THE BEES AND BIRDS: At last week's Trans-health Conference, everyone was buzzing about "trans kids" like Kyle. : Michael koehler

Her daughter grew into a happy, outgoing child. But her son was quiet, and often seemed sad, as though he were pondering something terribly important. When he began to speak, he said the damnedest thing: "I'm a girl." Stephanie would try to explain that because he had a penis, he was a boy, but she couldn't sell him on the idea. The child pouted when his sister wore dresses and he couldn't; he seemed truly happy playing dress-up with her clothes.

When he was three, Stephanie walked into the bathroom to find her son poking his penis with an unopened nail clipper. "It doesn't go there," he explained. When he was five, as his mother tucked him into bed, he told her, "God made a mistake."

Stephanie was bewildered. She went online and looked up "boys who dress like girls," but that only led her to porn sites. Most of the doctors and therapists she contacted didn't want to deal with her problem. Eventually, a pediatrician informed her about a psychiatric condition called Gender Identity Disorder. The causes aren't fully understood, but essentially there's a conflict between your gender identification and your biological sex.

Most parents with children in this predicament deny, ignore or attempt to treat the problem. But when Stephanie's son was six, she decided to try something else. Instead of repeatedly telling her son he was a boy — telling him that he was "defined by his genitals," as she says now — Stephanie allowed him to choose his own gender.

"He" became a "she."

At last week's Philadelphia Trans-health Conference, an annual gathering of trans people and their allies held at the Pennsylvania Convention Center, everyone was buzzing about "trans kids." There were several seminars on the subject, and PFLAG (Parents, Families and Friends of Lesbians and Gays) said that their trans chapter was getting two or three calls a week from parents with cross-gendered children aged 12 and under. (As recently as three years ago, they knew very few parents in this situation.)

Gender Identity Disorder isn't new, of course. Many trans adults say they knew from an early age that they didn't fit comfortably into their biological sex. But this vanguard of parents who allow their children to cross gender lines and publicly advocate on their behalf is a recent development. For many in the trans community, it's a welcome sign that society is beginning to understand gender fluidity. For others, it's a dangerous abdication of parental responsibility, and a careless approach to dealing with psychological problems.

Stephanie's daughter (as I will refer to her birth son), now 9 and having lived for the past three years as a girl, accompanied her mother to the conference. There were a lot of unconventional-looking people present, but "Rachel," as Stephanie has asked that her daughter be called, was not one of them. With a cascade of light brown hair and feminine mannerisms — she lay on the floor of the conference's playroom with her chin in her hands — she could never be mistaken for anything but a shy little girl.

Sitting beside her was an 8-year-old boy whom I'll call "Kyle." Kyle has buzz-cut blond hair, a hoarse whisper of a voice and a mischievous smile. His first memory, he says, is of taking a pair of scissors to his birthday dress, though his mother, a 28-year-old woman with hair as short as her son's, thinks he's just repeating a familiar story. Unlike Stephanie, who was driven into the trans world by the strength of her child's conviction, Kyle's mother had several trans friends when her birth daughter declared herself a boy, and never put up a fight. Now Kyle speaks distantly of the days when "people used to think I was a girl."

But defying one's biology does not come easy. Stephanie and her husband spend about $1,000 a month on therapy, to "undo" what they did in Rachel's early life, and the girl is still plagued by problems: As recently as a month ago, she attempted suicide.

Kyle doesn't have issues of the same magnitude, but his father has accused his mother of constructing this "gender crap" for her own "sick and selfish" purposes. The boy also recalls with dismay an incident when he was going to the bathroom and "somebody peeked." To prevent that sort of thing from happening, parents of trans kids are constantly explaining their situation to supervising adults.

"I used to be sort of embarrassed of it," Stephanie says. "Now I get tired of teaching."

It will almost certainly get harder. In a few years, Rachel will begin to develop the musculature of a man. Her testicles will descend and she will begin to grow facial hair. Kyle will begin to menstruate and develop breasts. All of these changes will crash up against these children's most basic understanding of themselves.

Eventually, if they can afford it and find doctors who are willing to work with them, Rachel and Kyle will have the option of undergoing the medical process of switching sexes: hormonal therapy followed by sexual reassignment surgery. But such measures are medically risky and irreversible, and the Harry Benjamin International Gender Dysphoria Association, which sets the accepted guidelines for such procedures, discourages anyone from beginning this process before the age of 16.

In the meantime, trans kids have the option of taking hormone "blockers," which can delay the onset of puberty until the child is old enough to make a decision. But blockers can cause a host of medical problems. And is a 16-year-old who has yet to hit puberty really psychologically fit to make a decision about gender? More importantly, is a 6-year old?

One of the seminars at the conference was titled, "When is young, too young?" The consensus seemed to be, when it comes to lifestyle (as opposed to medical) decisions, never. Outside the Convention Center, there are people who feel differently. Many object to the idea that a gender switch is ever appropriate. Jerry Leach, who runs a counseling service for "those afflicted with gender-identity confusion," says that gender dysphoria "is a conglomerate of emotional and traumatic wounds," and says he fields a lot of calls from people who regret their surgeries.

University of Pennsylvania bioethicist Paul Root Wolpe, author of Sexuality and Gender in Society, thinks that gender changes are sometimes necessary, but he advocates for extreme caution when it comes to children.

The stories of trans people who had cross-gender desires as children "are legion," Wolpe says. "That doesn't mean the opposite is true: that every [trans kid] goes on to be a trans person."

Many childhood desires don't continue into adulthood, he argues. "But to raise a child as an opposite-sex child reinforces that desire whether or not the desire would have remained. … I'm not saying there's no case. I just think that parents can be over-liberal about it." With children, he says, the correct approach is to "keep options open, rather than closing them."

It's lunchtime on the second day of the Trans-health Conference, and a small group of parents with trans children have gathered around a table in a crowded hall. Though some admit they'd never heard the word "transgender" before a doctor said it to them, they're all experts on trans issues now.

The relief of being in a circle of like-minded people is palpable as the parents parry arguments that are regularly hurled against them. They chafe at the notion that they're being "over-liberal." As with gays and lesbians accused of fabricating their orientation, they ask, "Who would choose this?" They also reject the suggestion that they are too lenient with their children.

"I certainly discipline my child," Stephanie says. "She's not allowed to go to the movies alone, she has a bedtime. This isn't about discipline. This is about recognizing who she is."

Even their lexicon suggests mastery. They deliver confusing pronouns with nary a pause, and don't say "transgender" when they mean "transsexual," or vice versa. Some of them even take exception to the term "Gender Identity Disorder," because it "pathologizes" their children's condition. But for all this, there is one question that throws these parents off. No manual exists for raising a trans kid, and very little research has been done on how they'll mature. So how do they decide what happens next?

Stephanie admits it's a difficult question. Then she says something that gets everyone nodding in agreement.

"I know I can only work with today," she says. "There is no commitment to a gender. Tomorrow's another day."