Q&A: A NC Teen And Her Parents On The Transition From Male To Female (2023)

Hunter Schafer is one of several North Carolina residents challenging the state's controversial new discrimination law in federal court.

Schafer, 17, is a junior at the UNC School of the Arts high school, and she's transgender. She was labeled male at birth, but transitioned to female her freshman year of high school. Her parents are Katy Schafer and Mac Schafer, a pastor at Hudson Memorial Presbyterian Church.

Jess Clark sat down with the three of them as they share the story of Hunter's transition.

When did you first realize you didn’t identify as a boy?

Hunter: I’ve always had this persistent need for femininity and expressing that—like ever since I was a teeny, tiny toddler.

Katy: I would say age two. We would show Hunter all the superheroes and he would want Catwoman or Hawkgirl... And I’m saying "he" because he was our oldest child and our son....

We made a point to see a preschool teacher when Hunter was three… I remember asking her "Is this 'normal' that our kid comes to school every day and puts on a pink dress, when all the other little boys have on plaid vests and fireman coats?" And that was not what our kid did.

Q&A: A NC Teen And Her Parents On The Transition From Male To Female (1)

Credit The Schafer family


Hunter, you came out as gay before you came out as transgender?

I came out to my parents as gay in seventh grade—like a gay boy at this time. And so they were beginning to understand where I stood as to where my sexual orientation was at the time. But gender identity was still a very separate thing from that. But coming out as gay—that set me apart enough for me to think about what else set me apart.

Katy and Mac, how did you react to Hunter coming out as gay?

Katy: We were going to love our kid no matter what. Everybody was on board. But it didn’t move forward from there. I just didn’t understand why it was still so difficult to buy clothing. If I took Hunter to the mall I didn’t understand, if Hunter is a gay male, why can’t you walk into something like the Gap and buy clothes? Like why is this always an issue?

Hunter, can you describe how you were feeling in your eighth grade year, and why you were so anxious?

It was later in the year and I could start to see peach fuzz on my upper lip... I was just really worried that I was starting to develop these secondary sex characteristics— especially facial hair just terrified me. That was something that just did not resonate with me at all, and I don’t really know why... [Gender dysphoria] is mostly this feeling of just dread and wrongness.

How did you come to learn about transgender identities?

I met some really open minded people that were educated in all the LGBT terms and what it was. And they were "fangirling" over people, Curt and Blaine on Glee... It was, like, a really positive new image of that whole community that kind of let me explore that part of myself. And so it was in seventh grade that I came to terms with the idea that maybe I wasn’t a boy.

Katy and Mac, Hunter says she tried to come out to you twice as transgender before her message finally hit home for you. Why do you think it took so many tries?

Mac: For me it was harder than Hunter being gay because I thought, this is not something that will just be who Hunter is on the inside and may be expressed in relationships, but how Hunter even appears has the potential to change.

Katy: I remember saying to Hunter, "Well just because you’re an artist and just because you like pretty things, that doesn’t mean you’re transgender. It doesn’t mean you’re a girl."

Q&A: A NC Teen And Her Parents On The Transition From Male To Female (2)

Credit The Schafer family


Mac and Katy, What was it about that third attempt that finally allowed Hunter’s message to get through to you?

Katy: The anxiety level in Hunter was so apparent that I know that we could not continue kind of turning an eye or not listening. I felt like we were reaching a crisis point, because we had kind of lost our kid. I think Hunter was just really struggling inside, and the anxiety was coming out. I remember there were lots of tears. It was kind of just this reality of we were going to have to let go of who we thought our kid was going to be... There were some things that had to be put away.

Mac, was there an important moment for you when you realized Hunter was transgender?

Mac: I remember going to pick Hunter at fashion-design camp. And they had a fashion show the final night of camp. And Hunter came up to me the morning before the fashion show and said "Dad, do you mind if I wear heels?"... Inside everything in me was going "no, no, no,"...but outside I said, "Yes, you can."... I think that’s when everything became real. And I thought, you know, the ideas I’ve had in my head of raising a son, in a sense, I’m putting those away and have grief in saying goodbye to that idea, but joy in sense of Hunter being birthed into who she was created to be.

Katy and Mac, how did you know this wasn’t just a phase, or that it was serious enough to take a medical intervention?

Katy: As a mom, I look over this trajectory of 17 years, and the draw to what is traditionally feminine has always been there. Since Hunter could express any kind of option for one thing or the other, maybe from 18 months on, it has always been the thing that you would have thought a girl would have chosen. So I can’t look at the arc of Hunter’s life and deny that that hasn’t been there always... It was always there. We just didn’t know what to call it.

Was it hard to start using the pronoun “she” for Hunter?

Katy: Some of Hunter’s friends really showed us---they were so far ahead of us. Kids would get in the car, and then one of them would say something about Hunter and use the pronoun "she." And I would think, "Is this kid talking about Hunter?" And so I realized most of Hunter’s friends used "she" for a pronoun… Instead of going straight to a feminine pronoun, I really found myself as a mom just focusing on using Hunter’s name. If you hear me talk a lot I won’t use the pronouns, and I will just say "Hunter."

Mac: When Hunter expressed that female pronouns were important to her, that was a game changer. And that’s when we really started using the female pronouns. And we would make a lot of mistakes, but eventually at least for me it became very natural to this point where I don’t think twice about it.

Q&A: A NC Teen And Her Parents On The Transition From Male To Female (3)

Credit Hunter Schafer


Hunter, you use hormone therapy so that your body matches your gender identity. Does it ever validate you in some sense when someone just assumes you are a cisgender girl (designated female at birth)?

It used to, because I was like "Ooo! I’m passing! I am looking more feminine than masculine!" But now as I’m exploring the nonbinary part of myself, it’s becoming almost—not annoying—but like I just wish that some people could see more to me than that right away ...

I do like people to know that I’m not a cisgirl because that’s not something that I am or feel like I am. I’m proud to be a trans person.

What does it mean to explore a nonbinary self?

I just feel like I don’t really need to be put in the male or female box… Taking myself out of the binary is something that’s appealing to me, and not having one of those labels. Because gender has kind of been this crazy thing that I’ve had to—not defy—but move past and through because I’ve moved from male to female and now I’m swinging back to somewhere in between. So kind of existing without that is appealing to me in a lot of ways.


What is it called when you are transition from male to female? ›

MTF: Male-to-female transgender person. Sometimes known as a transgender woman. Someone assigned the male gender at birth who identifies on the female spectrum. Transgender: An umbrella term for people whose gender identity does not match the sex they were assigned at birth.

What to do if my daughter says she wants to be a boy? ›

Support Your Daughter's Gender Style

Some children are more masculine or feminine in style, so be respectful of who your daughter is and do not try to change her. I encourage you and your husband to support her clothing choices, hairstyle, and even her gestures and mannerisms.

Whats the youngest age you can transition from male to female? ›

—Most genital surgeries starting at age 17, including womb and testicle removal, a year earlier than previous guidance. The Endocrine Society, another group that offers guidance on transgender treatment, generally recommends starting a year or two later, although it recently moved to start updating its own guidelines.

What are the symptoms of gender dysphoria? ›

  • A difference between gender identity and genitals or secondary sex characteristics, such as breast size, voice and facial hair. ...
  • A strong desire to be rid of these genitals or secondary sex characteristics, or a desire to prevent the development of secondary sex characteristics.
26 Feb 2022

How long does it take for a man to transition to a woman? ›

Transitioning is a process that can take anywhere between several months and several years. Some people, especially non-binary or genderqueer people, may spend their whole life transitioning and may redefine and re-interpret their gender as time passes.

What are the risks of transitioning? ›

While transitioning, you'll take hormones to achieve masculine or feminine effects.
Those hormones carry risks:
  • Low or high blood pressure.
  • Blood clots.
  • Stroke.
  • Heart disease.
  • Certain cancers.
  • Fluid loss (dehydration) and electrolyte imbalance.
  • Liver damage.
  • Increased hemoglobin.

At what age is it too late to transition? ›

You may have heard the quote, “It's never too late to be your authentic self.” That is just as true for older adults coming out as transgender or gender diverse as it is for any other part of life. Transition can be difficult at any age — but may be more challenging for older adults.

What age should you transition? ›

The Endocrine Society recommends that they wait until age 18, but because more kids are transitioning at younger ages, some doctors are doing these surgeries earlier on a case-by-case basis.

At what age is gender dysphoria most common? ›

Transgender Men

Gender dysphoria history: Of the 55 TM patients included in our study, 41 (75%) reported feeling GD for the first time by age 7, and 53 (96%) reported first experiencing GD by age 13 (Table 2). A total of 80% of patients reported that feelings of GD were among their earliest childhood memories.

What is the root cause of gender dysphoria? ›

The exact cause of gender dysphoria is unclear. Gender development is complex and there are still things that are not known or fully understood. Gender dysphoria is not related to sexual orientation. People with gender dysphoria may identify as straight, gay, lesbian or bisexual.

What does gender dysphoria do to the brain? ›

A recent study investigated the volume of grey matter in individuals with GD and found that they had a smaller volume in the left posterior superior hemisphere of the cerebellum compared to male controls and a smaller volume of the right inferior orbitofrontal cortex compared to female controls.

What is the best treatment for gender dysphoria? ›

Treatment for adults
  • psychological support, such as counselling.
  • cross-sex hormone therapy.
  • speech and language therapy (voice therapy) to help you sound more typical of your gender identity.

What happens if you don't treat gender dysphoria? ›

Although gender dysphoria is not a mental illness, when not addressed, it may lead to worsening mood issues, depression and anxiety, and may further complicate the issues the individuals may be having. Insurance may cover some illnesses associated with gender dysphoria and gender dysphoria care.

How can I encourage my daughter to be more feminine? ›

Ways to Teach Your Teen Daughter to Be A Lady
  1. Set an Example. One of the most powerful ways to teach your daughter to be a lady is to set an example for them. ...
  2. Watch Your Words. ...
  3. Focus on Clothes. ...
  4. Pay Attention to Attitude. ...
  5. Encourage Femininity.
18 Apr 2018

What to do when your child wants to change gender? ›

How Can I Help My Child with Gender Dysphoria?
  1. Offer support. ...
  2. Educate yourself. ...
  3. Get them in gender-affirming therapy. ...
  4. Ask questions. ...
  5. Allow for (and encourage) exploration. ...
  6. Help them with a medical transition. ...
  7. Advocate for your child.
5 Jan 2022

What are the stages of transitioning? ›

The 5 Stages of Transitions
  • Phase 1) Confusion. What is going on and how did I get here? ...
  • Phase 2) Depression. Where did I go wrong and what should I have done differently? ...
  • Phase 3) Acceptance. ...
  • Phase 4) Soul-searching. ...
  • Phase 5) The birth of a new you.
4 Feb 2018

How much does it cost to transition from a man to a woman? ›

Many transgender people transition without surgery. Some say they don't want surgery, or are interested in only some of the medical options available. But many cite the cost of the procedures – potentially more than $100,000 out of pocket – and the lack of insurance coverage as a barrier to their transition.

What to expect when transitioning? ›

Internal transition changes the way you see yourself.

You might try dressing differently when you're by yourself, calling yourself by a different name only in your head, or practice using your voice differently. You might start to notice times that you feel gender dysphoria or gender euphoria.

What are the long term effects of transitioning? ›

Transgender women have a higher risk of venous thromboembolism, stroke and meningioma compared to cisgender men and cisgender women. Compared to cisgender men, transgender women have a higher risk of breast cancer and transgender women > 50 years old have a higher risk of fractures.

How long does it take to recover from transition surgery? ›

Many people begin to feel more comfortable during the second week after their surgery. You'll need plenty of rest in the first two weeks. It's common to be back to your usual activities, including work, in six to eight weeks.

What are the long term effects of gender reassignment surgery? ›

Conclusions. Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.

How long should a transition last? ›

How Long Does Transition Last? As I mentioned earlier, transition is the shortest phase in labor, and it generally lasts about ½ hour to at most 3 hours long. You are so close, mama. You can do it!

How long does it take to start transition? ›

Some of the physical changes begin in as little as a month, though it may take as long as 5 years to see the maximum effect. For example, men transitioning to women can expect A-cup and occasionally larger breasts to fully grow within 2 to 3 years. But hormone therapy does more than alter your appearance.

Is transitioning difficult? ›

Transitions are hard for everybody,” says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. “One of the reasons why transitions may be hard is that we're often transitioning from a preferred activity – something we like doing – to something that we need to do.”

How can you prepare a child for a transition? ›

Prepare children for what's next – Settings and parents need to have conversations about the next transition their child's going to make. Showing them pictures of their new setting, it's environment and staff team or arranging visits before they move on to let children familiarise themselves with the environment.

How do you start a gender transition? ›

In general the first step is to explore your gender identity. This can include any combination of internal self-reflection, connecting with community and support groups, or working with a therapist who has expertise in gender identity issues. This process could take anywhere from months to years.

Can parents change their child's gender? ›

In California, you can ask the court to recognize your child's gender change and change their legal name. If you and the other parent agree, you can ask the court together. You file a petition, go to a court hearing if needed, and get an order recognizing your child's gender change and changing their name.

At what age does gender dysphoria go away? ›

Childhood GD and puberty development

For most children with GDC, whether GD will persist or desist will probably be determined between the ages of 10 and 13 years,26 although some may need more time.

How long does gender dysphoria take? ›

To be diagnosed with gender dysphoria as a teenager or adult, you must have experienced significant distress for at least six months due to at least two of the following: marked incongruence between your experienced and expressed gender and your primary or secondary sex characteristics.

How do parents deal with gender dysphoria? ›

Your child might change their name, pronoun, hairstyle or clothes. For gender-diverse children and teenagers who have gender dysphoria, affirming their gender can help reduce distress. Talking with your child about what they want and what they're comfortable with will help them.

What chemicals can cause gender dysphoria? ›

Recent evidence indicates that thalates from plastic and polychlorinated biphenyls (PCBs) are one of many factors predicting gender dysphoria, particularly in the case of male-to-female transgenders.

Can gender dysphoria be caused by trauma? ›

Gender dysphoria currently exists as a mental health diagnosis, perpetuating stigma as well as pathologizing gender variance. Clinical social workers have preserved a harmful formulation that gender dysphoria is a disorder caused by trauma.

Can gender dysphoria be caused by stress? ›

For some individuals, the stress caused in these situations by feeling a mismatch between their biological sex and gender identity results in gender dysphoria.

Can you physically feel gender dysphoria? ›

Gender dysphoria can feel different for everyone. It can manifest as distress, depression, anxiety, restlessness or unhappiness. It might feel like anger or sadness, or feeling slighted or negative about your body, or like there are parts of you missing.

Can you heal gender dysphoria? ›

Treatment can help people who have gender dysphoria explore their gender identity and find the gender role that feels comfortable for them, easing distress. However, treatment should be individualized. What might help one person might not help another.

How do you comfort someone with gender dysphoria? ›

The best thing you can offer them is an attempt at understanding what they are going through and some unconditional acceptance of who they are, such as:
  1. Hear them and listen with an open mind when they share their experience.
  2. Stand by them when they face judgement and hostility out in the greater world.

How do you treat dysphoria at home? ›

Exercise – a healthy amount of exercise can improve your mood. Do what you like - dance your heart out in your bedroom, do some yoga, ride a bike, go to circus classes, use the local park gym equipment, or look up exercises that will shape your body in ways that could reduce your dysphoria.

What age can you start hormone therapy? ›

In order to receive gender affirming hormone therapy services you need to be over 18 (or 16-17 with parental consent) and capable of providing consent for services. There are special consents for these services.

Can you start transitioning at 16? ›

In most places in the United States, you will need permission from your parent or guardian to do a hormonal or surgical transition before you are 18. You may also need to talk with a mental health professional and get a letter of support before starting treatment.

What's the best age to start HRT? ›

You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you're aged 40 to 45.

How long does it take to grow breasts on estrogen? ›

Breast development is a key feature of feminization and therefore important to transwomen. The Clinical Practice Guidelines of the Endocrine Society indicate that breast development starts 3 to 6 months after start of cross-sex hormone therapy (CHT).

What age is too late for estrogen? ›

The International Menopause Society guidelines recommend that if menopausal hormone therapy (MHT) is prescribed, it be commenced before the age of 60, or within 10 years of menopause.

What age can you start estrogen? ›

Age. Women who begin hormone therapy at age 60 or older or more than 10 years from the onset of menopause are at greater risk of the above conditions. But if hormone therapy is started before the age of 60 or within 10 years of menopause, the benefits appear to outweigh the risks.

How can I help my transitioning child? ›

  1. Strategies to support transitions and opportunities to teach. ...
  2. Give a transition warning and individual support. ...
  3. Sing the directions. ...
  4. Use play and children's interests. ...
  5. Choose your words carefully. ...
  6. Use visual cues. ...
  7. Give specific positive feedback after transitions.
18 Feb 2020

Will I look younger if I take HRT? ›

By restoring youthful hormone levels, HRT can help to improve your appearance and make you look and feel younger. In addition, therapy can also help reduce the risk of age-related diseases such as osteoporosis and heart disease. As a result, it can provide a wide range of benefits for older adults.

How long after starting HRT do you feel a difference? ›

It usually takes a few weeks before you feel the benefits of HRT. It can take up to 3 months to feel the full effects. If you have not felt the benefit of HRT after 4 to 6 months, it may help to try a different type. It can take your body time to get used to HRT.

Will my periods stop on HRT? ›

Sequential HRT

This means you'll continue to have a (usually) monthly bleed. Most women take this type of HRT for around four years, or until they reach 55 (whichever comes first). By 55, most women's periods have stopped. Sequential HRT contains oestrogen and progestogen.

What is the process of transitioning to a woman? ›

MTF transition can involve wearing traditionally feminine clothing and hairstyles, changing their name and pronoun use to “she/her/hers,” and coming out to family, friends, and colleagues as female. It can also mean seeking medical treatment to acquire a more feminine body through hormones or surgery (Hembree, 2017).


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