MS. SUSAN PAGEThanks for joining us. I'm Susan Page of USA Today sitting in for Diane Rehm. She's on vacation. Gender behavior can vary widely among young boys and girls, but when a child strongly identifies with the opposite gender, parents and teachers may struggle with the challenge it presents to cultural norms.

MS. SUSAN PAGEJoining me in the studio to talk about gender nonconforming children, Dr. Edgardo Menvielle of Children's National Medical Center, thanks for being here with us.

DR. EDGARDO MENVIELLEThank you, good morning.

PAGEAuthor and blogger Lori Duron, thanks for being here.

MS. LORI DURONThank you so much.

PAGEAnd joining us from the NPR bureau in New York City is author and lecturer Andrew Solomon. Welcome to "The Diane Rehm Show."

MR. ANDREW SOLOMONWhat a pleasure to be here.

PAGEWe invite our listeners to join our conversation later in this hour. You can call our toll-free number, 1-800-433-8850. Send us an email to drshow@wamu.org or find us on Facebook or Twitter. Well, Dr. Menvielle, let's start with you. Explain what we mean when we say gender conformity in children.

MENVIELLEWhat we mean is children who do not conform to the conventional norms of gender, so these are boys who are interested in feminine things, who have preferences who are typically considered feminine behaviors, gestures, et cetera, and the same with girls who have a preference and interest in masculine play, behaviors, et cetera.

PAGESo at what age do you see this in children?

MENVIELLEYou can see it as early as age two, sometimes even earlier. It tends to start manifesting when the child is able to express preferences, interests, you know, toys that they like, toys they don't like, et cetera.

PAGEAnd here's an email we've already received from Jen who writes: "Please distinguish gender nonconforming from transgender children. Every child experiments with different gender roles. Gender nonconforming children do not conform to one gender. The other, transgender children clearly reject their biological sex." You'd make that distinction?

MENVIELLEYes, I would make that distinction.

PAGEAll right. And Lori you have a son, C.J., who falls in this category. Tell us about him.

DURONHe's great. And as he explains gender nonconformity or his own, he says that he's a boy and he knows he's a boy and he only likes girl stuff and wants to be treated like a girl. And he knows in a very age-appropriate way what it means to be gender nonconforming and what it means to be transgender and he identifies as gender nonconforming.

PAGEAnd you have just published a book called "Raising My Rainbow" and I wonder if you would read for us just a very brief passage that starts chapter two.

DURONYeah, and this was when C.J. was about two and a half almost three. "It was like watching somebody come alive, watching a flower bloom, watching a rainbow cross the sky. It was the day that C.J. discovered Barbie. He was two and a half years old.

DURONOne late fall afternoon, I was doing some cleaning. I found a boxed Barbie in the depths of my closet and tossed her on my bed. What dat? I wobbled and nearly fell off my stepladder at C.J.'s shriek. It's Barbie, I said regaining my balance.

DURONThis particular Barbie was pretty fabulous. It was Mattel's 50th Anniversary Bathing Suit Barbie. She was a modernized version of the original 1959 doll with a two-piece black and white bikini trimmed with her signature color pink, pink hoop earrings, a long blond ponytail and a pink cellphone.

DURONI want to open she, C.J. declared. He held the box as he jumped up and down, up and down, up and down. I'm sure he gave Barbie a concussion. I hesitated. I had been trained well by my mother. You do not open a boxed Barbie, if you can at all help it. I was a little annoyed.

DURONI was going to open the box and take Barbie out and my son was going to play with her for a few seconds and move on to something else bright and shiny. Then I'd be left with a depreciated piece of plastic. But his face, his sweet, excited face could convince me to do worse things. We opened her.

DURONIn that instance, our lives changed forever in a way that we never expected. In our family's history, there is now BB, before Barbie and AB, after Barbie. Never underestimate the power of an 11 and half inch woman."

PAGESo how did you react to that, this revelation I guess when he so loved that Barbie?

DURONWell, I thought it would just be a phase. He had been getting his toys that were handed down from his older brothers so it was trains and trucks and balls and nothing excited him. I mean, he was a happy kid certainly, but when he found that Barbie, that was the thing that he clung on to. That was in his grip for, you know, weeks and months and now years.

DURONBut it was hard, it was hard. As a parent, you know, we want to kind of fix what's broken. We always want to know what's going on, what does everything mean and so I think I was really questioning what it meant and my husband was as well. So we had lots of late-night conversations.

PAGEAndrew Solomon, you have just spent a decade working on a book called "Far From the Tree" about children who are unlike their parents. And it includes a chapter on transgender kids. Tell us what you learned in doing research for your book.

SOLOMONWell, the larger quest of the book was to suggest that there are many kinds of difference and that all families who are dealing with difference have a great deal in common. So I talked to families of deaf kids. I talked to families of kids with autism. I talked to families with musical prodigies who were also overwhelmed.

SOLOMONAnd I concluded the book with a chapter on kids who were transgender and I was really interested in the question of whether kids who are transgender have a biological condition, like deafness and dwarfism or have one that is really psychological and whether the appropriate intervention for those kids is to make their minds line up with their bodies or make their bodies line up with their minds.

SOLOMONAnd what I came away with was the sense that there are some kids for whom it's easier to shift their minds and some kids for whom it's easier to get their bodies and their way of presenting themselves to the world to conform with the gender they know themselves to be.

SOLOMONAnd I was struck by the struggle the parents went through in trying to figure out which way their kids were and the enormous amount of prejudice that they had to fight back. And I wanted to tell those stories, to expose that prejudice and to send out a message of hope to parents whose children are transgender or even gender nonconforming and say you can have a rich and a worthwhile life being outside of the usual behaviors of the gender you are assigned at birth.

PAGEWell, you said that one goal of your book was to show how families with kids who are unlike them in some way, whether it's dwarfism or autism or gender nonconformity, how they're alike, what's common to them. What is common? What has come across those lines to these families?

SOLOMONI think there are really two kinds of identities that people have. There are vertical identities, which are handed down from parent to child, your ethnicity, your nationality, often your religion, usually your language. And then there are, what I called horizontal identities that have to be learned from a peer group in which a parent has a child who has a fundamental and profoundly defining quality which is completely foreign to the parent.

SOLOMONAnd the parent has to learn a whole new vocabulary in order properly to nurture, to love and to help their child and it's my belief that all of the families who are negotiating difference in that way have in common the struggle to get from the love that they presumably have had from their child from the beginning to a real acceptance of their child for who their child is.

SOLOMONAnd I ultimately came to think that the experience of difference is a nearly universal experience at some level, not always as extreme as the cases I was looking at, but very broad and that having a child whom you perceive to be exactly like you and completely normal in every way is actually the rare and lonely state.

PAGELori, you're nodding your head. The description that Andrew is giving us, is that the one that your family faced?

DURONYeah, for sure. I nod my head in agreement a lot when I hear Andrew speak...

SOLOMONThank you.

DURON...partly because he, I mean, you want to give us this hope and there is a hopelessness that first came over us and we felt really lonely. And now there's a lot of joy. I hear a lot from other parents through my blog who don't have children who are gender nonconforming, but who are maybe autistic or have some other special need, that they connect and that the, as parents, were feeling a lot of the same things, even though our child who is so different from us, you know, those children aren't alike, but the parents are going through similar things.

PAGESo Dr. Menvielle, tell us how common is this gender nonconforming behavior and do these kids grow up to be transgender adults?

MENVIELLEWell, the question of how common is difficult to answer if you want a specific number. It's probably more common than we realize because there is a taboo aspect to talk about it so a lot of people do not.

MENVIELLEAnd the question of whether these children grow up to be transgender adults, I think we know now that that is the case for some children, but it's not the case for others. And probably it's not the case for the majority of kids, if you consider gender nonconformity in a broad sense.

PAGEWe find that gender nonconforming girls have a much easier time of it than gender nonconforming boys. Why is that?

MENVIELLEWell, there seems to be a much higher penalty for boys who violate the norms of masculinity than there is for girls who violate the norm of femininity. You know, typically tomboys are accepted, I would say celebrated, whereas boys who express femininity tend to be condemned and criticized and judged in a negative way.

PAGEDo you agree with that, Lori?

DURONYeah, I do. It's something with society that sees masculinity, or a little bit of masculinity in females to be a strength an empowerment and you want to say, you go, girl. But you see a little boy, you know, with femininity in him and you get a far different reaction. It's seen as a weakness.

PAGEAndrew, these little boys can have a very tough time in school and elsewhere?

SOLOMONI'll tell you a little story. When I was a kid, I remember going to a shoe store with my mother and my brother and at the end of having our shoes fitted, the salesman said each of us could have a balloon. And my brother said he wanted a blue balloon and I said I wanted a pink balloon. And my mother said, I think you'd really rather have a blue balloon.

SOLOMONAnd I said, no, no, I really wanted a pink balloon and she said, remember, your favorite color is blue. So the fact that my favorite color now is blue and I'm still gay gives some evidence I think of both the parents' influence and its limits.

PAGEAndrew Solomon, he's a writer and lecturer on psychology, politics and the arts and author of "Far From the Tree: Parents, Children and the Search for Identity." And in this hour, we're also joined by Dr. Edgardo Menvielle, he's associate professor of psychiatry and director of the Gender and Sexuality Development Program at Children's National Medical Center and Lori Duron, author of a new book "Raising My Rainbow: Adventures in Raising a Fabulous, Gender Creative Son," and the Raising My Rainbow blog.

PAGEWe're going to take a short break. When we come back, we're going to go to the phones. We'll take some of your calls. We'll read your emails, stay with us.

PAGEWe're joined now by Allyson Robinson. She's a national transgender advocate and consultant. Welcome to "The Diane Rehm Show."

MS. ALLYSON ROBINSONThank you, Susan. How are you?

PAGEI'm good. So tell us, at what age did you start to feel as though you were not the gender of your birth?

ROBINSONWell, really, some of my earliest memories are around this growing self-understanding that I was not the person that everyone around me seemed to expect me as a little boy.

PAGEAnd what did you do about that? How did you handle it?

ROBINSONWell, you know, I was fortunate to grow up in a home and in an environment where I was not exactly encouraged in the late '70s, early '80s but were certainly given the freedom to experiment and to find ways of expressing myself that felt comfortable and right. By the time I got to kindergarten, though, at, you know, five years old and began to have a bit more of a sophisticated social life, well, that kind of expression was not really tolerated well. That kind of freedom just wasn't there.

PAGESo you got bullied at school?

ROBINSONAbsolutely. One of my earliest memories of that is in kindergarten, playing chase with all of the other boys and girls. And I'm playing on the girls' team because that was who I sort of knew myself to be. Of course when girls catch boys, at least back in our day, they kissed them. And I was actually beaten pretty badly by two kindergarten children for that breach of gender protocol.

PAGEDid you ever talk to your folks about your feelings?

ROBINSONYou know, I didn't, at least not until much, much later in my life. I really couldn't. And it wasn't through any fault of theirs. My mom was sort of a Southern California hippie chick from the '60s and was, you know, encouraging when she would discover that I'd been trying on her clothes or something like that. But I couldn't even look her in the eye when she would offer that encouragement.

ROBINSONThat when she would remind me that I wasn't sick or wrong, because to do that was to acknowledge that I was not ready to acknowledge.

PAGEYou went to West Point, graduated, got married, had four children with your wife. What happened then? What made things change for you?

ROBINSONWell, I reached a point, and I think many transgender people do, when, you know, forcing that sense of self down and out of my life was no longer feasible. I ran out of the energy to be able to do that. And in fact, it was the first time that I caught myself, seriously considering suicide as a way out of all of this. But I realized I needed help. And so I did reach out and got some professional counseling.

ROBINSONAnd that set me on the road to a much more healthy and whole way of dealing with it.

PAGEAnd the process of becoming a woman then.

ROBINSONYes, exactly. You know, at first through a fairly lengthy evaluation by the team that was working with me and then later with the help of medical doctors, endocrinologists and so forth.

PAGEAnd how do you feel now?

ROBINSONI feel alive. I love my life every day. I, of course, have -- I've had an experience that the many trans people don't. My family has stayed together. My wife Danielle is my strongest ally. My best friend and still we're the love of one another's lives. Our children are growing up strong and healthy and incredibly well adjusted. I wouldn't trade it for anything. My life is better than I ever imagined that it could be.

PAGEAnd do you think you had your own difficulties as a person growing being gender nonconforming? Are things different now for kids, do you think?

ROBINSONI think they are a little bit. But I think that that experience of mine of, you know, having my nonconformity literally beat out of me at a very young age is still unfortunately very common. My mom was wonderful, but at the time she lacked resources. She led with her heart and her value. She did her best. Fortunately today, more and more parents and educators are doing more to help kids like this.

ROBINSONFor example, the Human Rights Campaign's Welcoming Schools Project is an entire curriculum-based program for schools that help create gender-inclusive environments that can stop the kind of bias-based bullying that I and so many others experienced.

PAGEAnd what advice do you have for parents who are -- who have young kids and are wondering, kids who seem to be gender nonconforming? What advice do you have for them on what to do?

ROBINSONWhat I have learned from my own experience, both as a child and a parent and from watching, you know, so many other parents and adults who care for children like Lori and like Dr. Menvielle is that you can really trust your kids even when they're very, very young. If you stop and listen and engage them about their experience and then trust what they tell you about themselves, even if it makes you uncomfortable.

DURONOvercoming that personal discomfort and learning to listen and trust is really the first step, I think, to be a supporting parent of any child, including gender nonconforming and gender creative and transgender kids.

PAGEAll right, Allyson Robinson, thanks so much for joining us on "The Diane Rehm Show." So, Dr. Menvielle, what do you make -- what do you think about what Allyson Robinson has just told us?

MENVIELLEI think what she just told us, it's very correct and true and I think that that's an issue that is very important to me in my work because parents often are in a little bit of shock. They don't know what to do. They don't know how to talk to their kids. And the issue of trusting their child is really paramount.

PAGEBut sometimes is this a life condition and sometimes it's just a phase that kids go through? Or not? I mean, is that an attitude that parents have? And how would you distinguish if it could be one or the other?

MENVIELLEWell, you can't necessarily distinguish in the very beginning. You don't know how it's going to evolve for that person. You have to just be open to all the possibilities. And that's what we try to help parents to accept, the fact that they cannot predict the future. They can only be there to nurture and support.

PAGEAnd so, Lori, tell us about -- you told us about your reaction. How about your husband? How did he react?

DURONHe was great. But he -- but I hear from lots of families where the fathers or the male figure isn't great. He had questions. He grew in this home with all boys and a mom who was a tomboy, a professional surfer at one point. And so, he had never had girls around. So to have a son who was playing with girl toys, it didn't feel comfortable to him at first. And it didn't necessarily feel comfortable to me either.

DURONAnd then our son started dressing in girl clothes and, you know, that was another thing that we had to deal with. But my husband has been great. He's also a police officer. Before that he was a firefighter. So he tends to come from this really macho, masculine world, where homophobic slurs are kind of said every day. And so, he has to deal with his home life too and then also what he hears and what he sees at work. But he's been a great father.

PAGEAnd how did you handle wearing girls' clothes, for instance, to school?

DURONWell, so our son doesn't. He has his kind of public persona and his private persona. So when he's out in public, he self-edits and that's his choice and that's something that, you know, we were just talking about is we have to follow his lead and we had to work with a gender therapist to get to that point where we were comfortable following our, you know, five-year-old or six-year-olds lead.

DURONSo he self-edits. He has his outside clothes and his inside clothes. And outside he wears the most effeminate things that he can find from the boys' section. So super skinny jeans and like a pink polo or a purple V-neck, something like that and he does girl shoes and girl socks. So it's this fluid mixture of gender almost. And then when he comes home, he changes into what makes him really feel comfortable, which is a skirt and a lace tank top and a tiara or a head band. So he self-edits. A lot of kids don't. But that's how -- that's what he does.

PAGEAndrew, what did you think about what we heard from Allyson Robinson?

SOLOMONI thought it was very moving and it rang very true to me. It's consistent with the experience of many of the kids I've met and who I've dealt with. I mean, I think part of what makes Lori's book such a remarkable book and her experience with her child such a remarkable experience and what invests them both with so much courage is that there is a willingness to listen and a willingness to follow what your child thinks.

SOLOMONNow people can get carried away with that. I have small kids and I don't let them decide what they're going to have for dinner. So the idea of letting them just decide all on their own, I'm going to live in a different gender, you know, you're a parent, you have to be interacting with your child. You have to be saying, these are the difficulties that will pose. You have to be considering what the reasons are for your child making such a statement.

SOLOMONBut you have to do all of that still with the ability really to listen to the child and to allow the child to become himself. All of parenthood consists of this series of decisions in which you're either saying I need my child to be educated, I need my child to have manners. I need to teach him to be different than he would be in a state of nature. And then I need to accept the things about him that are profound and that are true and that are immutable and that who he is even if they're not exactly what I had imagined before I had a child myself.

SOLOMONAnd I think that both of these stories -- Lori's story and Allyson's story -- are stories about how people come to a coherent sense of their own identity. And I think that's a long process. I think it's a struggle and I think parents need to be supportive and wise about it. And as Edgardo has said, they need to be open to the idea that what seems to be true today isn't the same as what will seem to be true tomorrow.

PAGELori?

DURONAnd I do get that a lot. People will email me or through social media will say, okay, so you just let your son be whatever he wants to be. And if he wanted to murder people or if he, you know, anything he wants to be would be fine with you. And I think you're right, Andrew, we parent him to have -- the same way that we parent our older son, the basic right from wrong and manners and the golden rule and empathy.

DURONAnd those are what we're instilling in our children. But so you do have to listen to your child and see what's -- are they wanting to just be a different gender just because or is there something else going on there? So it's listening to your child. And by all means, you know, we don't let him have free reign. But as far as his gender expression and identity go, we certainly follow his lead.

MENVIELLEYou know, no matter how supportive a family may be, the child is still living in a world and that world is not always so sympathetic. So definitely what talked so far is absolutely essential for families to be able to listen and to be supportive. But there's also another step they have to take, which is to advocate for their child, because we find in many situations the children are going to be discriminated, ridiculed and, you know, suffer that kind of indignity.

PAGEWell, in fact, we're talking with Lori. Her husband who'd been accepting of their child, Allyson had positive experiences with her parents. But, Dr. Menvielle, you must deal with a lot of parents who are really struggling with this and they're not nearly as willing to accept this situation as something they need to adjust to.

MENVIELLEIt is true. Although I have to say, I've been doing this work for about 15 years and the parents today are very different from what they were five years and ten years and fifteen years ago. I think a lot more people are waiting to take a supportive stand and much more quickly. I think that people do and certainly they struggle before they arrive to our program. But what I see is that this travel has become shorter. I think that there's a great awareness now.

PAGEI'm Susan Page and you're listening to "The Diane Rehm Show." We're going to take your calls, 1-800-433-8850. Lori?

DURONThat was one thing, you know, I learned from watching my brother grew up and he was gender nonconforming at heart as a child but it was a different time and a different place and my parents parented differently than we do now and made some mistakes. And now he identifies as gay but we've talked to him a lot as we go through this process, raising a gender nonconforming child.

DURONYou know, what would -- we asked him what would he have wanted as a child? What did he need as a child that he feels like he didn't get? And what did he need from our parents that he didn't get? And so, I can see definitely that it's a different generation parenting, at least in our family.

PAGELet's go to Jackie. She's calling us from Orlando. Jackie, hi, you're on the air.

JACKIEHi, good afternoon. I was wondering -- I have a question for everybody on the panel. A lot of times when I see the presentation of transgender issues, it's piggybacked onto or associated with gay and lesbian issue. I find that nearly all the time. And because I think that gender identity and sexual orientation are two totally different things, I wonder why that always happens. I mean, that's how it's always brought up.

PAGEYou know, that's interesting. We've got a similar email from Wesley in Greensboro, NC who writes: Could you discuss the relation between gender and sexual orientation of cases where someone undergoes gender reassignment but her sexual orientation remains the same? Doctor, what do you think?

MENVIELLEWell, you know, they are two separate things and they relate to each other in different ways for different people. You know, we discuss them together perhaps because we can sort of classify all of them under the label of something different from the norm. But, yes, they are different from each other.

PAGEAndrew, Dr. Menvielle talked about how times have changed, attitudes of parents different now than they were 10 or 15 years ago. Do you think that's true? And if it is true, what's made the change in the culture?

SOLOMONI think it's certainly true. I think we live in a time in which there's been an enormous shift in acceptance of gay people and that acceptance of trans people has followed along in that. So I think the sort of one line distinction, which I've used before and used on the radio, which I heard originally from a trans man is your gender identity is who you are and your sexuality is who you bounce it off of.

SOLOMONBut I think, nonetheless, that the fact that we are more accepting now of gay people, that we live in an era of gay marriage, that we live in a time when the idea that all gay people suffered from a pernicious sickness has been removed, has ended up having a lot to do with gender. And the reason that the gay movement and the trans movement go hand in hand is that there are many gay people who are also gender nonconforming in some measure or some degree.

SOLOMONAnd if we begin to say that that's acceptable, then we become more open to accepting the gender variant, the more profound gender variance that's associated with actually being trans. And I think what Lori has described, which is having a child who might turn out to be trans, might not, might turn out to be gay, allowing the child simply to develop, that's part of building an altogether more tolerant society, which is what I think we're in the throes of doing.

PAGELori, you talked about in your book how Halloween is CJ's favorite holiday. Tell us about that.

DURONCertainly because he can be whoever he wants to be. He can dress up and he has, you know, an eye for fashion and for flair and for anything that sparkles and glitter and so he likes to get dress up. And that's also an evening when he can get dressed up as a girl and go out in public and it's absolutely fine. He actually feels like he's rewarded for it because he gets free candy. So that's his favorite holiday.

PAGEAnd he did he go as last year?

DURONLast year he was a fairy. This year he's leaning towards Alice in Wonderland. And he's also been Frankiestein from Monster High.

PAGELori Duron, she's author of a new book, "Raising My Rainbow." And we're also joined this hour in our discussion about gender nonconforming children by Dr. Edgardo Menvielle from the Children's National Medical Center. And from the NPR bureau in New York City, we're joined by Andrew Solomon, the writer and lecturer, author, of "Far From The Tree."

PAGEWe're going to go to the phones when we come back after a short break and take some of your calls and questions. You can send us an email at drshow@wamu.org. We're also going to talk about the case of Bradley Manning, now Chelsea Manning that has focused a lot of attention on the issue of transgender adults. Stay with us.

PAGETheresa's calling us from Cleveland, Ohio. Theresa you're on "The Diane Rehm Show."

THERESAHi, how are you?

PAGEGood.

THERESAGood. Actually my question is for Lori. Lori, I saw you on Facebook. My sister recommended that I follow you. My son, whose name is D.J., actually, if five and he is, like, Cinderella queen. He loves her to death and my thing is is that my family is -- most of my family's very supportive and most of my friends are very supportive, but when we go out into situations like church sometimes where he wears his Cinderella tennis shoes he gets made fun of. Some family members will, like, make faces, but to his face be OK, but then he'll see them, like, being harsh towards his choices and decisions. So my question is how do I direct him towards being accepting of himself in those kinds of situations, at such a young age of five?

DURONI think that's the hardest part is I want my son to be so strong and confident in who he is and he's going to need that regardless of what his future is like. So I try to raise him to be really strong. The thing that's worked for us is that he knows that he has a style, everyone has a style and that his style is different and not everyone likes it just like he doesn't like everyone else's style. So that's helped him to kind of own it. He'll say, you know, well, this is just my style.

DURONIt's also helped him -- we've told him because he was asking questions about himself. We told him that he's gender nonconforming. And I always tried to parent without labels, but once I gave that label to him and it explained to him what he was that's helped. And he'll tell other people -- he'll explain to them I'm gender nonconforming. That's why I'm this way. So that's helped.

DURONIt has also helped when we tell family members, like, sit them down -- so instead of them thinking this is just a phase or whatever we explain he's gender nonconforming. There's a name for it. If you want more information I can provide it and there are other kids like him out there. So that's helped a lot, but we've definitely lost family members. We've lost friends and I personally really struggle with religion right now just because of all of the things that you explained.

THERESAIt's just that I'm so teary that you guys came on the air and I got teary. It's just -- it's great that it's coming out, yeah, actually that there are kids like this and that's people against it and how to help them at such young ages to accept and to move forward, to be strong in who they are, you know.

DURONIt can feel so lonely. So I feel for you. And also I think you probably share -- and I don't want my son to ever know how hard it is to parent him. So, I mean, it's hard and I've had many crying sessions -- me and my husband, our conversations and where I've just broken down, but I never want my son to see that. So then I know you, as a mother, probably feel that same way. It's hard to be hopeless, but have your child see you as feeling strong and confident.

THERESAYeah, you have to have your mom face on.

DURONUm-hum.

PAGEYour mom face. That's a great -- that's a great phrase for you. So how old was your son when you noticed he was dressing -- he'd be attracted to things that were more feminine?

THERESAHe's was probably about three and a half, four. And he's not, like, he doesn't come home and throw on his tutu, but he'll wear his, like, flashy Cinderella shoes around the house, but he'll also -- he'll also say that I'm not going to leave the house in these because people will laugh at me. So it's just hard to find that boundary. And we've talked to a psychologist and she said, you know, don't force it, don't push it. Make him feel comfortable at home and then at that point, you know, you can get him to move further if that's the choice that he wants to make.

DURONYeah, it really -- I mean it's helped for us to realize it's his choice to make so he has to weigh -- he has to weigh how important the Cinderella shoes are. And you know what some days he rocks them and some days he doesn't feel like it's worth the risk, but it's his choice.

PAGEAndrew, what advice would you have, if any, for Theresa and for moms like her that are trying to deal with this situation?

SOLOMON...Over and over and over again which was of children who were diagnosed with all kinds of problems. There was one family, for instance, in which the child had been diagnosed with ADD, attachment disorder, oppositional defiant disorder and bipolar disorder. He was on a whole bunch of medication for all of these things. He was in constant therapy and he kept saying also, and them sort of marginally, oh, but I'm really a girl.

SOLOMONAnd finally they decided that they would let their child live for awhile as the girl that he insisted that he was or that she insisted that she was. And when they allowed that all of the diagnoses evaporated and it turned out that all of that pain and anguish and what appeared to be mental illness was a manifestation of the frustration and anxiety caused by being forced to live in a gender that felt wrong.

SOLOMONSo there is no question that there is resistance and hostility out in the world. There's an enormous amount of it. It's important to tell your child and to tell the other people who are commenting that diversity, as one historian of science put it, diversity is not disease and the anomalous is not the pathological, but I think the central thing to understand is that the choice, in many instances, is between having a child who is tortured by not being able to have an exterior self that conforms to his interior self or receives a certain amount of torture out in the world because of expressing that interior self and a parent and a family has to figure out what the balance is to strike there.

PAGEDr. Menvielle, I wonder what your reaction was to the developments involving Bradley Manning who now wants to be referred to as Chelsea Manning tried for treasonous activities sentenced now to prison asking to transition from a man to a woman. What was your reaction?

MENVIELLEWell, I've seen this happening before to other people so I take it in that context. This happens. You know, there are people who struggle for many years. They are internally conflicted. They seek for ways to erase it -- erase this part of themselves, you know, like the previous guest told us by joining the military or doing something that they feel is going to help them, kind of, get rid of their conflict, but in the end that doesn't happen. And they grow tired and exhausted and they have to, kind of, face the fact that their identity is not what they wanted to project in order to survive. It's something different and they have to own that identity.

PAGEAndrew, what did you think?

SOLOMONI wondered whether Chelsea Manning was going to be the best spokesman for the trans movement altogether given the, sort of, complicated and conflicting questions about what Bradley Manning did. But I think that if Chelsea Manning genuinely understands herself to be Chelsea Manning, if that's who she really believes she is, I think it's very important that the U.S. Military, which, of course, has historically been homophobic and transphobic accommodate who she is.

SOLOMONPeople who are in prison, even in military prison at Fort Leavenworth, are entitled to full medical attention. And I think that having a gender identity disorder, as it's frequently called, or having gender dysphoria, which is to say unhappiness about your gender, which is probably closer to the description of what Chelsea Manning has had. It's a real condition and it requires treatment and the treatment often involves physical intervention, it involves hormones, it involves being allowed to live as who she believes herself to be and not throwing her into prison with a lot of men who are male identified and who will doubtless make her life a living hell.

PAGEHere's a Tweet from Laurie. She writes, "I rejected my societal gender role early on, but not my biological gender and even turned out to be straight. It takes all kinds." Here's another email from Christopher. He writes, "Aren't we starting with assumptions about what it means to be male and female. My granddaughter likes to wear feminine clothing and makeup and she likes to swing a hammer with me in my workshop. And she likes to practice her quick draw with a toy pistol. I have no idea who she will eventually fall in love with and I don't care. I just enjoy watching her figure out who she is."

PAGEAnd here's a question an emailer from Cleveland, Dante, he writes, "This question is for Lori. How do you and your husband deal with thoughts about your husband's -- about your son's future? Will he grow up to be transgender, gay, both, neither when you're allowing him to self define?"

DURONWe've had to really let go of expectations and assumptions and realize that our son isn't a do over for -- he's not us. He is his own person. We, for a while, thought or considered, and from what he was telling us, that he was transgender. And you have to get to a place of that's his future and we'll help him and support him in any way that we can, but it is his future. And we have to allow him to be who he was created to be.

DURONSo we've gotten really good at kind of going with the flow, which isn't always easy to do as a parent, but, you know, a lot of parents don't understand what it's like. I have to sons right now, but in a year from now or five years or ten years I could have a son and a daughter and so it really changes -- it really changes the parenting journey.

PAGELet's go to Nancy. She's calling us from Rochester, N.Y. Nancy, hi, you're on the air.

NANCYOh, thank you for taking my call. I have a son who is now 25 years old, decided when he was 18 that he was transgender and we've kind of watched his whole transition from being a young, young girl, teenager and then now as a man. And what I would say is that my own experience has been one where I've had to deal with grieving, grieving the loss of a daughter, accepting the fact that I now have a son and allowing that grieving process to just take a back burner.

NANCYAnd that has been a little -- a struggle at times, but at the other times I've realized that by letting it take a back burner and just know that it kind of exists in the background I can then relate to him as though he's actually my child. I don't say male or female when I talk with him on the telephone. We're just having a conversation. He's the same person that he was when he was a girl and he's changed radically. He is much more in his body at this point than he ever was before. He's happy. He's in love with a young woman and the two of them are very happy together.

NANCYAnd what it allows me to do by putting the grief into the background and just let it just not even be a constant presence is that I can then enter into his world and find out what's going on for him. So that when last -- a couple years ago he was actually arrested -- he was part of the occupy Oakland experience and he found himself in jail and it was terrifying. And the best thing that I could do was to try to be there to support him in that way. And so the grief had nothing to do with it at that point. It just had to do with being there with your kid at the time when he's there now, as a man, being there for him and allowing those two to exist at the same time and it's OK.

PAGENancy, was it hard at all to get to that point of acceptance?

NANCYYeah, it took a while. It took a while. There was a lot of fighting it. There was a lot of resistance to not really asking the right questions and learning what the right questions were to ask him, to reading some materials about it. I met with a couple of other parents who were going through the same thing. One was very, very accepting and just loved her, now, daughter and finding that were just different ways to be -- it was OK. It was just, yeah, it was a struggle. There was a struggle there.

PAGEAll right, Nancy, thanks so much for calling us and sharing your experiences. Dr. Menvielle, what do you think? Is this a common story that you've heard?

MENVIELLEYeah, I think it's a common story. And I think it illustrates one point that I think is important to bear in mind. Some adolescents who come out as transgender were not gender nonconforming as children, at least, not to an extent that raised the parents' concerns. And then there are others who were gender nonconforming all along so the journey can be very different for the families.

MENVIELLEIn the first case, perhaps this case, someone that comes out in adolescence could be quite a surprise for the parents. They're not prepared for that, but if that child had been asserting that he was a boy all along the surprise would not be the same and perhaps the process will not be the same for those parents. So there's also diversity in how people process and deal with this experience.

PAGEI'm Susan Page and you're listening to "The Diane Rehm Show." Andrew, I wonder the newest version of the diagnostic statistical manual calls gender identity variance no longer a disorder. That's a change. Is that progress do you think?

SOLOMONI think it is. Before I answer that question I just want to say that a lot of the people who are calling in seem to need support, seem to feel alone and seem to need resources. There's an organization of which I'm on the board called Trans Youth Family Allies, TYFA. And TYFA is really specifically devoted to helping parents to work through some of these challenges and can be found on the web. And, um, sorry what was your...

PAGEOn the diagnostic...

SOLOMONOh, the diagnostic, of course. So the issue all along has been whether this constitutes a mental illness. And it's very difficult to say that it does and there are many people who said in the same way that homosexuality was a mental illness and now isn't that being trans had been treated as a mental illness and it should not be. And there are many people who have said if the way you address this problem is with surgery and hormones it should be an endocrine or physical disorder rather than a mental disorder.

SOLOMONThe harm of keeping the idea that it's a mental disorder is the stigma associated with it, which is very painful for many trans people who seem to have robust mental health. And the harm of removing it is that you lose access to services if you don't have a code that can be entered when people are providing the psychological treatment that some people with gender differences require.

SOLOMONAnd what's happened over time is that people have said there should be a category of some form of unhappiness about your gender or some sort of mental pain that you're experiencing because of it that doesn't say that the fact that you have male genitalia and are incredibly excited to open your mom's Barbie doll is a mental illness or that doesn't say the fact that you have female genitalia and you actually want to be a truck driver is an illness, that you actually want to be a truck driver who lives as a man.

SOLOMONSo it's been a very delicate process of figuring out what to do, but I think it represents enormous progress that we're no longer automatically saying anybody who's gender nonconforming is mentally ill. The same behavior that would be psychologically healthy in a girl represents a mental illness in a boy or vice versa. That was a very dangerous, very stigmatizing, very painful position.

PAGEHere's an email from Theda. She writes, "Please ask Ms. Duron how she came to the decision that she had the right to write about her son when he is at an age too young to really make that decision for himself that he wants that information about him out there." Is that a concern to you?

DURONIt's a huge concern to me that's why it took me months and months and months before I even started my blog. And then when I started my blog I write about my adventures in parenting him, but I don't write about his -- a lot of his personal stories and a lot of his personal struggles, which, yes, he has at the age of six and a half. I haven't on my blog -- I've never shown his face. I've never shown any of our faces. We all went by pseudonyms and so I was really trying to protect him in the best way that I knew how.

DURONAnd then after three years of doing this and after thousands of emails that are really, really touching I realized that kids like this need a voice and they need help and they need -- they need some acceptance and recognition and so that's why I decided to write the book. I'm still very, very careful when I write and I write it knowing that both of my sons will read it one day. I hope they do. I want them to. And at this point C.J. knows that he's gender nonconforming. There isn't a picture from the last two years where he looks cisgendered so he will always know that. And he will know that I did this for the best possible reasons and with his safety in mind.

PAGEAll right. Lori Duron, she's author of a new book, Raising My Rainbow." And we've also been joined this hour by Dr. Edgardo Menvielle from the Children's National Medical Center. He's director of the gender and sexuality development program there. And joining us from New York Andrew Solomon, he's a writer and lecturer. His recent book is called "Far From the Tree." I want to thank you all for being with us this hour on "The Diane Rehm Show." I'm Susan Page of USA Today sitting in for Diane Rehm. Thanks for listening.