[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.76,0:00:04.58,Default,,0000,0000,0000,,I want you all to think
Dialogue: 0,0:00:04.60,0:00:10.30,Default,,0000,0000,0000,,about the third word\Nthat was ever said about you --
Dialogue: 0,0:00:11.58,0:00:14.61,Default,,0000,0000,0000,,or, if you were delivering,
Dialogue: 0,0:00:14.64,0:00:18.34,Default,,0000,0000,0000,,about the person you were delivering.
Dialogue: 0,0:00:19.86,0:00:23.70,Default,,0000,0000,0000,,And you can all mouth it\Nif you want or say it out loud.
Dialogue: 0,0:00:23.73,0:00:29.29,Default,,0000,0000,0000,,It was -- the first two were, "It's a ..."
Dialogue: 0,0:00:29.31,0:00:31.33,Default,,0000,0000,0000,,Audience: (Mixed reply) Girl. Boy.
Dialogue: 0,0:00:31.36,0:00:32.36,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:00:32.38,0:00:33.98,Default,,0000,0000,0000,,Well, it shows you that --
Dialogue: 0,0:00:34.01,0:00:37.08,Default,,0000,0000,0000,,I also deal with issues\Nwhere there's not certainty
Dialogue: 0,0:00:37.11,0:00:38.68,Default,,0000,0000,0000,,of whether it's a girl or a boy,
Dialogue: 0,0:00:38.71,0:00:41.99,Default,,0000,0000,0000,,so the mixed answer was very appropriate.
Dialogue: 0,0:00:42.34,0:00:46.97,Default,,0000,0000,0000,,Of course, now the answer often comes\Nnot at birth but at the ultrasound,
Dialogue: 0,0:00:46.99,0:00:50.95,Default,,0000,0000,0000,,unless the prospective parents\Nchoose to be surprised,
Dialogue: 0,0:00:50.97,0:00:52.58,Default,,0000,0000,0000,,like we all were.
Dialogue: 0,0:00:53.84,0:01:00.84,Default,,0000,0000,0000,,But I want you to think about what it is\Nthat leads to that statement
Dialogue: 0,0:01:00.86,0:01:02.88,Default,,0000,0000,0000,,on the third word,
Dialogue: 0,0:01:02.90,0:01:05.38,Default,,0000,0000,0000,,because the third word
Dialogue: 0,0:01:05.40,0:01:10.24,Default,,0000,0000,0000,,is a description of your sex.
Dialogue: 0,0:01:13.16,0:01:15.55,Default,,0000,0000,0000,,And by that I mean,
Dialogue: 0,0:01:15.57,0:01:19.07,Default,,0000,0000,0000,,made by a description of your genitals.
Dialogue: 0,0:01:20.44,0:01:23.48,Default,,0000,0000,0000,,Now, as a pediatric endocrinologist,
Dialogue: 0,0:01:23.50,0:01:28.98,Default,,0000,0000,0000,,I used to be very, very involved\Nand still somewhat am, in cases
Dialogue: 0,0:01:29.00,0:01:35.27,Default,,0000,0000,0000,,in which there are mismatches\Nin the externals
Dialogue: 0,0:01:35.29,0:01:39.31,Default,,0000,0000,0000,,or between the externals\Nand the internals,
Dialogue: 0,0:01:39.33,0:01:44.14,Default,,0000,0000,0000,,and we literally have to figure out
Dialogue: 0,0:01:44.17,0:01:47.29,Default,,0000,0000,0000,,what is the description of your sex.
Dialogue: 0,0:01:48.50,0:01:53.78,Default,,0000,0000,0000,,But there is nothing\Nthat is definable at the time of birth
Dialogue: 0,0:01:53.81,0:01:57.05,Default,,0000,0000,0000,,that would define you.
Dialogue: 0,0:01:58.10,0:02:00.24,Default,,0000,0000,0000,,And when I talk about definition,
Dialogue: 0,0:02:00.27,0:02:05.03,Default,,0000,0000,0000,,I'm talking about your sexual orientation.
Dialogue: 0,0:02:06.27,0:02:10.14,Default,,0000,0000,0000,,We don't say, "It's a ... gay boy!"
Dialogue: 0,0:02:11.67,0:02:12.96,Default,,0000,0000,0000,,"A lesbian girl!"
Dialogue: 0,0:02:14.45,0:02:17.96,Default,,0000,0000,0000,,Those situations don't\Nreally define themselves
Dialogue: 0,0:02:17.98,0:02:20.17,Default,,0000,0000,0000,,more until the second decade of life.
Dialogue: 0,0:02:21.97,0:02:26.93,Default,,0000,0000,0000,,Nor do they define your gender,
Dialogue: 0,0:02:26.95,0:02:30.54,Default,,0000,0000,0000,,which, as different\Nfrom your anatomic sex,
Dialogue: 0,0:02:30.56,0:02:33.81,Default,,0000,0000,0000,,describes your self-concept:
Dialogue: 0,0:02:33.84,0:02:39.35,Default,,0000,0000,0000,,Do you see yourself as a male or female,
Dialogue: 0,0:02:39.37,0:02:43.33,Default,,0000,0000,0000,,or somewhere in the spectrum in between?
Dialogue: 0,0:02:44.59,0:02:49.87,Default,,0000,0000,0000,,That sometimes shows up
Dialogue: 0,0:02:49.90,0:02:52.86,Default,,0000,0000,0000,,in the first decade of life,
Dialogue: 0,0:02:52.88,0:02:56.50,Default,,0000,0000,0000,,but it can be very confusing for parents,
Dialogue: 0,0:02:56.53,0:03:01.23,Default,,0000,0000,0000,,because it is quite normative for children
Dialogue: 0,0:03:01.26,0:03:05.61,Default,,0000,0000,0000,,to act in a cross-gender play and way,
Dialogue: 0,0:03:05.63,0:03:07.94,Default,,0000,0000,0000,,and, in fact, there are studies that show
Dialogue: 0,0:03:07.97,0:03:13.80,Default,,0000,0000,0000,,that even 80 percent of children\Nwho act in that fashion
Dialogue: 0,0:03:13.82,0:03:20.74,Default,,0000,0000,0000,,will not persist in wanting\Nto be the opposite gender
Dialogue: 0,0:03:20.76,0:03:23.46,Default,,0000,0000,0000,,at the time when puberty begins.
Dialogue: 0,0:03:24.75,0:03:29.28,Default,,0000,0000,0000,,But, at the time that puberty begins --
Dialogue: 0,0:03:30.21,0:03:35.84,Default,,0000,0000,0000,,that means between about age 10 to 12\Nin girls, 12 to 14 in boys --
Dialogue: 0,0:03:37.24,0:03:38.95,Default,,0000,0000,0000,,with breast budding,
Dialogue: 0,0:03:38.97,0:03:42.84,Default,,0000,0000,0000,,or two to three times'\Nincrease in the gonads
Dialogue: 0,0:03:42.87,0:03:45.71,Default,,0000,0000,0000,,in the case of genetic males,
Dialogue: 0,0:03:45.74,0:03:47.36,Default,,0000,0000,0000,,by that particular point,
Dialogue: 0,0:03:47.39,0:03:52.32,Default,,0000,0000,0000,,the child who says\Nthey are in the absolute wrong body
Dialogue: 0,0:03:53.50,0:03:56.03,Default,,0000,0000,0000,,is almost certain to be transgender
Dialogue: 0,0:03:57.29,0:04:04.28,Default,,0000,0000,0000,,and is extremely unlikely\Nto change those feelings,
Dialogue: 0,0:04:04.30,0:04:08.84,Default,,0000,0000,0000,,no matter how anybody tries\Nreparative therapy
Dialogue: 0,0:04:08.86,0:04:11.04,Default,,0000,0000,0000,,or any other noxious things.
Dialogue: 0,0:04:12.74,0:04:15.19,Default,,0000,0000,0000,,Now, this is relatively rare,
Dialogue: 0,0:04:15.21,0:04:18.11,Default,,0000,0000,0000,,so I had relatively little\Npersonal experience with this.
Dialogue: 0,0:04:18.93,0:04:21.58,Default,,0000,0000,0000,,And my experience was more typical,
Dialogue: 0,0:04:21.61,0:04:23.65,Default,,0000,0000,0000,,only because I had an adolescent practice.
Dialogue: 0,0:04:23.67,0:04:25.34,Default,,0000,0000,0000,,And I saw someone age 24,
Dialogue: 0,0:04:25.36,0:04:29.93,Default,,0000,0000,0000,,genetically female, went through Harvard\Nwith three male roommates
Dialogue: 0,0:04:29.95,0:04:31.29,Default,,0000,0000,0000,,who knew the whole story,
Dialogue: 0,0:04:31.31,0:04:37.33,Default,,0000,0000,0000,,a registrar who always listed his name\Non course lists as a male name,
Dialogue: 0,0:04:37.36,0:04:40.31,Default,,0000,0000,0000,,and came to me after graduating,
Dialogue: 0,0:04:40.33,0:04:44.32,Default,,0000,0000,0000,,saying, "Help me. I know you know\Na lot of endocrinology."
Dialogue: 0,0:04:44.35,0:04:47.66,Default,,0000,0000,0000,,And indeed, I've treated a lot of people\Nwho were born without gonads.
Dialogue: 0,0:04:47.68,0:04:49.32,Default,,0000,0000,0000,,This wasn't rocket science.
Dialogue: 0,0:04:49.35,0:04:50.95,Default,,0000,0000,0000,,But I made a deal with him:
Dialogue: 0,0:04:50.98,0:04:52.77,Default,,0000,0000,0000,,"I'll treat you if you teach me."
Dialogue: 0,0:04:53.90,0:04:55.99,Default,,0000,0000,0000,,And so he did.
Dialogue: 0,0:04:57.16,0:04:58.97,Default,,0000,0000,0000,,And what an education I got
Dialogue: 0,0:04:58.100,0:05:01.82,Default,,0000,0000,0000,,from taking care of all the members\Nof his support group.
Dialogue: 0,0:05:03.65,0:05:06.17,Default,,0000,0000,0000,,And then I got really confused,
Dialogue: 0,0:05:06.19,0:05:08.73,Default,,0000,0000,0000,,because I thought it was\Nrelatively easy at that age
Dialogue: 0,0:05:08.75,0:05:10.33,Default,,0000,0000,0000,,to just give people the hormones
Dialogue: 0,0:05:10.36,0:05:13.78,Default,,0000,0000,0000,,of the gender\Nin which they were affirming.
Dialogue: 0,0:05:14.60,0:05:17.80,Default,,0000,0000,0000,,But then my patient married,
Dialogue: 0,0:05:17.82,0:05:22.63,Default,,0000,0000,0000,,and he married a woman\Nwho had been born as a male,
Dialogue: 0,0:05:22.66,0:05:25.93,Default,,0000,0000,0000,,had married as a male, had two children,
Dialogue: 0,0:05:25.96,0:05:30.23,Default,,0000,0000,0000,,then went through\Na transition into female.
Dialogue: 0,0:05:31.72,0:05:35.71,Default,,0000,0000,0000,,And now this delightful female
Dialogue: 0,0:05:36.54,0:05:42.20,Default,,0000,0000,0000,,was attached to my male patient --\Nin fact, got legally married,
Dialogue: 0,0:05:42.23,0:05:45.48,Default,,0000,0000,0000,,because they showed up as a man\Nand a woman, and who knew, right?
Dialogue: 0,0:05:45.50,0:05:47.00,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:05:47.97,0:05:51.00,Default,,0000,0000,0000,,And I was confused --
Dialogue: 0,0:05:51.50,0:05:53.90,Default,,0000,0000,0000,,"Does this make so-and-so gay?
Dialogue: 0,0:05:53.92,0:05:55.67,Default,,0000,0000,0000,,Does this make so-and-so straight?"
Dialogue: 0,0:05:55.70,0:06:00.52,Default,,0000,0000,0000,,I was getting sexual orientation\Nconfused with gender identity.
Dialogue: 0,0:06:01.61,0:06:03.78,Default,,0000,0000,0000,,And my patient said to me,
Dialogue: 0,0:06:03.81,0:06:05.28,Default,,0000,0000,0000,,"Look, look, look.
Dialogue: 0,0:06:05.30,0:06:08.71,Default,,0000,0000,0000,,If you just think of the following,\Nyou'll get it right:
Dialogue: 0,0:06:08.74,0:06:11.98,Default,,0000,0000,0000,,Sexual orientation\Nis who you go to bed with.
Dialogue: 0,0:06:12.00,0:06:15.34,Default,,0000,0000,0000,,Gender identity is who you go to bed as."
Dialogue: 0,0:06:15.80,0:06:17.80,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:06:17.83,0:06:20.62,Default,,0000,0000,0000,,And I subsequently learned\Nfrom the many adults --
Dialogue: 0,0:06:20.64,0:06:23.16,Default,,0000,0000,0000,,I took care of about 200 adults --
Dialogue: 0,0:06:23.19,0:06:24.86,Default,,0000,0000,0000,,I learned from them
Dialogue: 0,0:06:24.88,0:06:29.52,Default,,0000,0000,0000,,that if I didn't peek as to who\Ntheir partner was in the waiting room,
Dialogue: 0,0:06:29.54,0:06:33.22,Default,,0000,0000,0000,,I would never be able to guess\Nbetter than chance,
Dialogue: 0,0:06:33.24,0:06:37.44,Default,,0000,0000,0000,,whether they were gay,\Nstraight, bi or asexual
Dialogue: 0,0:06:37.46,0:06:39.61,Default,,0000,0000,0000,,in their affirmed gender.
Dialogue: 0,0:06:39.63,0:06:40.85,Default,,0000,0000,0000,,In other words,
Dialogue: 0,0:06:40.88,0:06:45.44,Default,,0000,0000,0000,,one thing has absolutely nothing\Nto do with the other.
Dialogue: 0,0:06:45.46,0:06:48.14,Default,,0000,0000,0000,,And the data show it.
Dialogue: 0,0:06:50.08,0:06:52.22,Default,,0000,0000,0000,,Now, as I took care of the 200 adults,
Dialogue: 0,0:06:52.25,0:06:53.84,Default,,0000,0000,0000,,I found it extremely painful.
Dialogue: 0,0:06:54.81,0:06:57.80,Default,,0000,0000,0000,,These people -- many of them --
Dialogue: 0,0:06:57.82,0:07:02.10,Default,,0000,0000,0000,,had to give up so much of their lives.
Dialogue: 0,0:07:02.12,0:07:04.55,Default,,0000,0000,0000,,Sometimes their parents would reject them,
Dialogue: 0,0:07:04.58,0:07:06.93,Default,,0000,0000,0000,,siblings, their own children,
Dialogue: 0,0:07:06.95,0:07:08.70,Default,,0000,0000,0000,,and then their divorcing spouse
Dialogue: 0,0:07:08.72,0:07:12.23,Default,,0000,0000,0000,,would forbid them\Nfrom seeing their children.
Dialogue: 0,0:07:12.72,0:07:14.48,Default,,0000,0000,0000,,It was so awful,
Dialogue: 0,0:07:14.51,0:07:17.76,Default,,0000,0000,0000,,but why did they do it at 40 and 50?
Dialogue: 0,0:07:18.29,0:07:23.03,Default,,0000,0000,0000,,Because they felt\Nthey had to affirm themselves
Dialogue: 0,0:07:23.06,0:07:24.84,Default,,0000,0000,0000,,before they would kill themselves.
Dialogue: 0,0:07:25.32,0:07:31.26,Default,,0000,0000,0000,,And indeed, the rate of suicide\Namong untreated transgendered people
Dialogue: 0,0:07:31.29,0:07:33.74,Default,,0000,0000,0000,,is among the highest in the world.
Dialogue: 0,0:07:35.06,0:07:36.21,Default,,0000,0000,0000,,So, what to do?
Dialogue: 0,0:07:37.02,0:07:40.93,Default,,0000,0000,0000,,I was intrigued, in going\Nto a conference in Holland,
Dialogue: 0,0:07:40.96,0:07:43.20,Default,,0000,0000,0000,,where they are experts in this,
Dialogue: 0,0:07:43.23,0:07:45.53,Default,,0000,0000,0000,,and saw the most remarkable thing.
Dialogue: 0,0:07:46.62,0:07:49.84,Default,,0000,0000,0000,,They were treating young adolescents
Dialogue: 0,0:07:49.87,0:07:55.84,Default,,0000,0000,0000,,after giving them the most intense\Npsychometric testing of gender,
Dialogue: 0,0:07:55.86,0:08:00.26,Default,,0000,0000,0000,,and they were treating them by blocking\Nthe puberty that they didn't want.
Dialogue: 0,0:08:00.28,0:08:02.84,Default,,0000,0000,0000,,Because basically,\Nkids look about the same,
Dialogue: 0,0:08:02.87,0:08:05.86,Default,,0000,0000,0000,,each sex, until they go through puberty,
Dialogue: 0,0:08:05.89,0:08:08.58,Default,,0000,0000,0000,,at which point, if you feel\Nyou're in the wrong sex,
Dialogue: 0,0:08:08.60,0:08:10.79,Default,,0000,0000,0000,,you feel like Pinocchio becoming a donkey.
Dialogue: 0,0:08:11.68,0:08:14.22,Default,,0000,0000,0000,,The fantasy that you had\Nthat your body will change
Dialogue: 0,0:08:14.24,0:08:16.89,Default,,0000,0000,0000,,to be who you want it to be, with puberty,
Dialogue: 0,0:08:16.92,0:08:19.64,Default,,0000,0000,0000,,actually is nullified\Nby the puberty you get.
Dialogue: 0,0:08:21.78,0:08:23.80,Default,,0000,0000,0000,,And they fall apart.
Dialogue: 0,0:08:25.33,0:08:28.80,Default,,0000,0000,0000,,So that's why putting the puberty\Non hold -- why on hold?
Dialogue: 0,0:08:28.83,0:08:31.88,Default,,0000,0000,0000,,You can't just give them\Nthe opposite hormones that young.
Dialogue: 0,0:08:31.90,0:08:33.74,Default,,0000,0000,0000,,They'll end up stunted in growth,
Dialogue: 0,0:08:33.76,0:08:36.31,Default,,0000,0000,0000,,and you think you can have\Na meaningful conversation
Dialogue: 0,0:08:36.33,0:08:38.82,Default,,0000,0000,0000,,about the fertility effects\Nof such treatment
Dialogue: 0,0:08:38.85,0:08:42.24,Default,,0000,0000,0000,,with a 10-year-old girl,\Na 12-year-old boy?
Dialogue: 0,0:08:42.66,0:08:45.17,Default,,0000,0000,0000,,So this buys time\Nin the diagnostic process
Dialogue: 0,0:08:45.19,0:08:47.02,Default,,0000,0000,0000,,for four or five years,
Dialogue: 0,0:08:47.04,0:08:49.34,Default,,0000,0000,0000,,so that they can work it out.
Dialogue: 0,0:08:49.82,0:08:52.45,Default,,0000,0000,0000,,They can have more and more testing,
Dialogue: 0,0:08:52.47,0:08:56.44,Default,,0000,0000,0000,,they can live without feeling their bodies\Nare running away from them.
Dialogue: 0,0:08:56.46,0:09:00.62,Default,,0000,0000,0000,,And then, in a program they call 12-16-18,
Dialogue: 0,0:09:00.65,0:09:05.50,Default,,0000,0000,0000,,around age 12 is when they\Ngive the blocking hormones,
Dialogue: 0,0:09:05.52,0:09:07.96,Default,,0000,0000,0000,,and then at age 16, with retesting,
Dialogue: 0,0:09:07.98,0:09:10.26,Default,,0000,0000,0000,,they re-qualify to receive --
Dialogue: 0,0:09:10.29,0:09:13.26,Default,,0000,0000,0000,,now remember, the blocking\Nhormones are reversible,
Dialogue: 0,0:09:13.28,0:09:16.17,Default,,0000,0000,0000,,but when you give the hormones\Nof the opposite sex,
Dialogue: 0,0:09:16.19,0:09:19.51,Default,,0000,0000,0000,,you now start spouting breasts\Nand facial hair and voice change,
Dialogue: 0,0:09:19.53,0:09:21.27,Default,,0000,0000,0000,,depending on what you're using,
Dialogue: 0,0:09:21.30,0:09:23.40,Default,,0000,0000,0000,,and those effects are permanent,
Dialogue: 0,0:09:23.42,0:09:25.24,Default,,0000,0000,0000,,or require surgery to remove,
Dialogue: 0,0:09:25.26,0:09:26.50,Default,,0000,0000,0000,,or electrolysis,
Dialogue: 0,0:09:26.52,0:09:28.65,Default,,0000,0000,0000,,and you can never really affect the voice.
Dialogue: 0,0:09:29.03,0:09:32.28,Default,,0000,0000,0000,,So this is serious,\Nand this is 15-, 16-year-old stuff.
Dialogue: 0,0:09:33.18,0:09:35.86,Default,,0000,0000,0000,,And then at 18,\Nthey're eligible for surgery.
Dialogue: 0,0:09:36.77,0:09:40.86,Default,,0000,0000,0000,,And while there's no good surgery\Nfor females to males genitally,
Dialogue: 0,0:09:40.89,0:09:44.19,Default,,0000,0000,0000,,the male-to-female surgery\Nhas fooled gynecologists.
Dialogue: 0,0:09:45.38,0:09:46.83,Default,,0000,0000,0000,,That's how good it can be.
Dialogue: 0,0:09:48.09,0:09:52.06,Default,,0000,0000,0000,,So I looked at how\Nthe patients were doing,
Dialogue: 0,0:09:52.09,0:09:54.95,Default,,0000,0000,0000,,and I looked at patients\Nwho just looked like everybody else,
Dialogue: 0,0:09:54.97,0:09:57.70,Default,,0000,0000,0000,,except they were pubertally delayed.
Dialogue: 0,0:09:57.73,0:09:59.64,Default,,0000,0000,0000,,But once they gave them the hormones
Dialogue: 0,0:09:59.67,0:10:02.28,Default,,0000,0000,0000,,consistent with the gender they affirm,
Dialogue: 0,0:10:02.30,0:10:03.53,Default,,0000,0000,0000,,they look beautiful.
Dialogue: 0,0:10:04.23,0:10:05.52,Default,,0000,0000,0000,,They look normal.
Dialogue: 0,0:10:06.04,0:10:07.40,Default,,0000,0000,0000,,They had normal heights.
Dialogue: 0,0:10:07.94,0:10:10.74,Default,,0000,0000,0000,,You would never be able\Nto pick them out in a crowd.
Dialogue: 0,0:10:12.52,0:10:15.08,Default,,0000,0000,0000,,So at that point, I decided\NI'm going to do this.
Dialogue: 0,0:10:15.10,0:10:19.59,Default,,0000,0000,0000,,This is really where the pediatric\Nendocrine realm comes in,
Dialogue: 0,0:10:19.61,0:10:24.43,Default,,0000,0000,0000,,because, in fact, if you're going to deal\Nwith it in kids aged 10 to 14,
Dialogue: 0,0:10:24.45,0:10:26.37,Default,,0000,0000,0000,,that's pediatric endocrinology.
Dialogue: 0,0:10:27.35,0:10:30.74,Default,,0000,0000,0000,,So I brought some kids in,
Dialogue: 0,0:10:31.51,0:10:34.07,Default,,0000,0000,0000,,and this now became the standard of care,
Dialogue: 0,0:10:34.10,0:10:36.90,Default,,0000,0000,0000,,and the [Boston]\NChildren's Hospital was behind it.
Dialogue: 0,0:10:36.93,0:10:41.07,Default,,0000,0000,0000,,By my showing them\Nthe kids before and after,
Dialogue: 0,0:10:41.09,0:10:44.92,Default,,0000,0000,0000,,people who never got treated\Nand people who wished to be treated,
Dialogue: 0,0:10:44.94,0:10:46.53,Default,,0000,0000,0000,,and pictures of the Dutch --
Dialogue: 0,0:10:48.04,0:10:49.26,Default,,0000,0000,0000,,they came to me and said,
Dialogue: 0,0:10:49.28,0:10:51.49,Default,,0000,0000,0000,,"You've got to do\Nsomething for these kids."
Dialogue: 0,0:10:51.51,0:10:53.57,Default,,0000,0000,0000,,Well, where were these kids before?
Dialogue: 0,0:10:54.77,0:10:57.14,Default,,0000,0000,0000,,They were out there suffering,\Nis where they were.
Dialogue: 0,0:10:57.89,0:11:04.04,Default,,0000,0000,0000,,So we started a program in 2007.
Dialogue: 0,0:11:04.06,0:11:06.46,Default,,0000,0000,0000,,It became the first program of its kind --
Dialogue: 0,0:11:06.48,0:11:08.84,Default,,0000,0000,0000,,but it's really of the Dutch kind --
Dialogue: 0,0:11:08.86,0:11:10.05,Default,,0000,0000,0000,,in North America.
Dialogue: 0,0:11:10.93,0:11:14.43,Default,,0000,0000,0000,,And since then, we have 160 patients.
Dialogue: 0,0:11:15.18,0:11:17.83,Default,,0000,0000,0000,,Did they come from Afghanistan? No.
Dialogue: 0,0:11:18.44,0:11:25.44,Default,,0000,0000,0000,,75 percent of them came\Nfrom within 150 miles of Boston.
Dialogue: 0,0:11:26.70,0:11:29.46,Default,,0000,0000,0000,,And some came from England.
Dialogue: 0,0:11:30.14,0:11:34.18,Default,,0000,0000,0000,,Jackie had been abused\Nin the Midlands, in England.
Dialogue: 0,0:11:34.20,0:11:36.07,Default,,0000,0000,0000,,She's 12 years old there,
Dialogue: 0,0:11:36.09,0:11:37.40,Default,,0000,0000,0000,,she was living as a girl,
Dialogue: 0,0:11:37.43,0:11:39.59,Default,,0000,0000,0000,,but she was being beaten up.
Dialogue: 0,0:11:39.61,0:11:42.18,Default,,0000,0000,0000,,It was a horror show,\Nthey had to homeschool her.
Dialogue: 0,0:11:42.65,0:11:44.99,Default,,0000,0000,0000,,And the reason the British were coming
Dialogue: 0,0:11:45.02,0:11:50.72,Default,,0000,0000,0000,,was because they would not treat\Nanybody with anything under age 16,
Dialogue: 0,0:11:50.74,0:11:54.45,Default,,0000,0000,0000,,which means they were consigning\Nthem to an adult body
Dialogue: 0,0:11:54.48,0:11:55.94,Default,,0000,0000,0000,,no matter what happened,
Dialogue: 0,0:11:55.96,0:11:57.54,Default,,0000,0000,0000,,even if they tested them well.
Dialogue: 0,0:11:58.11,0:12:02.79,Default,,0000,0000,0000,,Jackie, on top of it, was,\Nby virtue of skeletal markings,
Dialogue: 0,0:12:02.81,0:12:04.73,Default,,0000,0000,0000,,destined to be six feet five.
Dialogue: 0,0:12:07.14,0:12:10.04,Default,,0000,0000,0000,,And yet, she had just begun\Na male puberty.
Dialogue: 0,0:12:10.94,0:12:14.51,Default,,0000,0000,0000,,Well, I did something\Na little bit innovative,
Dialogue: 0,0:12:14.54,0:12:16.64,Default,,0000,0000,0000,,because I do know hormones,
Dialogue: 0,0:12:16.66,0:12:18.60,Default,,0000,0000,0000,,and that estrogen is much more potent
Dialogue: 0,0:12:18.62,0:12:22.41,Default,,0000,0000,0000,,in closing epiphyses, the growth plates,
Dialogue: 0,0:12:22.44,0:12:25.73,Default,,0000,0000,0000,,and stopping growth, than testosterone is.
Dialogue: 0,0:12:25.75,0:12:30.48,Default,,0000,0000,0000,,So we blocked her testosterone\Nwith a blocking hormone,
Dialogue: 0,0:12:30.50,0:12:33.96,Default,,0000,0000,0000,,but we added estrogen,\Nnot at 16, but at 13.
Dialogue: 0,0:12:34.91,0:12:37.49,Default,,0000,0000,0000,,And so here she is at 16, on the left.
Dialogue: 0,0:12:38.09,0:12:40.37,Default,,0000,0000,0000,,And on her 16th birthday,\Nshe went to Thailand,
Dialogue: 0,0:12:40.40,0:12:42.67,Default,,0000,0000,0000,,where they would do\Na genital plastic surgery.
Dialogue: 0,0:12:42.70,0:12:44.57,Default,,0000,0000,0000,,They will do it at 18 now.
Dialogue: 0,0:12:44.60,0:12:46.64,Default,,0000,0000,0000,,And she ended up 5'11".
Dialogue: 0,0:12:47.31,0:12:50.54,Default,,0000,0000,0000,,But more than that,\Nshe has normal breast size,
Dialogue: 0,0:12:50.56,0:12:52.85,Default,,0000,0000,0000,,because by blocking testosterone,
Dialogue: 0,0:12:52.87,0:12:56.22,Default,,0000,0000,0000,,every one of our patients\Nhas normal breast size
Dialogue: 0,0:12:56.25,0:12:59.26,Default,,0000,0000,0000,,if they get to us at the appropriate age,
Dialogue: 0,0:12:59.28,0:13:00.43,Default,,0000,0000,0000,,not too late.
Dialogue: 0,0:13:01.06,0:13:02.82,Default,,0000,0000,0000,,And on the far right, there she is.
Dialogue: 0,0:13:02.84,0:13:06.66,Default,,0000,0000,0000,,She went public -- semifinalist\Nin the Miss England competition.
Dialogue: 0,0:13:09.07,0:13:11.57,Default,,0000,0000,0000,,The judges debated\Nas to, can they do this?
Dialogue: 0,0:13:12.13,0:13:16.28,Default,,0000,0000,0000,,And one of them quipped, I'm told,
Dialogue: 0,0:13:16.31,0:13:20.28,Default,,0000,0000,0000,,"But she has more natural self\Nthan half the other contestants."
Dialogue: 0,0:13:20.30,0:13:22.19,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:13:22.21,0:13:26.46,Default,,0000,0000,0000,,And some of them\Nhave been rearranged a little bit,
Dialogue: 0,0:13:26.48,0:13:28.57,Default,,0000,0000,0000,,but it's all her DNA.
Dialogue: 0,0:13:29.68,0:13:32.77,Default,,0000,0000,0000,,And she's become a remarkable spokeswoman.
Dialogue: 0,0:13:33.12,0:13:36.98,Default,,0000,0000,0000,,And she was offered contracts as a model,
Dialogue: 0,0:13:37.01,0:13:39.13,Default,,0000,0000,0000,,at which point\Nshe teased me, when she said,
Dialogue: 0,0:13:39.16,0:13:41.70,Default,,0000,0000,0000,,"You know, I might have had\Na better chance as a model
Dialogue: 0,0:13:41.72,0:13:43.43,Default,,0000,0000,0000,,if you'd made me six feet one."
Dialogue: 0,0:13:43.46,0:13:45.44,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:13:45.46,0:13:46.61,Default,,0000,0000,0000,,Go figure.
Dialogue: 0,0:13:48.04,0:13:50.97,Default,,0000,0000,0000,,So this picture, I think, says it all.
Dialogue: 0,0:13:51.74,0:13:53.08,Default,,0000,0000,0000,,It really says it all.
Dialogue: 0,0:13:53.76,0:13:57.38,Default,,0000,0000,0000,,These are Nicole and brother Jonas,
Dialogue: 0,0:13:57.41,0:13:59.35,Default,,0000,0000,0000,,identical twin boys,
Dialogue: 0,0:14:00.43,0:14:01.93,Default,,0000,0000,0000,,and proven to be identical.
Dialogue: 0,0:14:03.98,0:14:07.57,Default,,0000,0000,0000,,Nicole had affirmed herself\Nas a girl as early as age three.
Dialogue: 0,0:14:07.60,0:14:10.10,Default,,0000,0000,0000,,At age seven, they changed her name,
Dialogue: 0,0:14:10.13,0:14:14.57,Default,,0000,0000,0000,,and came to me at the very\Nbeginnings of a male puberty.
Dialogue: 0,0:14:14.90,0:14:17.69,Default,,0000,0000,0000,,Now you can imagine\Nlooking at Jonas at only 14,
Dialogue: 0,0:14:17.71,0:14:20.50,Default,,0000,0000,0000,,that male puberty is early in this family,
Dialogue: 0,0:14:20.52,0:14:22.56,Default,,0000,0000,0000,,because he looks more like a 16-year-old.
Dialogue: 0,0:14:23.09,0:14:24.90,Default,,0000,0000,0000,,But it makes the point all the more,
Dialogue: 0,0:14:24.92,0:14:28.20,Default,,0000,0000,0000,,of why you have to be conscious\Nof where the patient is.
Dialogue: 0,0:14:28.66,0:14:31.37,Default,,0000,0000,0000,,Nicole is on pubertal blockade in here,
Dialogue: 0,0:14:32.45,0:14:35.56,Default,,0000,0000,0000,,and Jonas is just going --\Nbiologic control.
Dialogue: 0,0:14:36.19,0:14:37.89,Default,,0000,0000,0000,,This is what Nicole would look like
Dialogue: 0,0:14:37.91,0:14:39.97,Default,,0000,0000,0000,,if we weren't doing what we were doing.
Dialogue: 0,0:14:39.99,0:14:42.46,Default,,0000,0000,0000,,He's got a prominent Adam's apple.
Dialogue: 0,0:14:42.48,0:14:46.04,Default,,0000,0000,0000,,He's got angular bones\Nto the face, a mustache,
Dialogue: 0,0:14:46.06,0:14:48.13,Default,,0000,0000,0000,,and you can see there's\Na height difference,
Dialogue: 0,0:14:48.15,0:14:51.03,Default,,0000,0000,0000,,because he's gone through\Na growth spurt that she won't get.
Dialogue: 0,0:14:51.05,0:14:52.57,Default,,0000,0000,0000,,Now Nicole is on estrogen.
Dialogue: 0,0:14:52.59,0:14:55.06,Default,,0000,0000,0000,,She has a bit of a form to her.
Dialogue: 0,0:14:55.89,0:14:59.50,Default,,0000,0000,0000,,This family went\Nto the White House last spring,
Dialogue: 0,0:14:59.53,0:15:05.26,Default,,0000,0000,0000,,because of their work in overturning\Nan anti-discrimination --
Dialogue: 0,0:15:05.29,0:15:07.67,Default,,0000,0000,0000,,there was a bill that would block
Dialogue: 0,0:15:07.70,0:15:12.30,Default,,0000,0000,0000,,the right of transgender people in Maine\Nto use public bathrooms,
Dialogue: 0,0:15:12.32,0:15:15.07,Default,,0000,0000,0000,,and it looked like the bill\Nwas going to pass,
Dialogue: 0,0:15:15.09,0:15:16.80,Default,,0000,0000,0000,,and that would have been a problem,
Dialogue: 0,0:15:16.82,0:15:20.30,Default,,0000,0000,0000,,but Nicole went personally\Nto every legislator in Maine
Dialogue: 0,0:15:20.32,0:15:22.31,Default,,0000,0000,0000,,and said, "I can do this.
Dialogue: 0,0:15:22.34,0:15:24.33,Default,,0000,0000,0000,,If they see me, they'll understand
Dialogue: 0,0:15:24.35,0:15:26.50,Default,,0000,0000,0000,,why I'm no threat in the ladies' room,
Dialogue: 0,0:15:26.52,0:15:28.60,Default,,0000,0000,0000,,but I can be threatened\Nin the men's room."
Dialogue: 0,0:15:28.63,0:15:30.13,Default,,0000,0000,0000,,And then they finally got it.
Dialogue: 0,0:15:32.04,0:15:33.71,Default,,0000,0000,0000,,So where do we go from here?
Dialogue: 0,0:15:35.02,0:15:39.09,Default,,0000,0000,0000,,Well, we still have a ways to go\Nin terms of anti-discrimination.
Dialogue: 0,0:15:39.12,0:15:42.78,Default,,0000,0000,0000,,There are only 17 states\Nthat have an anti-discrimination law
Dialogue: 0,0:15:42.81,0:15:45.38,Default,,0000,0000,0000,,against discrimination in housing,
Dialogue: 0,0:15:45.41,0:15:48.50,Default,,0000,0000,0000,,employment, public accommodation --
Dialogue: 0,0:15:48.52,0:15:51.51,Default,,0000,0000,0000,,only 17 states, and five of them\Nare in New England.
Dialogue: 0,0:15:51.53,0:15:53.44,Default,,0000,0000,0000,,We need less expensive drugs.
Dialogue: 0,0:15:53.46,0:15:54.85,Default,,0000,0000,0000,,They cost a fortune.
Dialogue: 0,0:15:55.16,0:15:59.06,Default,,0000,0000,0000,,And we need to get\Nthis condition out of the DSM.
Dialogue: 0,0:15:59.08,0:16:03.78,Default,,0000,0000,0000,,It is as much a psychiatric disease\Nas being gay and lesbian,
Dialogue: 0,0:16:03.80,0:16:06.72,Default,,0000,0000,0000,,and that went out the window in 1973,
Dialogue: 0,0:16:06.75,0:16:08.25,Default,,0000,0000,0000,,and the whole world changed.
Dialogue: 0,0:16:08.65,0:16:10.99,Default,,0000,0000,0000,,And this isn't going to break\Nanybody's budget.
Dialogue: 0,0:16:11.02,0:16:12.48,Default,,0000,0000,0000,,This is not that common.
Dialogue: 0,0:16:13.28,0:16:16.66,Default,,0000,0000,0000,,But the risks of not\Ndoing anything for them
Dialogue: 0,0:16:18.00,0:16:24.48,Default,,0000,0000,0000,,not only puts all of them at risk\Nof losing their lives to suicide,
Dialogue: 0,0:16:24.50,0:16:30.75,Default,,0000,0000,0000,,but it also says something about\Nwhether we are a truly inclusive society.
Dialogue: 0,0:16:30.78,0:16:31.93,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:16:31.95,0:16:35.93,Default,,0000,0000,0000,,(Applause)