“So, gender dysphoria,” Mr. Tongo began. “Congratulations to you both! Mazel tov! How exciting!” Mr. Tongo was the hospital handyman Rosie called late in a shift when she was otherwise out of options for a patient. He wasn’t really a handyman, of course, though he wasn’t a doctor either. Technically, he was some kind of multi-degreed social-working therapist-magician. It wasn’t that he made miracle diagnoses or magic cures. It wasn’t that he could pull secret strings or unglue red tape. It was that he had an entirely different way of looking at things.

And a different way of looking at things was what they needed. Rosie didn’t think there was anything wrong with Claude physically. She didn’t think there was anything wrong with Claude emotionally or psychologically either. He was already worried his teacher and his classmates thought he was weird. The third to last thing Rosie wanted to do was make him think his parents thought so too. The second to last thing she wanted to do was make him self-conscious about what he wanted to wear and who he was. But the last thing she wanted to do was ignore her baby as he slipped away from her and disappeared.

In Mr. Tongo’s office, they all three sat on giant colored balls like they were in some kind of exercise class, Mr. Tongo bouncing up and down on his and rubbing his hands together like a kid who’d been promised ice cream after a dinner of French fries. Penn was prepared to defend Claude against people who thought boys in dresses were sick. He was prepared to defend against people who thought his son was repulsive or deviant. He was prepared to defend Claude’s right to be Claude in any of his many wonderful manifestations. But he was not prepared for congratulations. “Uh … thanks?”

“Yes! Yes! You should both be very proud.”

“We should?” Penn glanced at Rosie for guidance but found her smiling unquestioningly at Mr. Tongo.

“Certainly you should. What an interesting child you’re raising—not that gender dysphoria, if that’s what this turns out to be, is caused by parenting, good or bad. But you must be doing a fine job if he’s come to you and said, ‘Mother, Dad, I must wear a dress,’ instead of hiding in shame—not that there’s anything to be ashamed of, you understand. And you’ve said yes to the dress, as they say, the dress and the heels and the pink bikini. What fun! I’m so pleased for you all.”

Rosie put a hand on Penn’s arm but did not take her eyes off the bouncing social worker. “Thank you, Mr. Tongo.” Penn could not imagine why she wasn’t on a first-name basis with this man. “We’re glad too. But the drawings, the lack of friends, the worry, his changing clothes all the time, his inability to just be himself. Our first concern is his happiness, of course. But not just today.” Because it wasn’t that simple, was it? Raising children was the longest of long games. It would make her kids ecstatically happy if she replaced all meals for the next month with Halloween candy consumed in front of the television and then let them skip showers until Thanksgiving, but in the long run, one imagined they’d miss school, their teeth, and not smelling like feet. “We want him to be happy next week, next year, the years to come too. It’s hard to make out this path, but it’s even harder to see where it leads. We want him to be happy and comfortable of course, but we’re not sure how best to make that happen.”

While Rosie talked, Penn tried to decide what to make of Mr. Tongo and found nothing to hang on to. He imagined writing him into the DN and couldn’t think how he’d describe him. Mr. Tongo might have been sixty-five with good skin or thirty-five and prematurely gray, his smoky hair alternately patted down and sticking out in all directions. He might have had a trace of an accent Penn didn’t recognize or the remnants of an old, overcome speech impediment, or it may have been simply that he spoke with an odd quizzical deliberateness at once welcoming and unsettling. Any race or nationality at all you cared to name, Penn could believe Mr. Tongo was at least half a member of it. He wore scrubs, in case any of his patients had to vomit or bleed, Penn supposed, though on the wall behind him he had a drawing of a bear, also in scrubs, holding up a sign that read REMEMBER: I AM YOUR FRIEND, BUT I AM NOT A DOCTOR.

He was fiddling with a magnifying glass he picked up off his desk. “As you may know, gender dysphoria is a condition wherein the patient’s assigned sex—their anatomy, their genitalia—does not match their—some say preferred, some say affirmed, some say true—gender identity.” He closed one eye and peered through the glass at them. “It’s the Case of the Mistaken Genitalia.” Then, just when Penn was about to write Mr. Tongo off as too quirky to address the gravity of their situation, he stopped bouncing and sleuthing and congratulating. “Now, who knows? Maybe he’ll grow out of this, or maybe it’s here to stay. Maybe he’ll be trans and maybe he’ll be she, or maybe he’ll be something we haven’t thought of yet. There’s no need to settle on a label at the moment. The important thing is this: prepubertal children suffer from gender dysphoria in direct proportion to attitudes and expectations they encounter at home, at school, and in their communities. If the parents are sending negative messages—even silent ones—that what a child does and who a child is are not okay, those are very powerful for a young person. Even though your intentions might be only to protect him from a hard, often intolerant society by helping him fit into prescribed gender molds, you may unwittingly be telling him, ‘Act this way, behave this way, deny yourself, or you’ll lose my love.’”