill could be interpreted to ban mental health treatment for transgender youths, including medication, that it could effectively ban social transition and that it did not go far enough to protect children currently receiving treatment.

Rep. Kyle McNorton, R-Topeka, said, "We're hearing from our local hospitals that this bill will make it so they cannot treat mental health with drugs."

Rep. Brenda Landwehr, R-Wichita, and Rep. John Eplee, R-Atchison, took the lead in trying to assuage any qualms. They assured legislators the bill wasn't intended to ban medications used to treat mental health, that the language didn't ban teachers from affirming a student's gender identity at school and there was enough time for children to transition off treatment.

While it wasn't in the original version of the bill, legislators later added the provision to allow transgender youths to transition off their treatment through the end of the year in order to win over the support of Sen. Brenda Dietrich, R-Topeka. But the caucus meeting indicated some patients who already had surgery may lose access to medications necessary to prevent complications.

Eplee also acknowledged that some children and their families would likely be forced to seek continued care outside of Kansas if they wanted to continue their treatment.

Landwehr told people considering a no vote that the issue polls well politically.

"They are opposed to what's happening to kids, because kids are not ready to make this decision, and the parents may not be educated enough to do anything but follow what one medical individual recommends," Landwehr said. "If I could, I would make this ban up to the age of 26 or 27 when the brain fully develops."

Likewise, Rep. David Buehler, R-Lansing, said the polling on the issue was "probably the strongest I've heard" on any health bill.

"The reason I voted for it is it keeps a minor child from removing his genitals, period," said Rep. Sean Tarwater, R-Stilwell. "Any parent that would do that to their kid is a sick person."

He also offered political advice.

"If you voted for this once and you're worried about reelection, no one wants a wishy washy person," Tarwater said. "They're going to use it against you either way. You voted for it once. The post card is there. Stand up and fight for it. Be proud you voted to make it end. These people are sick."

Senate Republicans voted to override veto

The bill had supermajority support in the Senate, where supporters of the legislation argued that there isn't enough research to support the effectiveness of affirming practices on minors, and that the ban protects children from overzealous medical professionals.

"The bottom line here is this bill is about protecting children, and with that you ask yourself who you're protecting the children from. Unfortunately, in today's society, the predator is a woke health care system and woke health care providers," said Sen. Mark Steffen, R-Hutchinson.

Sen. Cindy Holscher, D-Overland Park, said the broad language in the bill would "not only punish those seeking care, but it would also punish physicians, teachers and social workers." She also pointed out that many of the proponents who testified in support of the bill came in from out-of-state, while several Kansans opposed it.

Senate Minority Leader Dinah Sykes, D-Lenexa, said lawmakers "are telling our medical professionals that we know best."

Opponents also reiterated a previous argument that anti-transgender legislation could lead to more suicides.

"Research has already identified that due to societal mistreatment, transgender youth have higher rates of suicide attempts and completions than their peers," said Sen. Mary Ware, D-Wichita. "What is the acceptable number of youth suicides?"

"The bottom line here is this bill is about protecting children," Steffen said, "and with that you ask yourself who you're protecting the children from. Unfortunately, in today's society, the predator is a woke health care system and woke health care providers."

How did Topeka legislators vote?

Here's how Topeka legislators voted on the veto override:

Yea : Republican Sens. Brenda Dietrich, Rick Kloos and Kristen O'Shea, and Republican Reps. Ken Corbet and Kyle McNorton.

Nay : Republican Rep. Jesse Borjon, Democratic Reps. John Alcala, Kirk Haskins, Vic Miller, Tobias Schlingensiepen and Virgil Weigel.

WMUR Manchester

Joyce Craig backs access to gender reassignment surgery for NH youth | CloseUp

Posted: April 28, 2024 | Last updated: April 28, 2024

On CloseUp, Joyce Craig said she supports giving families and their children the power to decide on gender reassignment surgery if they consult with a doctor.

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‘We are literally erased’: what does it mean to be intersex?

The documentary Every Body explores the fraught medical history and forced stigma of difference through the lives of three intersex Americans

A balloon pops with pink confetti. A mini rocket shoots blue dust. A gun shoots a box which contains pink explosives. Every Body, a new documentary following three intersex Americans, opens with snippets of a bizarre, if familiar, ritual: gender reveals, in which people surprise friends and family with a shower of pink or blue. The videos all includes screams of joy – a series of people conflating the celebration of new life with a confirmation of the gender binary.

As Every Body powerfully contends, such an emphasis is not only irrelevant to young children, but inaccurate to the vast spectrum of human bodies. It is possible, explains the intersex expert Dr Katharine Dalke, to be a biological female with testes, and a biological male with a uterus, among many other variations between the two sexes. About 1.7% of humans are intersex, an umbrella term for any variation within a person’s sex traits, including genitalia, hormones, internal anatomy or chromosomes. (For comparison, that’s about the same percentage of people born with red hair.) Some traits are present at birth, while others develop naturally over time, and 0.07% of people – or about 230,000 Americans – possess traits so significant they may be referred for surgery.

Not that most Americans are aware of such differences, owing to misinformation about intersex people, a near-desert of representation and widespread pressure on intersex people to keep quiet. “I’d say, by and large, 80-90% of people probably could not comfortably tell you what it means to be intersex,” said River Gallo (they/them), an intersex activist who appears in the film. “More people are using the LGBTQIA acronym, but still – if you were to ask people what the ‘I’ stands for, it would be ‘what does that mean?’”

Every Body, directed by Julie Cohen (the Oscar-winning co-director of the 2018 documentary RBG) follows three intersex awareness advocates and activists: Alicia Roth Weigel (she/they), a political consultant and writer who lives in Austin, Texas; Sean Saifa Wall (he/him), a Bronx-raised doctoral student living in Manchester, England; and Gallo, a New Jersey-bred actor and film-maker now based in Los Angeles. All three were subjected to non-consensual, medically unnecessary surgeries in their youth – long the standard medical treatment for intersex people, under the assumption that life within an artificial sex binary would be preferable. (The United Nations condemned such irreversible procedures , conducted to “normalize” genitalia under the guise of preventing the shame of living in an “abnormal” body, in 2013.)

And all three grew up with an expectation of secrecy, shame and stigma – their difference framed as a potential threat to future happiness and security, rather than as part of a community or collective history of intersex people. “We get spoken to in these hyper-medical, pathologizing terms that keep us thinking that there’s something wrong with us and makes us reluctant to ever find anyone else, because there’s this part of you that’s inherently broken and shameful,” said Weigel, who was born with a vagina, sans uterus and tubes, with internal testes and XY chromosomes. “What would then inspire you to ever look for other people like you?”

“An important piece of the film is that it’s not just a sob story, that there’s a lot of joy interspersed in there,” she added, referring to growing into her identity as an intersex person and evolution as an activist. As a youth, she was told her condition, complete androgen insensitivity syndrome, was a problem to be managed, and underwent surgery to remove her testes, an irreversible procedure requiring lifelong hormone replacement therapy and other complications, such as osteoporosis; now 32, she did not realize she was intersex until she was 27, after reading a profile of the Belgian intersex model Hanne Gaby Odiele .

Gallo, 31, was born without testes, and was not informed of their condition until age 12. They recall years of poking and prodding, a handling of their body with fear and trepidation. At age 16, they underwent surgery to implant prosthetic testicles. “At the time, I just thought it was medically necessary because that’s what doctors told me,” they said. Their parents, immigrants from El Salvador, followed the lead of doctors; however well-intentioned, the message was: you need to be fixed. It took years, as Gallo explains in the film, “to face how angry I was”.

Oftentimes, as Every Body explains, doctors advocated for care rooted in rigid gender ideals under the assumption that it was in the best interest of the patient. But such decisions were “a misapprehension of what might be the best way to handle this complicated situation”, said Cohen. In one scene, Wall reviews his birth records from 1979; for sex, an obstetrician initially checked a box titled “ambiguous”. Though born without a uterus, Wall was assigned female for “the emotional well-being of the parents”, according to the record. At 13, he underwent a gonad removal surgery; according to Wall, his mother consented to the medically unnecessary procedure after doctors inaccurately led her to believe they were cancerous.

Wall had other people in his family with the same variation, but no one talked about it. “I think people were deeply scarred,” he said. “There was a lot of shame, a lot of silence.

“I would’ve given anything as a young, queer, intersex, eventually trans person, to meet another queer person,” he said. “I think about myself as a young person and not seeing those role models, not seeing those people who I can aspire to be.”

The version of medical practice experienced by Wall, Weigel and Gallo – the secrecy, the surgeries at a young age, the belief that picking and sticking to one sex would produce the optimal result – largely stems from the teachings of one physician. The middle section of the film delves into the teachings of Dr John Money, a psychologist and researcher at Johns Hopkins University, and the tragic story of his most infamous medical experiment. In 1967, Money learned of the existence of two infant twin boys in Canada, one of whom had his penis critically burned during a botched circumcision.

Money, a proponent of the “theory of gender neutrality”, which assumed gender identity was imparted primarily through social learning, recommended that the boy, then named Bruce Reimer, undergo sex reassignment surgery to female at the age of 22 months and be raised as “Brenda” alongside his twin brother, Brian, as the experiment control. In later interviews, Reimer recalled that he never believed he was a girl; at the age of 14, he learned the truth of his surgery and went back to living as a boy named David.

David Reimer was not intersex, but the “success” of his “treatment” with Money became the basis for the “optimum gender rearing model” for medical treatment of intersex people. The film includes footage of a 1999 news interview with an emaciated and haunted-looking Reimer, in which he expresses hope that non-consensual surgeries on people will end. He died by suicide in 2004. The “experiment”, though decades-old and debunked, “actually had led to decades’ worth of mistreatment of intersex people that is in some cases still going on today, that certainly is impacting a lot of other people that are alive today”, said Cohen.

Wall, Weigel and Gallo all advocate for legal measures to prevent the legacy of “optimum gender” treatments: unnecessary, nonconsensual surgical procedures to assign intersex youth to a binary sex. In a cruel irony, intersex people have been lumped into the recent spate of state-level anti-trans legislation barring surgery from minors’ gender-affirming care; the same measures that ban the procedures sought by trans youth include carve-outs for pediatric intersex procedures. “These bills are including intersex people and erasing intersex people, which is a tragedy,” said Gallo. As Weigel put it: “We are literally erased from the conversation about our own erasure.”

With footage of Weigel telling her story to the Texas state legislature amid efforts to pass anti-trans legislation, or Wall participating in an art exhibit celebrating his body, or Gallo leading a protest against a hospital still performing surgeries on intersex youth, Every Body gestures to a larger, national fight for bodily autonomy. “Just like trans rights activists, and for that matter reproductive rights activists, the intersex rights activists are just asking to be making the decisions themselves that relate to their own bodies,” said Cohen.

Crucial to that fight is recognition. “A documentary like this is – I was going to say ahead of its time, but it’s the right time,” said Gallo. “It’s overdue.”

Every Body is out in the US on 30 June with a UK date to be announced

• Documentary films

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