The next day, I scheduled an appointment with a therapist who was experienced in treating transgender patients so that I could get the letter for my insurance. Her office was only half an hour away, so when the day of the appointment came around, I drove myself there while everyone was at work and school. Over the phone, she had asked me to bring anything that could document my dysphoria and transition. I did my best, but I didn’t have much.
I checked in with the lady at the front desk, and then I followed her instructions until I found the waiting room for the psychologist that I was meeting with. I read TIME magazine while I waited. After a few minutes, the door to the office opened and a middle-aged woman and a girl about my age came out.
“See you next week, Christine,” the middle aged woman said. She looked at me. “Are you Cameron?”
“I am.” I said. I put down the magazine and stood up. She held the door open for me, and I walked into her office. When I was seated and she was seated in front of her desk, facing me, she smiled. “I’m Dr. Foster. It’s nice to meet you.”
“It’s nice to meet you too,” I said.
“So, you called me about getting a letter so that your insurance will cover your gender-affirming surgery, is that correct?”
“Yes,” I said.
“So you haven’t met with a surgeon yet?”
“I have,” I said. “In Kansas City.”
“Did you go for a consultation?”
“Yeah, he was nice.”
“Good, I’m glad.” she said. “Did you bring the guidelines for your letter that your insurance gave you?”
I nodded and opened my file that I had brought. The paper was on top, and I handed it to her.
“Perfect, thank you.” she looked at it, then put it on her desk. She looked back up at me and smiled. “Where would you like to start?”
“I don’t know,” I said.
“Well, we can start simple. What pronouns do you use?”
“Male pronouns,” I said.
“How long have you been using male pronouns?”
“Um,” I thought for a second. “About twelve years, I think.”
“Very nice,” she said. “So you identify solely as a man?”
I nodded. “I never want anyone to think of me as… as a woman.”
“I can’t speak for anyone else, but I promise that I will think of you as male, always.”
“Thanks,” I said.
“Do you have family or friends that recognize your gender identity?”
“Yes,” I said, smiling. “All of my family and friends do, I think.”
“That’s good to hear. Will they be supporting you through your surgery?”
“Yeah, my dad is helping pay for it, and he drove me to my last appointment.”
“Are you and your father close?”
“Um,” I said, laughing a little. “It’s complicated.”
“Well, I was in foster care for my entire childhood pretty much.”
“And this is your biological father that we’re talking about?”
“I see,” she said, tapping her lips with her pen. “When did you begin living with him?”
“How has that been?”
“It’s been good,” I said. “He’s really nice and I know he loves me a lot. I think maybe… I don’t know. I think he feels kind of left out of my life sometimes.”
“Why is that?”
“Well, I was with my last foster family from when I was seven until this May, and I’m really close to them. I call them a lot and I went to visit them in July, and I think he sees all that and feels like I don’t need him or something.”
“This may be an awkward question, but bear with me. Do you care for him the way that he cares for you?”
“Mostly, yeah. I think so. The whole time I was in foster care I thought about my parents and I hoped that they were alive and that they would love me for who I am, but I don’t think I knew to miss them as much as he knew to miss me. If that made sense.”
“That made sense. Have you enjoyed your time living with him?”
“Yeah, of course. It’s been really nice to get to know him and my cousins and know where I came from.”
“I’m really glad that it has been a positive experience for you.”
“Me too,” I said.
“So, since you were in foster care, I suppose it may have been hard to find documentation of your transition?”
“Yeah, it was,” I said with a laugh. “My dad had some pictures of me as a baby, and he got some of me as a toddler from my old social worker, but I mostly have pictures of me after I transitioned.”
“Would you mind showing me?”
“Sure,” I said. When I had scheduled the appointment and the therapist had asked me for documentation, I had called Mrs. Parker and asked for pictures. She sent me a link to a Google Drive, and I had spent hours staring at pictures that I hadn’t known existed.
“I can do the baby pictures first, I guess.” I said, pulling out the pictures my dad had given me. In the first one, I lay in my bassinet in the hospital, dressed in pink pajamas.
“You were a very cute baby,” Dr. Foster said, smiling at the picture.
“Thanks,” I said, turning the picture back to me and smiling at it. I handed her the other three pictures, one more of me alone, a few weeks old, in my crib at my parents’ old house. The other two were of my mom holding me, smiling with her mouth but not her eyes, and one of my dad holding me, smiling with his whole face.
“How do you feel when you look at these pictures?” Dr. Foster asked, handing them back to me.
I shrugged. “Lots of ways. It makes me sad, seeing my mom. She died before I got the chance to know her.”
“How does it feel seeing yourself?”
“I know I’m wearing pink and that, when the pictures were taken, they were calling me a girl and everything, but I honestly just see a baby.”
“You don’t see you as a baby? You just see ‘a baby?’”
I frowned. “Yeah, I guess I just do see ‘a baby.’ Not really me.”
“May I ask what your birth name was?”
“Tia,” I said. “I really hate it.”
“I’m sorry. I won’t mention it again.”
“It’s okay.” I said.
“You can tell people when something isn’t okay,” she said softly. “Your identity is not something you necessarily have to be polite about. You deserve to be respected as who you want to be.”
I nodded. “Thanks.”
“I only asked the question for the record. It is part of your transition, and often the name change helps some grow used to your identity without putting too much thought into it.”
“You said you had some pictures from when you were a toddler?”
“Yeah,” I said. I pulled three pictures out of my folder. One from my first foster home and two that my social worker had taken for my file. In all of them, I had long hair. In the first picture I wore shorts, a t-shirt, and a cowboy hat. I was grinning from ear to ear. In the other two pictures, I wore dresses, and my smiles seemed fake when I looked at them now.
“Do you know how old you are in these?”
“I think I’m two in the cowboy one,” I said. “Otherwise I’m not sure.”
“This is when you were living as a girl?”
“Yeah,” I said. “My second foster family used to tell me how I came to their door wearing boys’ clothes with boys’ toys. They really hated me for that.”
“So you think that your first foster family let you be yourself, but your second one did not?”
I nodded. “I kind of got kicked out of my second foster home.”
“Because of your dysphoria?”
I had read that word online, but no one had ever applied it to me. Somehow, it made me feel better. “Yeah. I argued with them about what I wore a lot, and I, well… I kind of tried to pee like a guy and made a mess multiple times.”
Dr. Foster smiled warmly. “Many transgender children go through similar things. It’s nothing to be ashamed of.”
I smiled. “My third foster home was kind of the same story. The mom let me play with the other boys, but she still made me wear dresses. The dad really didn’t like me playing with the boys. I cut my hair short a couple times and he hit me.”
“Was that the only time that he hit you?”
“No, he hit me for playing with the boys and for saying that I was a boy.”
“So there were other children in the house?”
“Yeah, lots of them. There was even…” I caught myself and blushed. “There were other foster kids.”
Dr. Foster studied me. “Did you get along with them?”
“Some of them. Mostly just two of them.”
“What were they like?”
I swallowed. The only people I had ever told about Chelsea were Terin and Mrs. Parker. “Tony was my age, and we just played kid games, you know. Like spies and stuff.”
“Did he recognize you as a boy?”
“Well, I told him once and he was nice about it, but he never called me my real name or anything.”
“And how old were you at this time?”
I shrugged. “Six or seven.”
“You had another friend?”
I nodded and stared at my feet.
“Do you not want to talk about them?”
“It’s hard to talk about.”
“That’s okay. No pressure, no judgement. Nothing you say will leave this office, okay?”
I stared at my feet a little longer. “She was a little older than me. Her name was Chelsea. But only to me. Everyone else called her Chet.”
“She was transgender as well?”
I nodded, still staring at my shoes. “She helped me find my middle name, and I helped her find her first name. We talked about it in secret, and we had a plan to run away.”
“Did you ever run away?”
“Yes, but not with her.” I said.
I squeezed my eyes shut. “The dad hit her too.” I heard Chelsea screaming, and I wanted to cry. “And when he caught her with a bra on, that was the end of it. He threw her out.”
“And that made you feel unsafe in the home?”
I nodded. “I ran away to find her, but I never did.”
“Do you think about her a lot?”
I kicked at the carpet. “Not as much as I used to.”
“Do you feel any guilt about it?”
“Yeah,” I admitted. “I thought that if we had run away before she got caught, we would be together, and everything would be okay. Or if I would have worked harder to find her, then I’d know if she was okay or not.”
“Have you ever tried finding her Facebook profile or anything?”
I looked up. “No, I haven’t.”
“That could help you find closure.”
I nodded. “That’s a good idea. Thank you.”
“Would you like to talk about her more, or should we move on?”
“I’d like to move on.” I said.
“Are the rest of your pictures from your fourth placement?”
“Yeah,” I said, pulling them out. “With this family, I introduced myself as Cameron, and none of them knew I was transgender until a while later.”
“How did they react?” Dr. Foster asked.
“They were very supportive,” I said. “I never felt like they thought any less of me because of it.”
“That can make such a big difference, can’t it?”
I smiled and nodded. I looked down at the first of ten pictures I had printed out. The first was of me and Mrs. Parker in the kitchen, either Kagan, Vlad, or Mr. Parker must have taken. I was wearing clothes that they had bought me for Christmas.
“You look happy here,” Dr. Foster said when I gave her the photo.
“I was,” I said.
“Is this woman your foster mother?”
I nodded. “She taught me to sing and play piano.”
“That’s very sweet.”
The second and third photos were of Terin, Jerico, and I. The first was on my eighth birthday, and I couldn’t tell when the second one was exactly.
“Were these your foster brothers?” Dr. Foster asked.
“Yeah.” I said. “They were both younger than me, but the older one is my best friend.”
“Did they ever know that you were transgender?”
“The older one does,” I said. “I told him years ago when he kind of guessed it.”
In the next few pictures, I was older. In one of them, I could see the back of Kevin’s head in the background.
“What are you doing in this one?” Dr. Foster asked, pointing to the books on the table in front of Terin and I.
I looked at it. “Just reading. We were really into history.”
“Really? You don’t meet many kids who love history these days.”
The last four pictures were more recent. In one of them, Jed, Terin, and I had our arms around each other. One was Terin and I after taking our GEDs, one was Terin and I holding our paper licenses, and the last one was me on my first day of work at the museum.
“I was homeschooled, so that’s when we took our GED,” I explained, pointing to the picture I was referring to.
“Is this one for a dance or something?” Dr. Foster asked, holding up the one from my first day of work.
“No, I used to work at a museum. That was my uniform.”
“Very cool,” she said, grinning at me. She handed all of my pictures back, and I put them back in the folder.
“What does your license look like?”
“You mean like what name is on it?”
“My birth name is on it. It says I’m female.”
She nodded. “Do you plan to change your gender marker and name legally?”
“Yes, I just don’t really know how.”
“I have just the thing for you,” she said. She got up and went around her desk. She pulled a pamphlet out of one of the drawers and brought it over to me. “Put together by yours truly.”
“Thank you,” I said, looking at it, and then putting it in my folder. “I’ll definitely be reading that later.”
We talked for a long time about my goals for continuing my transition, how I felt about my upcoming surgery, and then she asked about my mental health history.
“Do you have any history of anxiety or depression?” she asked.
I bit my lip. “I’ve never been diagnosed with anything, but I’ve never been to a psychologist until now.”
She nodded understandably. “Have you ever experienced anything that you think could have been either of those?”
“Yeah, I think so,” I said, looking back at the floor.
“I’m not judging you, Cameron,” she promised. “Mental health is nothing to be ashamed of.”
I looked back up. “I always felt kind of dumb for feeling sad.”
We talked about some times I had felt depressed or anxious for a while, and I admitted that I had cut myself before. She was really nice about it and didn’t make me feel bad for doing it.
“I’m never going to do it again,” I said. “I don’t think it was worth it.”
“I’m glad to hear you say that,” she said. “But if you ever do, remember that you’re not alone, okay? There are plenty of people who care for you and would gladly help you avoid situations like that.”
“I know,” I said.
“You may not know this, but is there any history of mental illness in your family?”
“The only one I know about is my mom,” I said. “She was bipolar.”
Dr. Foster nodded. “Do you ever worry that you might be bipolar?”
I shook my head. “I looked it up, and I’ve never really felt anything like how they describe mania.”
“Was your mom ever treated for her condition?”
“I don’t know,” I admitted. “I just know that she, um, she killed herself.”
“I’m sorry to hear that.”
“It’s okay,” I said. “I never really knew her anyway.”
We talked for a little bit longer, until Dr. Foster looked up at the clock. “I think our time is just about up.”
“It went really fast,” I said.
She smiled. “I’m glad you think so too. It was very nice to get to know you.”
“You too,” I said.
“I will get to work on your letter, and I’ll give you a call when I have it ready, okay?”
“Sounds good,” I said. I stood up and grabbed my folder, making sure nothing fell out of it.
“If you ever feel like you would like to have a long-term relationship with a therapist, or you feel those old feelings of depression coming back, give me a call, okay?”
“Okay.” I said. “Thank you.”
“You’re welcome.” she said. She came over and opened the door so that I could leave.