Girl in Bloom: The Story of a Teen’s Transition

Rose was born a boy, but she’s always felt like a girl.

“I wanted to be a girl, but I didn’t have a word for it,” says Rose, who grew up as Kevin. “Around age 13, I did some research and I found it: transgender.”

The word transgender brought Rose relief. It struck like an arrow to her heart, resonating in every cell of her body. She had discovered the truth about herself, and it opened her up.

Shortly after learning what it meant to be transgender, she came out to her brother. While he was supportive, Rose worried about telling her parents. She knew it would rock their world, partly because Rose was the “ideal” child—a shining star in school and the community who never made waves.

“When Rose first told me she was transgender, as a typical Asian mom I was shocked,” says Jessie. “I was overwhelmed with questions, like ‘What does transgender even mean?’ ‘Is it permanent?’ ‘Did I do something wrong?’ and ‘What should I do to help Rose?’”

Rose’s family needed help understanding what it means to be transgender—when a person’s assigned sex doesn’t match identified gender. It was important to Rose’s mom to seek care from a comprehensive clinic led by doctors. She chose the Pediatric and Adolescent Gender Clinic at Lucile Packard Children’s Hospital Stanford, where a team of experts in pediatric endocrinology, adolescent medicine, OB/GYN, psychiatry, psychology, urology, and plastic surgery provide all-around care for gender-expansive youth. 

“Without the help of the Gender Clinic, I would have fought with Rose a lot,” Jessie says. “Having that reassurance from the doctors and a parent support group really helped me to fully accept the fact that Rose is Rose.”

When Rose first came to the Gender Clinic, she was withdrawn and shy. As an assigned male who wanted to be female, she felt that her insides did not match her outside, which made her feel self-conscious.

“Rose is tall, and when I first met her, she sat hunched down as if she was trying to be shorter, as if she wanted to simply blend in and exist,” says Tandy Aye, MD.

During early sessions, Dr. Aye, the pediatric endocrinologist who started the clinic, noticed that Rose was getting extremely thin. Vital signs confirmed her concern: Rose had an eating disorder. 

Dr. Aye explained that Rose couldn’t start therapy with hormones—something Rose very much wanted—until she was medically safe. Rose agreed to be admitted into the Packard Children’s Comprehensive Eating Disorders Program, where she spent two weeks. Rose’s eating disorder was a turning point for her mom.

“Seeing her in the hospital bed looking thin as paper really woke me up. I realized I just wanted my kid back,” Jessie says.

Had Rose gone to a clinic with limited services, her eating disorder may have been missed.

“Eating disorders are fairly common in transgender youth who have not received gender-affirming interventions. They attempt to manipulate their weight in order to align their body with their gender identity, which puts them at risk for developing an eating disorder,” says adolescent medicine specialist Jonathan Avila, MD.

Dr. Avila believes the power of the Gender Clinic is its multidisciplinary approach, which allows for highly individualized care. Every gender-expansive youth has his or her own unique needs, and because the clinic is widely comprehensive, it can meet all of them, from legal assistance, voice therapy, and sexual health care to individual and group counseling, hormone therapy, and top surgery.

“There’s no one recipe for being transgender. Being transgender doesn’t mean you need hormones or surgery,” he says. “Our job isn’t to push any certain type of treatment. Our job is to figure out what transgender youth need and learn how we can support them so they can be their best, healthiest selves.”

Besides treatment for an eating disorder, Rose’s care program includes legal help to change her name and starting gender-affirming therapy with hormones. Hormones allow transgender youth to go through the appropriate puberty.

“Hormone therapy is great. It is slow, but that’s the way it works. I have been noticing changes, and that feels good,” Rose says. “It’s relieving to start looking the way I feel.”

Rose has been taking estrogen for about six months. She is looking forward to achieving more feminine facial features, less body hair, less muscle mass, breasts, and a higher pitch to her voice.

“I feel like a lot of burdens are being lifted. Transitioning socially to everyone I know, looking more feminine, and being called the right name in public is very freeing,” Rose says.

Jessie’s priorities have shifted. Rose’s happiness and health are now her top concerns.

“In the past, I was proud of Rose for her academic achievements and winning national STEM competition medals. Now, I am proud of her for having the courage to stand up and say, ‘This is me. Accept me as I am,’” Jessie says.

This past summer, Rose created a curriculum for an honors chemistry class after some of her fellow students and friends asked her for help learning the material. She knows chemistry—she asked for a chemistry book just for fun at age 13, took a college chemistry class when she was 15 years old, and recently passed the AP chemistry exam without even taking the class. She taught her class to students over Zoom during the pandemic. Rose would have readily done it for free, but she decided to charge so that she could give back to the doctors who cared for her during her transition. Rose donated all of her earnings to the Packard Children’s Gender Clinic and the Comprehensive Eating Disorders Program as a way to say thank-you.

“The last time I saw Rose, she walked in with her head held high and her long hair flowing. She seemed really happy,” Dr. Aye says. “Oftentimes, when transgender youth make the transition, they are happy for the first time in their lives because the gender they identify with finally matches what they see in the mirror.”

At 16, Rose radiates a confidence and sense of self that defies what it means to be a teen. Maybe that’s because she has spent so much time defining who she is. She’s no longer Kevin. She’s a blooming Rose.