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Today, Max identifies as a woman. Her discomfort grew more internalized—less a frustration with how the world treated women and more a sense that the problem lay in her own body. Trauma, particularly sexual trauma, can contribute to or exacerbate dysphoria in some patients, but again, no one yet knows exactly why. Stella, now 24, socially transitioned at 15, started hormones at 17, got a double mastectomy at 20, and detransitioned at That group went through a comprehensive diagnostic process prior to transitioning, which included continuous access to mental-health care at a top-tier gender clinic—a process unfortunately not available to every young person who transitions. While representative long-term data on the well-being of trans adults have yet to emerge, the evidence that does exist—as well as the sheer heft of personal accounts from trans people and from the clinicians who help them transition—is overwhelming. She gradually decided that she needed to transition. The therapist referred the family to some nearby gender-identity clinics that offered transition services for young people. Most began transitioning during adolescence or early adulthood. How can they help their children gain access to the support and medical help they might need, while also keeping in mind that adolescence is, by definition, a time of fevered identity exploration?
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