“Reverse course?” He said it like she’d recommended burying Poppy in sand up to her ears and leaving her in the desert for three days. He said it like she’d offered their youngest heroin as a midnight snack. “You think it would be easier if she’d just be Claude?”

“I don’t think it,” Rosie said gently. “It would be. It would be easier. Maybe we put to bed long ago the idea that easier was the goal. Maybe when easier is a matter of degrees like these, it doesn’t even count. But no question, by anyone’s definition, it would be easier.” She considered their last New Year’s Eve in Madison when they’d decided “easy” wasn’t on their wish list. She considered how much harder “hard” had gotten in the years since then.

“How can you think Claude would be easier?”

“Well, for starters, she’s right: she’d probably make a lot more money.”

“Is that what you’re—”

“Jesus, Penn, of course that’s not what I’m worried about. It’s. Her. Penis. Are you daft? It’s her penis!”

“But puberty blockers—”

“Are not the perfect miracle you imagine them to be.”

“They are though.” Penn got out of bed to kneel on the floor in front her like he was going to propose. “They are. These kids on blockers? You should read their stories.”

“No, you should stop reading their stories.”

He’d known that was what she would say, so he kept going. She was the doctor, but he was the reader, and he knew things too. “The blockers are effective. They’re safe—”

“How do you know they’re safe?”

“Mr. Tongo said—”

“Mr. Tongo is not a doctor. Mr. Tongo has not read all the studies.” She closed her eyes. “And even if he had, the research isn’t reliable. It’s incomplete. They’ve only been doing this treatment for a few years in this country, so there are no long-term studies. It’s biased and unrigorous—”

“How can it be—”

“Because when a little girl wants to wear jeans and play soccer, her parents are thrilled, but when a little boy wants to wear a dress and play dolls, his parents send him to therapy and enroll him in a study. We just don’t know yet the long-term effects on these kids of puberty suppression.”

“But they know the effect on those other kids, right? The precocious ones? And they’re fine.”

Rosie’s fingers squeezed and unclenched, squeezed and unclenched under the covers. “The drug itself seems safe, but that’s only some of the picture. Those kids restart puberty in the normal way at the normal time. Here, you’re stopping the body’s natural inclination—”

“But Poppy’s body is wrong. It’s always been wrong.”

“It’s not that simple, Penn. This is the problem. You’re oversimplifying.”

She understood his point because it was not logical. She understood because once she’d decided they had to leave Wisconsin, no amount of reason from her husband or misery from her eldest child or evidence from her mother or history at her hospital or love for her life just the way it was made any difference. On the way home from the ER after those unspeakable hours with Jane Doe, she had watched the sun come up and understood already that the only way forward was deeper. She saw this with her patients all the time. Through weeks of symptoms and months of tests, they didn’t want to believe it was what it was. But once they accepted, deeper was their only way forward too. They stayed up all night doing advanced medical research they couldn’t begin to understand. They joined support groups and read books and bought T-shirts and ran 5Ks. They rededicated their lives to what they’d rejected utterly only days before. And then when their story strayed from that path—the cure didn’t work, the cure worked too well, the indicators indicated something else instead—they found themselves more lost than ever. The wood was dark indeed, perilous and terrifying, but Penn could see a way through. She didn’t want to bar that path to him. But she wasn’t sure that around the bend up ahead, it didn’t plunge into the sea.

Rosie took a deep breath and tried again. “You’re stopping everything, not just her turning into a teenage boy. I understand why you don’t want her to grow chest hair, but it’s more than that. It’s slowing her growth—right now she’s supposed to be getting taller, her bones denser, longer, stronger, and if you stop the hormones, that won’t happen. It could impinge on her maturation, mental and emotional as well as physical. Hormones contribute to intelligence and creativity, critical thinking, abstract analysis. We might be taking that away from her. Aggie and Natalie and Kim are going to start to turn into young women, Penn. They’ll start to look older and more mature, but they’ll also start to act older and more mature. It’s not just that they’ll have breasts and she’ll stay flat. They’ll have crushes on classmates and anger at authority figures and moodiness at home—”

“Yeah, it’d be a real bummer to miss that.”

“You want to halt her puberty so you don’t have to deal with her foul moods?”

“Of course not. I was kidding.”

She knew he was. She just didn’t think he was funny. Or she knew he thought he was funny, but she also knew he wasn’t entirely kidding. Or somewhere in between those things. Just because she couldn’t pinpoint his objection didn’t mean she couldn’t disagree with it. Poppy or Claude, Poppy and Claude, needed to go through the part where they hated their family and no one understood them. They had to go through the part where they questioned who they were and where they came from and all they’d ever been told and taken for granted. They had to fall in love for a week and then get their heart broken over the weekend and then fall in love again on Monday. Whichever one, Poppy or Claude, he or she couldn’t stay a little girl forever.