"I’m a Pediatrician. Here’s What I Did When a Little Boy Patient Said He Was a Girl."

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“Congratulations, it’s a boy!” Or, “Congratulations, it’s a girl!”

As a pediatrician for nearly 20 years, that’s how many of my patient relationships began. Our bodies declare our sex.

Biological sex is not assigned. Sex is determined at conception by our DNA and is stamped into every cell of our bodies. Human sexuality is binary. You either have a normal Y chromosome, and develop into a male, or you don’t, and you will develop into a female. There are at least 6,500 genetic differences between men and women. Hormones and surgery cannot change this.

An identity is not biological, it is psychological. It has to do with thinking and feeling. Thoughts and feelings are not biologically hardwired. Our thinking and feeling may be factually right or factually wrong.

If I walk into my doctor’s office today and say, “Hi, I’m Margaret Thatcher,” my physician will say I am delusional and give me an anti-psychotic. Yet, if instead, I walked in and said, “I’m a man,” he would say, “Congratulations, you’re transgender.”