Transgender children and their parents face unprecedented medical choices these days. "Puberty-blocking" drugs can stave off biological changes. Hormones — either estrogen or testosterone — can help patients acquire the characteristics of the gender they identify with.
But how is a child entering puberty — or the parents for that matter — supposed to make an informed decision about taking such drugs, especially when "treatment can be controversial" and there is "very little research" on the long-term effects of some of the drugs, according to the Frontline report "Growing Up Trans," that debuts Tuesday on PBS?
"It is very hard to make the decision to allow your child to take a medication that has unknown side effects," says the mother of one of the children in the film, 13-year-old Alex Singh, who is transitioning to male and wants testosterone injections. "But it becomes a lot easier when you have seen your child suffer and struggle as we have seen Alex struggle."
The triumph of "Growing Up Trans" is that it makes viewers feel the struggle, suffering and some of the victories for the children and their parents even as it provides a world of information on coming-of-age transgender. The 90-minute documentary exhibits the same kind of sensitivity and depth as the Golden-Globe-winning Amazon series "Transparent." But as wise and touching as that series is, it's fiction. "Growing Up Trans" is real-life for these families.
Not that TV has been ignoring the matter. Cable and network news couldn't get enough of the transition of Caitlyn Jenner — and there's more on the way.
Jenner, who has been sharing parts of her journey from hyper-masculine identity as Olympic champion Bruce Jenner, has dominated primetime attention from her April interview with ABC's Diane Sawyer, to a "Vanity Fair" cover story in June and now publicity for an eight-part reality series, "I Am Cait," scheduled to debut July 26 on the E! channel.
Jazz Jennings, a 14-year-old girl who says she began her transition at age 6 and now has more than 70,000 YouTube subscribers to her channel, also has a reality series, "I Am Jazz," arriving July 15 on TLC. MTV, meanwhile, has already offered its take on transgender teens with "Laverne Cox Presents: The T Word," a documentary hosted by the transgender actor from Netflix's "Orange Is the New Black" featuring teens and young adults in various stages of changing gender identity. It premiered in October.
Future productions include "My Transparent Life" for the ABC Family channel, a look at life through the eyes of a teenage boy whose parents are divorcing as his dad transitions to becoming a woman, and a VH1 docu-series, "TransAmerica," featuring the model Carmen Carrera and a group of five transgender women. Ryan Seacrest is producing the former, while Tyra Banks is doing the latter.
But nothing on transgender identity this side of "Transparent," with Jeffrey Tambor as 70-year-old Mort Pfefferman transitioning to Maura, has impressed me like "Growing Up Trans."
Made by the team of Miri Navasky and Karen O'Connor, it goes deep inside the lives of eight transgender kids ages 9 to 19 and their families. It's that incredible intimacy as they face complex and scary decisions that makes this production such a winner.
The documentary opens with 9-year-old Lia Hegarty on a surfboard splashing about in the ocean. From the sun, sea and her gleeful little-girl calls as she catches a wave, the sound and images dissolve to her sitting in her bedroom saying, "I am transgender. I was born male, and I identify female. But I like to say I'm a girl stuck in a boy's body."
Lia says she "transitioned" when she was "6 or 7" to being "more of a girl."
Now, she says, "I'm almost completely female."
This year, she adds, "I changed my name officially. So now, I've changed my name, my clothes, my room and my pronouns. That's really all you need except for the fifth one that I still need: surgery and medicine to help me look like a girl."
With Lia's elegantly simple, straightforward opening words, "Growing Up Trans" is instantly grounded in the larger discussion of identity.
We are a culture having an identity crisis — whether it's the debate over a woman who was born to white parents but identifies as African-American leading a chapter of the NAACP, or Jeb Bush listing himself as Hispanic on a 2009 voter registration form. Indeed, how much of Barack Obama's presidency has been consumed with debates about his identity — to the extreme of some demanding to see his birth certificate?
The societal preoccupation with identity grows in part out of changing demographics as the nation moves from a white majority to one dominated by persons of color. But there's also a newly formed mainstream understanding of the fluid nature of identity — that it is not fixed, as earlier generations were taught.
Biology need not be destiny. Or, does it?
That tension is at the heart of "Growing Up Trans," and Lia Hegarty's words perfectly set the table when she says all she needs now is the "surgery and medicine."
That raises the issue of the "puberty blockers" and the cross-sex hormones. The latter are the ones that bring about some changes that cannot be undone.
It is impossible to watch this film and not feel the profound uncertainty and even anguish of some of the parents as they meet with doctors and therapists to discuss the choices they face.
The mother of Alex Singh says she understands the problems with letting her son be in the "driver's seat" on a decision so big, but explains her decision to allow the testosterone injections by saying, "We are not experiencing what he is experiencing."
After Alex is informed that the changes in his body will not be reversible, we witness the boy signing off on consent forms and then receiving his first injection of testosterone.
In the case of 13-year-old Ariel, who came to her new female name from a love of Disney princesses, we listen in as a counselor explains to her that starting the cross-gender hormonal therapy at her age will preclude the possibility of her having a biological child.
She explains that, though she definitely wants children, she wouldn't want to have one "that way" — one that has any connection with her former male identity. She describes the thought as "horrible."
The candor elicited by O'Connor and Navasky is remarkable.
The journey of 16-year-old John Blanchard has created a crisis in his family. As viewers meet the family, John's mother has accepted her son's transition to being male. But his father has not. You wonder if the marriage will hold.
John speaks openly about becoming" "very stressed out" and "punching and kicking holes" in the walls of the family's home before his mother's acceptance and professional help.
"I was drifting off into very violent experiences in my head," he says. "I thought about hurting my family."
One night, John says he was in such pain that he came to his mother and said, "I want you to take me to a hospital. I want to get locked up."
John now wants to start taking testosterone, but his father is resisting. His father says he is doing it out of "love." But John's mother says it doesn't "feel like love" from where she sits.
"Growing Up Trans" treats these children, adolescents and parents with such sensitivity and respect for their experiences and words that it feels like love from where I sit. The film seems more like a work of ethnography than the hyped-up, run-and-gun, high-concept, sound bite TV journalism of today.
I appreciated ABC's coverage of the 65-year-old Jenner, and I love Amazon's groundbreaking creation by Jill Soloway of Maura Pfefferman.
But watching these children and teens grappling so honestly with deep and complex feelings and issues of identity is inspirational.
I would love to see a follow-up that shows where they are at in 10 years. I know how hard money for such documentary projects is to come by.
But you made me care about them, Frontline. Thanks for that.
"Growing Up Trans" premieres at 10 p.m. Tuesday on PBS.
"I Am Jazz," arrives July 15 on TLC.
"I Am Cait" debuts July 26 on E!.