From the time they are born, we put our boys in blue beanies and our girls in pink ones. It's a societal norm, an expectation even, that you just are what you are born - a boy or a girl.
From early on, we divide toys and activities by distinct gender lines, with superheroes and trucks and muck on one side and princesses and dolls and all things frilly on the other.
Many children land, enthusiastically, on the expected side. Others dabble in both "girl" and "boy" things. But what if your kid, even from an early age, mostly showed interest in doing opposite-gender things? More importantly, what if they wanted to BE the opposite gender - or a less-defined mix of both? And what if they wanted to test those limits in public places, such as school?
Would you let them?
It's not, of course, that pat of a process. Parents don't just decide to let their kids switch genders. But, whether parents are dragged through the process, or if they decide to work it through more openly, more kids are challenging the boundaries of traditional gender, and going public at younger ages.
And they are doing so with the guidance of a growing faction of medical experts who no longer see this as something to be fixed. Last year, the American Psychiatric Association removed "gender identity disorder" from its list of mental health ailments.
Some experts predict that views on gender will evolve in much the same way they have for sexual orientation, since homosexuality was removed as a mental illness nearly four decades ago. Today, the gender spectrum includes those who are transgender, who see themselves as the opposite gender, and those who are gender variant, or gender nonconforming, whose gender is more "fluid." For kids, it means they identify part of themselves as boy and part as girl.
"Now these kids are beginning to have a voice and I think that's what's been making things interesting and challenging - and difficult, sometimes - depending on the family, the kid or the school," says Dr. Robert Garofalo, director of the Center for Gender, Sexuality and HIV Prevention at Lurie Children's Hospital of Chicago.
Families seeking help
The center at Lurie opened recently, in part, to meet the demand from parents seeking guidance for children who are questioning their gender identity and to provide support to older transgender youth who sometimes struggle more in adolescence, even facing a greater suicide risk, especially if they have no backing from family and others around them.
The center also serves as a resource for schools with transgender and gender variant students.
Increasingly, those students are making the transition as early as elementary school, if not earlier.
While the numbers are still relatively small, it means that schools are having to figure out how to accommodate them, some more successfully than others.
The questions often start with the basics: Which bathroom do they use? Where do they change for gym class? What if teachers or students don't want to use the pronoun, "he" or "she," or a new name the student prefers?
It can be difficult, and uncomfortable - and, at least in Colorado, beyond the realm of legal debate. A few days ago, the Division of Civil Rights ruled that Eagleside Elementary in Fountain-Fort Carson School District 8 discriminated against 6-year-old Coy Mathis, a transgender child, when it barred her from using the girls' bathroom at school.
The decision could have wide-ranging impact, as it marks the first ruling in the nation upholding transgender students' rights to use the bathrooms that match the gender with which they identify.
"This gives a loud and clear message that transgender students may not be targeted for discrimination and that they must be treated equally in school," says Michael Silverman, executive director of the Transgender Legal Defense & Education Fund, the New York-based nonprofit that handled the Mathis' civil rights complaint. "This is a victory not just for Coy, but for transgender students throughout Colorado."
Of course, how a school staff and a community respond still varies widely from place to place.
But, overall, attitudes about differences in gender identity have been changing, even in the last decade, says Eli Erlick, a transgender student and graduating high school senior in Willits, Calif., a small town in the northern part of the state.
When Erlick began her transition from boy to girl at age 8, she says that even she didn't know what the word "transgender" meant. She just knew that she wanted to live life as a girl. "I thought I was the only person like this," she says.
School was difficult. Some teachers made fun of her in front of the class, she says. To avoid dealing with which bathroom to use, she would pretend to be sick, so she could go home and use the facilities there.
Now Erlick is the director of an organization called Trans Student Equality Resources, which provides schools with training and information about students like her. Erlick also has helped her school district and others in California develop transgender policies.
Some schools in other states are doing the same.
Grant High in Portland, Ore., has established a student support team to determine how well the school is meeting the needs of transgender and other students. Earlier this year, the school also created individual gender-neutral bathrooms that any student can use.
Bathrooms often become a focal point because, when children are young, the transition is often more "social," a change in clothing and hairstyle.
A separate bathroom was not, however, a workable solution for the parents of Mathis, who was told she could no longer use the girls' bathroom at her school a few months into her first grade year.
"If it were just a toilet, then just having the gender-neutral option would be fine. But it's really about being accepted," says Kathryn Mathis, who removed Coy from classes and began home-schooling in February, after filing a discrimination suit with the state. "What's happening now - they will call you a girl but you're not really a girl, so you don't get to act like one. And that's incredibly damaging."
In a sternly-worded ruling, Steven Chavez, director of the Colorado Division of Civil Rights, agreed, finding that the bathroom restriction at Coy's school created an "exclusionary environment" that could lead to isolation.
"It also deprived her of the social interaction and bonding that commonly occurs in girls' bathrooms during these formative years," Chavez wrote.
"Telling the Charging Party (Coy Mathis) that she must disregard her identity while performing one of the most essential human functions constitutes severe and pervasive treatment and creates an environment that is objectively and subjectively hostile, intimidating or offensive."
Support is crucial
Scott Morrison, a transgender student at Grant High School in Oregon, says having support at home and at school, as he did, will make a big difference for kids such as Coy.
Morrison moved to Oregon from Virginia three years ago.
"Gender identity is probably the most important part of me," Morrison says. "It's the most important discovery I've made about myself."
He transitioned from female to male a year later and says support from his mom, his friends and his new school - and help from a counselor - likely prevented him from committing suicide.
According to a 2010 National Transgender Discrimination Survey, 41 percent of transgender people surveyed said they had attempted suicide. That figure rose to 51 percent for those who said they'd also been bullied, harassed, assaulted or expelled because they were transgender or gender nonconforming at school. The survey was a joint project of the National Center for Transgender Equality and the National Gay and Lesbian Task Force.
The Mathis family recently moved to Aurora, where Coy will begin second grade in the fall.
Mathis says she's heard from several parents who've made the decision for their transgender children to go "stealth." In other words, they make the transition - from boy to girl or girl to boy - and then move, so no one knows.
With the recent decision by the state, though, such stealth tactics might no longer be necessary for families with transgender children living in Colorado.
"This is huge for Coy, and every transgender child throughout the state," Mathis says. "We had the law in place, but this is the first statewide ruling saying that yes, it was discrimination."
Gazette reporter Stephanie Earls contributed to this report.