Gay, lesbian, bi, trans or queer? Trans can be either male to female (MTF) or female to male (FTM). Queer is an umbrella term for those who reject traditional gender or sexual identities.

Being a parent of a transgender child can be challenging. It usually involves children transforming their appearance from what they used to look like: a name change—easy; the use of different pronouns when talking to them—tricky, especially if they prefer the use of gender neutral ones like “we,” “they,” or “them.” It may be confusing, but you better get it right, if it is important to them. At a support group for parents of trans children, one father explained that for him, “them” conjured up visions of Siamese twins. A stressed mother wondered why her daughter couldn’t have been “just a plain old lesbian!” To many participants it seemed that the little boy or girl they welcomed in the world went into hiding.

Many sex characteristics can be wrought by hormone therapy. Increasingly, however, transgender people opt to have sex reassignment surgery (SRS), also called gender reassignment surgery (GRS), which is extensive, expensive, painful, irreversible and hardest for parents to take, especially since many children want to undergo these operations without their family’s support. Fortunately parents have a chance to get used to all these changes gradually since they take years to complete.

Last week I was fortunate enough to speak with Leslie, whose 34-year-old child, born Brian, now Debrah, had completed “bottom” surgery five weeks earlier. Leslie and Debrah are extremely fortunate because they managed to talk to each other during the almost twenty years it took Debrah to feel that her body, heart, and soul were one.

From the time he was very young Brian was aware that he was different from his older brother and from the other boys in his small Midwestern town. He decided that he was gay and came out during his early teens. His classmates hooted when he started to wear nail polish. Fortunately his mother, then already his best friend, supported him. Twenty years ago this was so unusual that her efforts made national newspaper headlines. Leslie, working together with the Gay, Lesbian & Straight Education Network (GLSEN), a New York-based organization, helped turn Brian’s high school into the country’s first gay and lesbian “safe school.” In spite of her efforts, Brian kept being harassed. Brian’s father and brother never got on board.

College obviously was better, but even as an openly gay man Brian still felt ill at ease. Gradually he realized that his gender identity was at odds with him being male. He concluded that he really was a woman. When he told his mother she was shocked. They argued and she came around. She looked at Brian and “saw a lot of both feminine and masculine traits.” She never wavered in her love and support.

During his junior year Brian became Debrah, started wearing women’s clothes and eventually underwent estrogen therapy. Ten years later, surgeons in Thailand performed SRS. Currently Thailand is reputed to be the place to have this type of surgery. Not having insisted on accompanying Debrah on this difficult journey is Leslie’s one regret.

For people who change their gender it is difficult to bridge the past and the present. For parents it is crucial to remember that on a basic level any transgender child is still the same person he or she was: happy, sad, funny, selfish or giving. Debrah honors the little boy she had been. Leslie loves the fact that her daughter was and is so articulate and emotionally intelligent.

There are two aspects to any major change: One’s inner reaction and sharing the news with the world at large. Even today most people don’t know how to react when you tell them that your child is gay, let alone transgender. Leslie admits that it can be tricky to speak of the past. She avoids discussing Debrah’s journey with new, casual acquaintances by simply talking about her daughter. She “comes out” to others by describing Debrah’s accomplishments.

I too know how hard it is to inform bystanders about private, uncommon matters regardless of whether they happened to yourself or the people you love. You are afraid that your listener will react with pity, blame, or disdain. Telling, however, provides a new feeling of freedom, honesty and strength; it makes you feel whole. I am always surprised how many people can relate to one’s story.

Accepting and “coming out” is a step in making the world a bit more tolerant. Fifty years ago, openly gay people could be arrested in the USA. Today Tim Cook, the CEO of Apple, declares that he is “proud to be gay.”

To protect privacy of the interviewee, names and other details have been changed or omitted.