[sally]

Carol says she finally sat down and showed him. From then on, Bradley drew boys as directed. Male figures with anemic caps of hair on their heads filled the pages of his sketchbook.

Another Family, Another Approach

Three-thousand miles away, on the West Coast of the United States, another family noticed their small son's unconventional tastes.

Jonah was 2 when his father, Joel, first realized that no amount of enthusiasm could persuade his child to play with balls. Trucks languished untouched. Fire engines gathered dust. Joel says Jonah much preferred girl toys, even his stuffed animals were female.

"Like, I would always say, 'What's that guy's name?' and the response would always be, 'Oh, she's bunny, she's, you know, this or that,'" Joel says.

Like Bradley, as Jonah grew older, these preferences became more pronounced. Jonah is physically beautiful. He has dark hair and eyes, a face with China-doll symmetry, and a small and graceful frame. Occasionally, while running errands, casual acquaintances, fellow shoppers, passers-by, would mistake Jonah for a girl. This appeared to thrill him. And, Joel says, Jonah would complain bitterly if his father tried to correct them.

"What began to happen was Jonah started to get upset about that," Joel says. "Like, 'Why do you have to say anything!' … I remember one distinct time when we were walking the dogs and this person came up and said ... 'Oh, is this your daughter?' and I said, 'Oh, no, this is Jonah.'... And Jonah just came running up and said, 'Why do you have to tell! Why do you have to say anything!'"

Then around the age of 3, Jonah started taking his mother Pam's clothing. He would borrow a long T-shirt and belt, and fashion it into a dress. This went on for months — with Jonah constantly adjusting his costume to make it better — until one day, Pam discovered her son crying inconsolably. He explained to his mother that he simply could not get the T-shirt to look right, she says.

Pam remembers watching her child mournfully finger his outfit. She says she knew what he wanted. "At that point I just said, you know, 'You really want a dress to wear, don't you?' And [Jonah's] face lit up, and [he] was like, 'Yes!'"

That afternoon, Pam, her sister and Jonah piled into the family car.

"I thought [he] was gonna hyperventilate and faint because [he] was so incredibly happy. ... Before then, or since then, I don't think I have seen [him] so out of [his] mind happy as that drive to Target that day to pick out [his] dress," Pam says.

Pam allowed Jonah to get two dresses, but felt incredibly conflicted about it. Even though Jonah asked, she wouldn't allow him to buy any more dresses for a year afterward, so Jonah wore those two dresses every day, nothing else, until Pam got sick of looking at them. After a year, she and Joel finally began to permit other small purchases. But every item, Joel says, provoked a crisis.

"We'd spend a few nights talking: 'Do you think the shoes are like a line that we should cross? Or, you know, the girly hat, or the girly jacket with the frills?' ... Like, what are we doing? Are we encouraging this? Are we doing something that we shouldn't be?" Joel says they would ask.

Joel and Pam also ended up in front of a gender specialist — Diane Ehrensaft, a psychologist in Oakland. Joel remembers an early session when Pam talked about her concerns.

"I remember her talking to the therapist and saying something to the effect of, like, you know, 'I'd be OK if Jonah just was gay, I just don't want ... him to be transgender.' And the therapist just laughed, she said, 'You know, 15 years ago, I had people on this couch saying, 'I don't mind him being a little effeminate, as long as he's not gay,'" Joel says.

In fact, Diane Ehrensaft's approach could not have been more different than the approach of Bradley's therapist. Like Zucker, Ehrensaft is a gender specialist. She says she has seen more than 50 families with children who have what Zucker would describe as gender identity disorder.

Ehrensaft, however, does not use that label. She describes children like Bradley and Jonah as transgender. And, unlike Zucker, she does not think parents should try to modify their child's behavior. In fact, when Pam and Joel came to see her, she discouraged them from putting Jonah into any kind of therapy at all. Pam says because Ehrensaft does not see transgenderism itself as a dysfunction, the therapist didn't think Pam and Joel should try to cure Jonah.

"She made it really clear that, you know, if Jonah's not depressed, or anxious, or having anything go on that [he] would need to really be in therapy for, then don't put a kid in therapy until they need it," Pam says.

Ehrensaft did eventually encourage Joel and Pam to allow Jonah to live as a little girl. By the time he was 5, Jonah had made it very clear to his parents that he wanted to wear girl clothes full time — that he wanted to be known as a girl. He wanted them to call him their daughter. And though Ehrensaft does not always encourage children who express gender flexibility to "transition" to living as a member of the opposite sex, in the case of Jonah, she thought it was appropriate.

Last year, when he started kindergarten, Jonah went as a girl. He wore dresses, was addressed as "she" by his classmates and teacher. He even changed his name, from Jonah to Jona, without the "h." It was a complete transformation.

Joel and Pam were initially anxious, but Joel says their worry soon faded.

"They have these little conferences, and, you know, we were asking, like, 'How's Jonah doing? Does [he] have problems with other kids?' and the teacher was like, 'God, I gotta tell you, you know, Jonah is one of the most popular kids. Kids love [him], they want to play with [him], [he's] fun, and it's because [he's] so comfortable with [himself] that [he] makes other people comfortable," Joel recalls.

It was shortly after that that Joel and Pam started referring to their son Jonah as "she."

Two Families, Two Therapists, Two Approaches

The treatments practiced by Zucker and Ehrensaft are radically different and, therefore, are liable to produce radically different results. In fact, Zucker and Ehrensaft are representatives of a broader divide in the mental health community over the appropriate treatment for children like Bradley and Jonah.

This divide is so intense that there is very little common ground. There is little common ground even in the ways that the issue is conceptualized. Therapists like Ehrensaft tend to view kids like Bradley and Jonah as transgender, and see transgenderism as akin to homosexuality.

Thirty-five years ago, homosexuality was considered a mental illness — a pathology so severe that it required aggressive therapeutic intervention. According to Jack Drescher, former chairman of the American Psychiatric Association's committee on gay and lesbian issues, one treatment was to try to condition homosexuals out of their sexual preference by attaching them to electrical shock machines and shocking them every time they were aroused by homosexual pornography.