Penn raised himself from his knees to sit next to her on the bed and hold both her hands in his. They were switching roles here, she could see. It was like the Changing of the Guard. For no other reason than it was time, she was going to be the crazy one for a while and he got to be the calm one. “Puberty is one thing”—his voice was irritatingly reasonable—“but she shouldn’t have to hate her body.”

“She’s going to be a woman,” said Rosie. “She should get used to it.”

“Yes, ha-ha, but seriously—”

“No, seriously.” Rosie could hear herself shrieking but could think of nothing to do about it. “You think Poppy will be the only kid to feel betrayed by her body when it goes through puberty? All teenagers feel betrayed by their bodies when they go through puberty. You think Poppy would be the only woman to hate the way she looks? All women hate the way they look. Her body may not be immutable, but it’s not like changing the water filter. The drugs, other drugs, yet more drugs, a lifetime of drugs, the surgeries, the stuff that can’t be made whole regardless of surgery, these things are huge. These things are scary. These things are mysteries, unpredictable, uncertain. There are strange effects, side effects, unintended effects. There are hard decisions that can never be unmade. There are hard decisions she’s not old enough to make. There are decisions that just shouldn’t be made for you by your parents. If she is a girl, if deep inside this is her truth, if she needs this, if she wants this, if she must, if she’s sure, then yes, of course yes, thank God yes, we will support her and help her and do all we can and much we can’t yet but will have to figure out, as we have already, as we do for all our children. But easier? It would be easier for her to be a boy. So if she’s questioning, if she’s on the fence, this is information she should have.”

It wasn’t that Penn didn’t understand these things. It was that he didn’t care. The blockers were like magic, like a child’s answer to a child’s prayer: just make it stop, just turn it off. Blocked kids did not turn into people they were not, did not hide, did not despair, did not stand in the sand pleading with the sea, endeavoring to stop the tides. They did not poison or mangle their bodies. They did not choose death instead. Claude had been a boy, had had a penis, would grow into a man, but Poppy did not have to. Blockers meant Poppy’s time of being Claude was all behind her, never to resurface. She could stay child-Poppy until she could become adult-Poppy, Poppy-entire. Penn understood all of Rosie’s careful doctor points. But they were nothing compared to the capacity of magic.

“Has she shown any signs at all”—Penn made sure not to sound condescending—“that she might want to go back?”

“I don’t know how she’d know.” Rosie answered a different question. “She can’t even remember Claude. Poppy is what’s normal. And not just Poppy, Poppy with a penis. That penis is as unremarkable to her as her elbow. For something that’s the focus of all that’s coming and the zenith of the trouble here, she doesn’t give it a second thought. It doesn’t signify maleness to her. And you know what else?”

“What?”

“Soon it’s going to be something north of unremarkable. It’s going to start feeling better and better. It’s going to be fun to play with. And that’s hers too. I don’t want her to feel bad about it. And I don’t want to take it away.”

“She’s a girl, Rosie. She is. Look at her. Listen to her. She’s not a fish. She can’t be both. She doesn’t have to take turns. Or maybe she’s that other kind of fish she told us about. At first she was male, but then she transformed—her colors changed, her patterns, her biology, her roles and relationships, everything. Whatever she used to be, now she’s female. Fully female.”

“Prepubescent female.”

“Yeah?”

“So sometimes it’s testosterone that makes people seem male, feel male, be male,” said Rosie-the-physician. “And you, you want to block it.”

“That’s not what I want.”

“It is, Penn. It’s what it means when you object to my telling her she can still change her mind.”

“I don’t want anything. I want … I only want to do whatever’s best for her.”

“Me too. Of course me too. If we knew what that was. But unfortunately, that exceeds my skill set. That’s not prognosis. That’s prognostication. We need a seer, not a doctor.”

“Then that’s my skill set,” said Penn.

“You can see the future?”

“It’s the stuff of fairy tales, not hospitals.”

“That’s a nicer place to be,” Rosie admitted, “but it’s not real.”

“Sure it is,” said Penn. But Rosie rolled over and went to sleep.

Who Knows?

When the phone call came, Rosie was in with a sixty-two-year-old patient who was complaining of knee pain. She had been complaining of knee pain since Rosie met her four years earlier. The patient was a runner. She ran fifty, sixty, seventy miles a week. She ran every day. Some days, she ran twice. Run less, said Rosie. Every other day, swim instead or do yoga or lift weights. Run half as far and make up the rest with walking or a bike ride or, hell, sitting and reading a book. But the patient only ran more. And her knees hurt worse. Rosie had the conversation down by heart and was in the middle of the part that began, “As we get older, the lining in our joints begins to break down,” when Yvonne knocked on the door.