All language subtitles for Transgender.Kids

This programme contains scenes which
some viewers may find upsetting.

Do you think you are happier as
Camille or Sebastian?

Camille.

How do we get this thing off?

But Sebastian was happy too, wasn't
he?

No. You don't think so?

No.

Why not?

He was not happy.

What wasn't happy about him?

He did not like...

He wanted to be a girl and then he
did not like his name

so he changed his name.

# Whoa-ah! #

'For the last several months, I'd
been meeting children who say

'they were born into the wrong body.

'San Francisco,

'a leading light in gay rights,

'is now blazing a trail for the
transgender community,

'helping boys and girls at ever
younger ages to transition.'

What is that little thing in there
doing?

Making it so I don't go through
puberty.

And why don't you want to go through
puberty?

Because I don't want to be a girl.

'Intervening early allows them a
chance to create the bodies

'they feel they always should have
had,

'but it's also fraught with
difficulties

'and raises questions about how old
a child should be

'to make changes affecting his or
her whole life.'

She'll say that she wants a vagina.

She uses the V word?

Yeah. Yeah.

And what do you say?

Erm, I've just been telling her
that when she's old enough

and she's ready to make that
decision

that if she still wants one, erm,
that she could have one.

Smile.

'I was with Casey and Eduardo and
their child Camille...'

Be careful. Stay out of the road,
Camille. Come this way.

'..Who until recently had been
called Sebastian.'

Oh, my God, that was cool.

'The family were about to have their
first appointment with

'Dr Diane Ehrensaft,

'a clinical psychologist

'specialising in transgender
children.'

And you can make a story in the sand
tray of anything you want.

It's kind of like having a dream or
telling a story in your head,

but you get to do it with all the
things here,

and then we'll take a picture of it.

To put it simply, what brings you
here today?

Well, we have a child who has asked
us

if they can be a girl and we
want to make sure that we're

fostering the best approach to make
it a smoother ride

and to kind of know that we're doing
the right thing.

When did this request first come up?

Not too long ago. Erm, we were
just sitting on the couch

and Sebastian asked me if...

"How do I become a girl?"

And we had pretty much... The process
with us had started in October

when Sebastian had requested an
all-girls Halloween costume.

Camille, did you want to tell us
something?

It was Monster High. Frankie's
my favourite.

Oh, OK. I'm going to spend a
little time with Camille.

The first thing we're going to do is
draw, OK?

Mm-hm.

So, Camille, the first thing,
I'm going to ask you just to draw

a picture of a person.

That's me.
I can draw myself on here.

That's me.

So when you were born, a long time
ago,

your mummy and daddy thought they
had a little boy named Sebastian.

Right now, how would you describe
yourself?

A girl. Not a boy. I'm a girl.

You're a boy and a girl but you'd
like to be a girl and not a boy?

Not a boy and a girl any more.

Not a boy and a girl any more.

Not transgender.

And not transgender but, erm,
so what shall we call it?

Erm, girl.

OK.

Bye, Diane.

Goodbye, Camille. I hope I'll see
you again soon.

How did that go, as far as you were
concerned?

As far as I was concerned, it
went quite well.

I mean, can you say at this point
that she is transgender

and was, as it were, born in
the wrong body

and will grow up to be a woman?

I would say it lines up in that
direction. So here's what I saw.

This is a child who's been insistent
and consistent and persistent

since age 18 months about being
gender non-conforming.

But what is not there is a child who
from age two,

when then Sebastian, he
developed language,

was saying, "I am a girl."

Do you sometimes see that?

I sometimes see children as young
as between age two and three

saying things like...

In response to, "Honey, such a good
girl."

"No, Mummy, boy," and it starts
there, so the answer's yes.

'Aged just five, Camille was on the
cusp of a decision that could

'change her entire life.'

Hello. Hello.

Can I come in?
Come on in.

A change of outfit! Look at that.

Did we have a nap?

Did we have a little rest?
Yes.

A tiny one? Tiny.

What's striking looking around
is all the photos of Camille

as Sebastian.

Mm-hm. Yeah.

Looking very boyish.

Yeah. Yeah.

And how old... I mean, I guess
it's a he in this.

Is that right or do you read it
back into the past and say,

"Well, it was always a she,
we just didn't realise"?

Yeah.

I think that's what...
Where we're at now,

is that it's always been a girl and
we just didn't realise it until now.

Uh-huh.

And, to me, that one's a tough one
because that was the last time

we captured Sebastian.

In honest opinion, that was the last
time

we saw that, you know, spiky little
hair and the cute little clothes.

I think it was really, for me,
kind of saying goodbye.

And I don't... And it's not a bad
thing in my mind.

It's kind of like, "Ah! That was a
phase. We're done."

What is going on? Camille, what are
you doing?

Putting lipstick on.

For how long have you been
using Camille

and the she pronoun at home?

A month. A month.

Just a month? Yeah.

So this is all really new to you,
this.

Very, very new. It's... We get
confused quite often.

How are you feeling about it?

I'm fine.

I... It's just hard getting used to
going from one to the other.

It's difficult. It's really
difficult.

It's not an easy thing to do.

Do you find it confusing ever?

Yeah. Yeah.

Yeah, I think that's kind of par for
the course sometimes,

and I think it's that way with
kids a lot but, erm,

definitely with discovering who you
are as a person.

Trying to figure out what is solid
and consistent and dependable

and cater to that and support
that.

It is difficult and I'm not going to
lie, it's not easy,

this is not a very easy thing.

We may have had not so bad of
a time at this,

but it's not an easy road to travel.
You...

It's gut-wrenching, honestly.

It's a battle dance.

A battle dance?

Yes.

You have... You have to dance as
best that you can

and you have to do this.

I don't even know if I know what
a battle dance is.

Does that mean that...

You have to dance the best.

It's a competition?

Yes.

MUSIC: Bad Romance by Lady Gaga

'There is a growing trend in America
towards enabling trans kids

'to transition as early as possible.

'San Francisco's Benioff Children's
Hospital is spearheading

'the approach, under the direction
of Dr Ehrensaft

'and Dr Steve Rosenthal.'

So do you prefer boy pronouns or...?

Like "he" or girl pronouns
like "she"?

I just want to do it the way you
want it.

'Kids identified as trans can hold
off puberty using blockers.

'Later, by taking hormones, their
bodies can

'mature in the direction of the
gender they feel they really are.

'In some cases, the final step is
surgery.'

I think hopefully by... When I turn
18,

I'll be fully transitioned, meaning,
like, I'll have bottom surgery,

do you know what that means?
Uh-uh.

So I'll have surgery that will, erm,
change my penis into a vagina.

Uh-huh.

What's he doing?

A month ago he had another implant
put in.

What do you mean by an implant?

Erm, she is on a puberty blocker and
he had...

Hi, Shane. Louis.

Can we see that, Shane?

Yeah.

It's under the skin there.

There's some stitches dissolving.

Shane, as you understand it, what is
that little thing in there doing?

Making it so I don't go through
puberty.

And why don't you want to go through
puberty?

Because I don't want to be a girl.

You don't want to? No.

Do you know what the next step is on
the

medical side of the journey?

I want to go on T, or testosterone,
but I have to wait until I'm

14, so that's two years, and this
should last for another two

years, so hopefully I'll be able to
just transition after that's done.

Transition meaning?

Get... Go on testosterone.

And what would that do?

It would make me go through guy
puberty

and my voice goes deeper and stuff.

Hello, hello...

'A 14-year-old trans girl had
come in for a check-up.'

Good to see you again.
Nice to see you.

I'm Louis.

Hi. Isabel. Hi, Isabel.

Hi, Louis. Gerry. Gerry.

Hi. Louis. Hi.

What's your name? Nikki.

Nikki.

At the last visit I saw her, I did
increase her oestrogen dose

and so she has, erm... She does have
one breast bud,

so she's had some response from that
dose increase.

When girls develop breasts, it very
frequently starts

on one side and then the other side,
so this is normal.

Yeah.

Do you enjoy coming here, Nikki?

Erm, yeah. Yes, I do.

What do you like about it?

Erm, that, like, every time
I come here we're, like,

making, like, a step forward, I
guess.

I guess, like, I'm just really
excited about, like, the future...

Like, you know, and erm...

Yeah, I just can't wait.

Ah, that's wonderful.

'For the first 13 years of her
life, Nikki had been Nick.

'Last year, Nick had come home from
school

'and found his mum watching a TV
programme about trans kids.'

So Nikki had seen this TV show. Were
you watching it with her?

I was really debating... And I don't
know if it's mother's intuition,

I was really debating whether or not
to allow her to watch this show

because I guess I knew deep down
inside what was going to happen next

and within 15 minutes, you were
like, "That's me," and I'm like...

She said that out loud?

"That's me." Yeah.

And I'm like... Inside of me, I was
like, "Oh."

Nikki, for you, as soon as you saw
the show you thought,

"That's what I am. That's who I am"?

Yes.

Was it a...

What made it important to you to do
something straight away?

Probably because, like, I was
starting puberty.

Like, my male puberty

and I knew it was going to, like...

Well, I knew it was going to get
worse for me

because I didn't want to start male
puberty and it would be, like,

really harder for me, like, to do,
like, the treatments and I just

wanted to make myself look like a
girl and I just...

Yeah, I just really didn't want
any...

I just really wanted to start with it
fast.

This has all happened quite quickly,
hasn't it?

Yes.

There's two things you can do here.
I mean, you can...

As a parent, you can be in denial,
which to some degree we were.

You can say, "We can fight it."
You know, we could say,

"No, this is not the way you
were born. You were born a boy,"

and force that down that path.

There's a good chance Nikki would
have conformed to some degree,

for a period of time.

Nikki would have become an adult,
and this happens

all the time, right, where people
become adults and really still

feel this way and then they learn to
transition when they're adults.

Life is a lot harder, in my opinion,

when, as parents, we fail to see
that and I see it

as protecting the life of my child,
in a way, and taking that right

fork and that's why I justify what
I've done here, as a father.

I guess what you're doing here
that's a little

different from some other

comparable places is doing
interventions relatively early.

Is the risk there that, you know,
they may get it wrong in some sense?

The child may not... May think he or
she knows who he or she

really is but then five years, ten
years on,

having taken the intervention, may
change his or her mind.

Is it a risk?

Let's call it a possibility, so with
that possibility then we'd

think the most important thing is
the same exact idea -

to find out who you are and make
sure

you get help facilitating being that
person then.

We have one risk we know about.

The risk to youth when we hold them
back.

You don't...

And hold back those interventions -
depression, anxiety,

suicide attempts, even successes,
and if we can facilitate a better

life by offering these
interventions, I weigh that

against there might be a possibility
that they'll change later,

but they will be alive to change, so
that's how I weigh it on the scales.

'I was with Casey on the way to
picking up Camille.

'It was the first day she'd been
allowed to wear a dress to school.'

Mummy!

Hello there. How's it going?

Good. High-five.

Finally I got to see you.

How did it go?

Good.

Look at you! What a nice dress.

What would you want?

I would like regular chocolate,
please.

Whoa! Oreos and sprinkles! I want
those Oreos and...

Was it any different wearing a dress
than it is normally?

It was actually easier getting her
dressed today

because it was something that she
wanted to wear.

Did it feel like a big step for you?

It did. I was kind of worried
about the reaction from

other parents, cos I know people are
going to be gawking

and just looking at Camille a little
bit different.

I mean, you don't think Camille's
still exploring?

Trying different things?

I don't know.

Honestly, it's been such a quick
journey in the last one year

that we've been going through this
that it doesn't feel like

there's a lot of exploration left
now.

It's big leaps and bounds forward.

I don't think there's any more
exploring.

I think this is... This is Camille
and this is her coming-out party.

'Casey had told me that

'Camille's transition had caused
a rift in the family.

'Back at home I had some more
questions.'

You were saying that your father...

Mm-hm.

...is, erm, is a bit of a sceptic on
all this.

I think that they think that
she's too young

and that we should wait till she's
older to make her decisions

that could affect her life.

He's OK with her wearing dresses
around the house

and stuff like that?

Yeah, inside the house is fine but,
you know,

out in public where other people
could see.

And what about changing the name and
changing the pronouns?

They're not happy with that at all.

They think that's a big step for

a five-year-old to have
to undertake.

Does he call Camille Camille or
Sebastian?

Sebastian.

Sebastian, him, he.

Does that bother you?

I don't...

Yes and no.

I mean, I know it's hard.
Like, a lot of people can't...

It's hard to remember to do it,

but when you're blatantly ignoring
the fact that, you know,

we're making this transition and
you're not listening

to what we're saying, that's
disrespectful and hurtful.

So your dad's position is basically,
it's Sebastian, it's a he,

and just give it time and see where
you get to.

What I say is, it's very different
day to day when you're at home with

Camille, that it's not just...

This is not us putting it on our
child,

putting so much responsibility on a
five-year-old to decide what to do.

All these big life-changing things.

These are things that she's coming
to me and saying.

I'm not the one who's, "Are you a
girl? Are you a boy?"

No, this child's coming to me
and saying,

"I am a girl and I want to be a girl.

"How do I become one?"

'Some trans people become so unhappy
with their bodies

'they experience dysphoria, feelings
of anxiety and depression.

'For older kids and adults, there is
the option of surgery.

'Among the leading surgeons in the
field is Dr Curtis Crane.

'He offered to show me some of his
handiwork.'

Can I join you over there?

Oh, please. Yes.

This is a thigh as a donor site,
giving quite a large phallus.

That's about six and a half inches.

Here's a forearm as a donor site,

giving a five and a half inch
phallus.

I'd be hard pressed to see this
patient walking around a

locker room and find someone that
wouldn't say, "That's not a male."

Hello.

'One of Dr Crane's patients,

'17-year-old Amaya, had come by for
a check-up.'

Hello.
Good to see you.

Good to see you again.

Well, very good. So it's been a
while since your surgery.

Almost a year, yeah.

Almost a year and how have you
healed?

Pretty good. I haven't really been
doing much for the scars themselves

but I mean, they're healing pretty
well. Yeah.

The scars, you know, they take
a little while to go away and

they're going to get better whether
you do anything for them or not.

It's pretty amazing. All of our
friends are saying it.

Well, thank you. You look fantastic.

Pretty good. Yeah, look at that.

Like I said, they're still there,
obviously, but...

No, they're fading very nicely.
Yeah.

There's a little bit of redness
under here.

Yeah.

And will that gradually fade,
Dr Crane?

Er, possibly. You know, a scar isn't
totally mature for a year

so we're just a little bit before
that and then

if it's not to Amaya's liking,
there's options of

getting a little bit of laser to
take out some of that red.

Could do that?
Yeah, it's very easy.

So is that it for you, surgery-wise

or have you thought about or talked
about bottom surgery?

For now, that's it. I don't see
myself going that route for

a while and I don't know how I'll
be in five, 10, 20 years.

But for now, this is all I really
needed.

You don't have dysphoria to do with,
er, downstairs?

No.

Definitely not as much as upstairs.

How old were you when you changed
pronouns?

That was only in the last year or so.

In the last year or so?
Yeah.

So were you... Before you grew
breasts you weren't having

dysphoria to do with your, erm...

Er, no.
..your body?

Not that I can remember, at least.
It was really that, you know,

sixth, seventh grade when I was
11 or 12 was really

when I started to develop and when
all of those dysphoric issues

started to come up and then
progressed from there.

And what was that like?

It was tough. It definitely
kind of hurt my own mental health

a little bit, I guess I could say.

Why?

It didn't make me want to be very
social.

It kind of gave me a little bit of an
anxiety issue and

it just didn't help anything in terms
of me going out in public

and having to deal with it.

It definitely made me have a bit of a
struggle, in that sense.

It just didn't feel like it was you

or you didn't like the way it
felt or looked or...?

I didn't like mainly the way other
people were perceiving me

and so it was a lot of how I was
perceiving myself plus

how others would see me just on the
street, people that didn't

know me necessarily and how they
would think of me.

'The path of transition, rarely
easy, becomes even less clear

'when parents don't see eye to eye.'

Hello.

CAT MIAOWS

Hi. Hi.

Joy? Yes. Louis.

'I was about to meet a child whose
parents'

'divorce had made her true gender
a matter of dispute.'

You've got a daughter called
Crystal. Yes.

Is that... Would you...?

Well, she was born Cole.

But she was born Cole, with
male anatomy?

Correct.

At what point did you switch to
using, erm, female pronouns?

We go back and forth, and it's
difficult because at school

or in places where she's a he,
we can trip over ourselves.

At school it's he, it's Cole?

Uh-huh.

Er, and it's Cole and then at
home...

At home...

Here, it's... She.

...Crystal and she?
Er, yeah.

Is there a reason you haven't
transitioned at school?

Because her father and I,

I don't think see this from the same
perspective.

So Crystal or Cole hasn't expressed
a clear preference, it sounds like.

She has said, privately with her
therapist, that she is a girl,

erm, almost 100%.

When I've sat down and had private
conversations with her and said,

"Would you ever be interested in
hormones, blockers,

"they need to be started soon,
right?"

So, erm, you know, I've had to have
more serious conversations.

"Do you... Let me explain to you how
your body's going to change.

"Do you want to stop that? How do
you feel about it?"

Erm, and her answer is,

"I can't... I can't do that, Mummy.

"L have to be a boy,"

and I enquire further as to why and
she says,

"Because I'm Poppy's only son and it
would destroy Poppy."

How you doing? Can I say hello?

Yeah.

Louis. What's your name?

Crystal.

Crystal. But you've got another
name. What's your other name?

Cole.

Do you have one that you like
better?

No.

Your mummy was telling me that one
is sort of for school,

is that right?

And one is what, more for home?

So that's different.

Is that fun having two names?

Kind of.

But what about maybe going outside
and, erm... Do you like to pogo?

OK. I'll just have to get on my
shoes.

OK.

Hang on, no hands? Isn't that
dangerous?

No.

Two hands, one leg. I like that.

How many can you do?

I have a small record.

Go on, let's see you.

I just fall off.

So what do your sisters call you?

Er, either Crystal or Cole.

Either one? Maybe I should ask them.
What's your name?

Rebecca.

I call Crystal Crystal

and sometimes Cole when, erm,

when she wants to be called Cole.

Do you think of them as a boy or
a girl?

Cole usually is a boy and Crystal's a
girl.

Doesn't that get confusing?

No.

So how do you decide?

I decide on what clothes I'm
wearing, like, that day.

Like, if I want to wear these
kind of clothes, I'm a girl.

If I want to wear, like, those kind
of clothes, I'm a boy.

Like, it depends on, like, what I
feel like doing that day.

And do you prefer one?

No, I don't.

And do you think at some point
you'll decide one way or the other

or do you think you might just keep
kind of going back and forth?

I'll just decide one day.

You think you will?

'I was making a follow-up visit to
Nikki and her family.'

Hi, Gerry.
How are you?

Yeah, good. How are you doing?
Good to see you.

Bit of an early start. Yes.

'Since our first meeting, four
months earlier,

'I'd been curious about the progress
of her transition

'and its impact on the rest of the
family.'

Hi, Nikki. How are you doing? Nice
to see you.

I'm good.

So you're allowed to wear make-up to
school?

Yeah, but I don't wear that much,

cos I don't like wearing a lot of
make-up,

cos it's really, like... It takes
for ever to put on a lot.

Since I last saw you, your hormones
were increased.

Yeah, they have. Like, I'm starting
to see a lot of changes

and pretty much...

Cos, er, last time when I saw you
GUYS

was when I just, like, started
on it, I think.

Yeah.

Like, it was a month I started
in on it,

but I've been, like, seeing and,
like,

feeling a lot of changes to that.

Go on.

Erm, like, erm...

Well, I've been, like, getting...

Well, I've been getting a lot of mood
changes.

Because a mood's brought on by the
hormones, do you think?

Yeah, it brings you, like, certain
feelings that you don't

want to go out into the world because
it's who you are

and just get, like, so scared.
I don't know.

I started, like, feeling that when I
started hormones.

I started getting more, like, sad
and emotional a lot of the times.

And there are maybe things that...

When you're in a mood that...

that are bringing you down a little
bit?

I just want to, like, stay away from
everyone.

At school?

Yeah, and sometimes I don't, like,
really want go back to school.

Like, they don't get it.

They call me, like, faggot, like a
fag and stuff and, erm, yeah.

Do you like what you see when you
look in the mirror?

Yeah.

I mean, I like it.

Erm, I wouldn't exchange it for
anything.

This is Daniella.

Hi, Daniella. I'm Louis. Hi.

How do you do? Good.

What's this been like for you?

Erm, it's...

It's been an experience.

It was hard at first,

erm, but then I really got used to
it

and then I just really learned
to, like, love her.

You had a brother, or thought you
had a brother, called Nick.

Yeah.

Who you were quite fond of, I
imagine.

I didn't want to accept the fact
that she was transitioning.

I didn't. I just said, "No. Like,
I'm not OK with this."

Why not?

Erm, because it was kind of like

I was the only girl in this family
and I wanted to be the first

to wear make-up, the first to do all
the girl stuff, erm,

and now I wasn't going to be because
she's older than me and she's going

to be doing all that stuff first
and I just...

I've been living my whole life with
Nick and I really...

I didn't want anything to change.

Did you know that she felt that?

Yeah, I kind of did.

Erm, it was really, like... She was
really confused

when my mum told her.

It feels quite normal now, does it?
Yeah.

Yeah. It's just Nick is gone
and I'm OK with that now

and Nikki is, like... I don't know,

I just feel like she was Nikki her
whole life.

Bye, honey. Bye.

See you later.

Bye.

One thing that had come up when
I was talking to Nikki was that,

erm, some of the kids weren't
fully accepting.

A lot of her peers don't
really get it.

They don't really understand
what transgender means.

They think she's gay. Mm-hmm.

Erm, and it's really hard for Nikki
to explain that to them

because she's so quiet

and she doesn't like to create,
like, problems or get into arguments

or... Not that she would have to,
but she'd rather just let it go.

A lot of that will be alleviated
moving forward

because we have made movement.

We've gone through the court
to officially change Nikki's name.

Did that feel like a big step?

Yes, it was a big step for...

I mean, for her too,
she was very happy.

I was... It was bittersweet for me

but I know I'm doing
the right thing.

As a matter of fact,
we just got her

new birth certificate two clays
ago and the first thing

she pointed out was her gender,
and she was very happy.

Bittersweet for you in what way?

That I don't have my son any more.

It's...it's hard sometimes.

You know, I have to refer...
I have to look... I'm sorry...

There's always, you know,

there will always be a sense of,
erm, of grief. Even though

it's not a total loss, you,
erm, you go through that

and you have a, erm,
for ever memory, you know?

Because anybody that has children,
you had them as babies and you did

things when they were little
and you're not going to...you can't

just erase those memories. And many
times they were boy memories

and erm, you know, that... You know,
that's not going to go away.

Isabel, how would you explain
the sadness?

I don't know,
I guess just that I won't...

You know, like, I often wonder,
like, what would Nikki be as Nick

as a teenager, you know? I know her
life is going to be a little harder,

you know, she will always have
something that she has to overcome,

you know, erm, and it...

Her future scares me a little bit,

I'll be honest.

I was visiting the reconstructive
surgeon Dr Crane again.

This time I was hoping to find
out about his more ambitious

surgeries and also get
a perspective on childhood

transition from his older patients.

Good to see you. Good to see you.

Another day in the office.

Yes, it is.

You've got some
candidates coming in.

Yes, we've got
a lot of patients today.

Louis. Nice to meet you, Louis.

What's your name? Ketch.

Ketch? Yes.

So tell me, erm,
what brings you here today?

I'm doing a pre-op appointment for,
erm, I guess the final stage

of my phalloplasty, doing testicular
implants and glansplasty.

So you've already had a...
a shaft made?

Yes.

And how did that go?

It went really well, actually.

It was a lot different
than I expected it to be,

but, erm, the results are amazing.

I'm very happy with it and it...
it's, erm, what's the word?

Useful.

That's great.
How old are you, Ketch?

I am 36. I'll be 37 in five days.

And you were assigned
female at birth?

Yes, yes.

Which is hard to believe,
looking at you.

That's awesome.

Which I guess is a good thing,
right?

It's a wonderful thing.

I've been meeting kids mainly
who are trans

and in the process or figuring out
whether they are trans,

and some of them
are transitioning as kids

and taking pubertal blockers
and cross-gender hormones.

Uh-huh.

Looking back, does it seem to you
that that's something you wish,

erm, you'd done earlier?

Oh, absolutely. Really? Absolutely.

When I was a kid, I'm like...l felt
that was a missing part of me.

You know, erm, going to the bathroom
and having to sit down or

to stand up, that, you know,
that really bothered me

cos in pre-school, the kids would all
go to the same bathroom.

You know, you have the teachers
there supervising and I'm like,

"OK, so why's he standing? Why don't
l...? I have to sit down," you know,

and so I would for years and years
and years find a way

to try to fix that, you know, so...
How?

Erm, just try different devices to,
you know, stand and pee.

Correct me if I'm wrong, but it's
more just the act of wanting to

stand and pee maybe even more
than...than the sexual side of it.

Oh, it's definitely more than
that because after I, erm,

I had top surgery, it still...
I still wasn't complete, you know?

Going to the beach and,
you know, feeling like

somebody's looking at me like,
"Oh, you know, you look like a guy

"but, you know..." There's no bulge.

Yeah, exactly.

Literally that?
Literally, yes. Yeah.

I'm out at the beach and...

Yeah.

You've got...you know
it's something that people,

if they're looking that way...
If they're looking.

...there'll be something there.

Yeah, definitely. It's functional,
it's very functional, so...

It feels good? Yes.

Hello. Hi.

Hi. Louis.
Hi, hello, Minerva.

You must be Minerva. How're you
doing? It's good to meet you.

And, Tristian, yes. Yes.

Nice to meet you.
Pleased to meet you.

What kind of questions can
I answer for you?

Specifically, I mean, I've known for
sure, like, I want an orchiectomy.

I've been hearing
things from a friend of mine

who I think recently got done
here, like, a kind of...

She was calling it a
no-depth vaginoplasty.

An orchiectomy is the removal
of the testicles

and phallus as well?

No, just testicles.

And, erm... But I heard you say
a no-depth vaginoplasty.

Uh-huh. Meaning?

It's essentially, erm,
you construct a vulva

and a clitoris, erm, but the vulva
doesn't lead to anywhere.

There's a lot of options. You know,

I very much tailor the care of my
patients to exactly what they want.

I... Basically I'm a...
I see my job as a counsellor

and she can have anything.

And so at this point... We said
this at the beginning but you have

a pretty clear idea of what you...
what the destination is for you?

Yeah. Financially, I think...
I think I'm going to

spring for the orchi,
I think, right now.

I'm not... Which is a, it's...
It's a good middle ground, I think,

because that is definitely something
that I want and it doesn't preclude

any other options if, you know,
what I need changes as I grow older.

So then you're in a kind of,
sort of, erm, middle stage,

is that...?
I mean, I could, I could...

I'm not going to, you know,
make guesses

as to what me in 20 or
30 years would want, but, erm,

for now I would be absolutely happy
with an orchiectomy.

And keep the phallus as is. Yeah.

There's no dysphoria around
her phallus, so why surgically

remove it, you know? We're trying
to solve dysphoria, we're not

trying to put everyone in a box that
the rest of society believes in.

Are you in a relationship,
may I ask?

Mm-hmm, this is my girlfriend.

OK.

Nice to meet you.
Nice to meet you too.

And so, Tristian, may I ask you,
how do you self-identify?

Well, I'm also a woman.

And have you had any
surgeries at all?

Yeah, I did experience much more,
erm, dysphoria and emotional pain

around my genital configuration
than Minerva does,

erm, so I did have a...

full reassignment or
reconfiguration, erm, last summer.

How's that working for you?

It's, erm...it's working out
pretty well.

It's, erm,

it's been a lot better,
a lot better since.

Feeling good.

He's going to make it.
Yep, you're going to make it.

Oh, nice!

I was back with Crystal.

Unlike her mum, her dad Erik
has been reluctant to embrace

Crystal's female identity
and so this was a Cole day.

Oh, too much.

That one's going in. There you go.

Well played.

So now you can try
and get a hole in one.

Yeah, free game.

So we met Joy and we talked to her
a little bit about Cole

and she sort of has
a point of view on that,

is that the best way of putting it?

Yeah, I look at it a little
bit different.

I might be a little bit more
conservative

and approach things as, you know,
Cole or any of my kids,

you know, might want to have...
are going to have certain things

that they want to do and, you know,
I have limitations on that.

Do you feel you're putting up
a little bit of resistance?

You know, in the sense that,
are there times when Cole might say,

you know, "I'd like to buy some
make-up," or do this and that,

and you might say, "Well, I don't
think that's such a great idea."

I think he's clear,
kind of, on what he can

and can't do at his mum's
and kind of what,

how he...what he can and can't do
when he's with me. Erm, I mean...

But I've had the conversations
with him that, you know,

"I don't want to prevent you
from being who you are,

"I just feel there's a time and a
place for who you want to be

"and how you want to express that."

If he truly were transgender,
if you thought you

were seeing that, would you...?
What would be your view then?

I don't want to be in the position
where I've made a decision

and then a few years later,
it's like, it was something

that he may not have wanted to do.
Or at least that his mind-set,

when he's 18, 20 or whatever,
you know, "I didn't want this."

And I don't want to have to carry

that burden that I made that choice
for him and then he changed it.

Whoa, and it just floats?

'Back at Mum's house, I was hanging
out with Cole-slash-Crystal.'

Oh, my God.

We didn't really talk about what
I should call you, either.

Crystal.

Crystal. Mm-hmm.

So, is this your area?

Yes. Talk me
through what you have in here.

OK, so, this is practically my light
and it has, like, little things,

thingamajiggers in here.

This is my perfume.
I don't know where the top went.

This is one of my favourite movies.

Spirited Away. Yeah.

Oh, yeah, that's
a Japanese animation.

Yeah, it's by Miyazaki and then...
I'm really into Japan too and

so this is my kimono
and it's really pretty.

And it's really silky too, so...
Does that feel nice?

It feels very nice and sometimes
I sleep in it. And then this is

my very, very special dress,
and it's really good

and I really like it.

When do you wear that one?

Well, I just got it, so I haven't
had the chance to wear it yet.

And how do you see
yourself in that way?

I don't know.

I mean, cos most people would say
I'm either a boy or a girl,

some say they're
somewhere in between.

I'm somewhere in between.

Do you feel pretty happy?
Are you happy?

Do you think you
feel like you're happy?

Yeah, I'm happy, I have a fine life.

And as far as...
Because, you know, we met your mum.

It's joy, isn't it? Uh-huh.
And then your dad is Erik. Uh-huh.

And I get... From meeting
both of them, I get the impression

that you do more of the girl type
things when you're with your mum

and you do less of them
when you're with your dad.

I would do, like, things that,
like, are, erm,

something that a boy could do
and a girl could do too.

Do you have any sense of whether
when you're grown up

you'd like to be Crystal full time?

Actually, when I grow up,
I'm thinking of being Cole.

So not like Crystal, like this.
This is, like, practically till

I'm, like, out... When I'm
practically out of high school.

When you think of yourself
as a grown-up,

do you think of yourself as more
of a man or more of a woman?

A man. You do?

Uh-huh, and that's...
I think about life like...

Oh, well, I don't know why,

but I think of having
a wife and two children

and like this... Like, you know
how in Japan there are

these really weird houses,
like with the pointy-end roofs?

I want a house like that because
I'm really into Japan now.

I love their clothing and their
style and everything and I love...

Silk?

Yes. Well, silk actually
came from China.

Good point.

So, how have you been doing
vis-a-vis Cole-slash-Crystal?

Feeling like we don't need to make
any decisions right now

and that, erm, we're not -
at this time, anyway -

going to really pursue
any kind of hormone,

hormone blockers

or anything like that.

Do you think it's possible
you were wrong before about

what your child wanted?

I don't think...

I don't...l don't think
I was wrong about what she wanted.

I think what's changing is being
able to be who she is as Cole

and being accepted that way.

She's Cole and when she's Cole -
a boy at school, right? -

she can still have her mannerisms

and her likes and her dislikes
and all of these things,

and she has friends who love
that in her and, erm,

she's happy and doesn't have
to take on the role of a female

to be who she is.

In her bedroom just now, she, erm...

she or he was saying that he intends
to be a man when he grows up.

I think that he, being Cole,
isn't all that miserable

and quite honestly, that's the easy
road and I hate to say that,

but that's the easier road.

So if she can be happy in that
skin as a boy...

...erm...

...that's the preferred route
for, you know, safety.

And socially, unfortunately, it's
still that way, so I support that.

Having spent time with both Cole

and Crystal, I was still unsure as
to which was the truer identity...

...whether she'd had
her true nature repressed

or had never been trans
in the first place.

At the Benioff Children's Hospital,

Nikki and her family were
back for her check-up.

For me, it was a last
chance to see Nikki

and get a sense of how
she was faring in her transition.

Hi, Gerry, hi, Isabel. Hi.

How you doing, Nikki?
Nice to see you.

I have some questions
because I just want to pick up

the first time we ever met... Yeah.

...until today, cos I want to just
find out that space in between.

I don't know, I've been feeling
more excited about all these,

like, medication and everything.
I'm more happier, definitely,

than I used to be. I can be,
like, different, like, emotions.

Do you two see the same thing?

She does get emotional.
You know, sometimes we have very

good clays and some clays she gets sad
because she finds it a little hard.

In what way, would you say?

The fact that she has to take her
medicines, she has to come here,

you know, and do the doctor
thing every three months.

So I think that kind of makes
her feel...

sad, you know,

in knowing that this is going to be
pretty much the rest of her life.

So the notion you have to
kind of medicate to be who you are,

like that? Yeah. Yeah.

Is there anything else, do you
think, that we should touch on

in terms of things that could
make your life better right now?

Erm, maybe, like, having God with me
because I don't feel that

he is always with me and I've been,
like, losing hope.

And, like, I'm losing faith because,
erm...

I don't...l don't see it like
how my parents do

or anything because I just feel
that he, erm, he's never there.

She feels that she's a mistake
and I tell her, you know,

"God doesn't make the mistakes -
you were born to be who you are..."

Uh-huh.

...you know, and, "We love you."
And I know she also worries

about finding someone
and being married and being a mum.

Those are...those are worries
that she has as well.

Uh-huh. And, erm...

You know, all I tell her is

it is going to get better,
it is going to be OK.

But I think right now
she just doesn't believe it.

Right, Nikki?

Well, no, not really.
I don't see any, like...

I don't, like, see my future yet,
I guess. Yeah.

It almost sounds like
you're 14, you know?

Just what life is going
to be like in high school

and what life is going to
be like in college and having...

If you're going to find that right
person and I'm hearing a...you know,

some things that I hear from
a lot of 14-year-olds too.

- Did I get that right, or...?
- Yeah.

- Yeah.
- I think, yeah, that's right.

That felt, erm...

quite emotional, didn't it?

I think Nikki's, erm,
struggling a little bit.

The kids that I work with who know
before they go into puberty that

they're transgender, and that many
of them have already

socially transitioned
and they're looking like

they're having a good time,
they're happy,

they hit this age - 12, 13, 14 -

when everybody's bodies are changing

and when you do start to think
about your future a little bit,

and they don't tank, but they slow
down, and I just saw it in Nikki.

What is it, do you think?

When you get to this age, you start
being able to think abstractly,

you can think in larger constructs,

you have a different sense
therefore of yourself.

You have to deal with reality and
you understand what reality means

so in this case, we have a girl
who doesn't have a uterus

who wants to be a mummy.

We have a girl who will grow breasts
but she hasn't gotten them

yet and she has to do them
by coming here to a clinic,

and the reality of that has set in.

And you start
thinking about your romantic self -

"Who's going to want me?"

You know, in this case -

"I'm a girl with a penis.
How am I going to do that?"

So all of that, I saw right
there in Nikki's

kind of almost tearfulness.

I'm not surprised.
I was a little sad myself to see

Nikki in that slope down, and I do
think that what Meredith said

was right, it will get better,
and I think she knows that as well.

Nikki, do you feel any better
after that upstairs?

I do, yeah. You do? Yeah.

Good. And what about you, Isabel?

How did that go for you?

You seemed quite concerned in there.

I just, you know...
because I see her when she's up

and I see her when she's down
and I just want to make sure

we're doing the right thing and,
you know, being there for her and...

When I was up there, I was thinking
about how, when I was 14 and

turning 15, that was probably
the hardest year of my life.

Yeah.

It really was.

It's hard, yeah.

Cos you're thinking about,
how do I fit in?

Yeah, yeah.

And you're not a child
but you're not a grown-up

and it's a very confusing...

it's a very confusing
and lonely time sometimes. Yeah.

Is that how you feel? Yes, exactly.

Do you feel you're on
the right path?

Yeah.

Yeah, I guess mostly, yeah, I do.

I said goodbye to Nikki with
a feeling of trepidation

for the difficult journey
she was embarked upon

but also confident that with her
family's love and support,

she'd have the best chance of
making her transition

as painless as possible.

I had one last appointment.

When I'd first met Casey,
Eduardo and Camille,

they'd just started their journey
towards transition.

Four months on,
I wondered how it was going.

Will you come and pour me some tea?

Oh, wow, lovely.

That tastes delicious.

Do you remember why we're making
this TV programme about you?

Transgender.

I get everything.

Are you one of those transgender
people, do you think?

Uh-huh, yes.

How do you know?

Because I'm turning into a girl.

Do you think you were always
trans...transgender?

Yes.

How did you realise it?

Because of myself.

Because being myself turning
into a girl.

And do you think someone who
turns into a girl

can turn back into a boy?

No.

I would never do that.

You're going to stay girl,
is that what you're saying?

Yes.

Is that because it's more fun
being a girl?

Yes.

And you also feel that that's who
you really are, is that right?

Yes.

And do you think you were
always a girl

or that you are turning into a girl?

Always a girl.
I will always be a girl for ever.

(MY hair!)

How confident are you that, erm,

this is how it will be from now on,
you know, for the rest of her life?

Every single day,
it reinforces it for me.

I'm...l would say I'm 99% sure
this is where we're at.

I'm 100.

I mean, I don't care either way
if something does change

in a few years. You'd be OK with
that? Totally OK. Uh-huh.

I think the biggest thing is,
she's taught me

personally how to be more
authentically myself.

It's something that I never...
I mean, I've always thought,

you know, just be yourself, but
that's different when you have

a child that's telling you,
"Well, I was born a certain way,

"but this is really who I am," and
you kind of re-evaluate yourself too.

So if that means in five years
she's Sebastian,

well, what do I care?

So you wouldn't mind, it wouldn't be
an issue for you were it ever

to come to that, that she
wanted to be Sebastian again?

No. Nope.

To me,
it's the same as if she's Camille.

It's the same thing.

Why would it matter going the
other way, if that was the case?

So... Mm-hmm.

I think we've been through a lot
and we can pretty much handle...

handle most changes at this point.
Mm-hmm.

There's a sale going on, Camille.
Lucky you.

Look at that.
ls that too cute or what?

Yes, that's too cute!

In our time together,
I'd been moved by Casey

and Eduardo's readiness to support
their child's choices but also

aware of the heavy responsibility
of the decision they were making.

These are too cute.

The choice to transition involves
the possibility of social

rejection and a lifetime
commitment to medication,

but it is also a chance to exercise
the most fundamental right

we have - the right to be ourselves.

In the end, the hardest part
of the challenge may be knowing

who it is we really are.

This one's your favourite? Yes.

Why's that?

Pink and purple.

It does look great on you.