RENEE MONTAGNE, HOST:
We've been hearing a lot about HB2, North Carolina's controversial bathroom bill. It limits the use of public restrooms. In particular, restrooms in public schools are restricted to the biological sex listed on a person's birth certificate.
As it happens, though, North Carolina is also home to one of the only gender clinics for kids in the South. Mary Harris from NPR member station WNYC's podcast Only Human spent a day there to find out who's coming in for treatment and how they're coping.
MARY HARRIS, BYLINE: The gender clinic at Duke University's Children's Hospital is only open a couple of days a month.
UNIDENTIFIED MAN: Drew, when's your date of birth?
DREW ADAMS: 9/29, 2000.
HARRIS: Fifteen-year-old Drew Adams is checking in. He was born a girl. But he's been living as a boy for the last year and a half.
UNIDENTIFIED MAN: Who's your primary care doctor?
D. ADAMS: Dr. Tarbox (ph).
HARRIS: It's Drew's second time here. He and his mom, Erica, drove almost eight hours to get here from Jacksonville, Fla. HB2's on their minds. Erica said that when Drew had to stop for a bathroom break on the way up...
ERICA ADAMS: I held my breath because you just don't know. You don't know if he's going to walk out, and everything's going to be fine. You don't know if he's going to be in there a while. I'm going to stand there and go, I wonder if anybody else is in there. I wonder if he's having to defend himself. I don't know what's going on in there.
HARRIS: Drew looks pretty androgynous. He's got blond hair cut short with a sweep of bangs across his forehead. He has a ring through the center of his nose. And as the medical assistant gets his height and weight, Drew squints at her through his wide, wire-framed glasses.
UNIDENTIFIED NURSE: I'm going to get your blood pressure.
HARRIS: He's hoping the doctor will prescribe testosterone - a once-a-month injection.
UNIDENTIFIED NURSE: Did you guys have any questions or concerns about anything?
D. ADAMS: Nope.
HARRIS: While they're waiting for the doctor, my producer, Jillian, asks Drew about the shirt he's wearing.
JILLIAN WEINBERGER: Can you tell me what your t-shirt says?
D. ADAMS: Yeah. It says, this is what trans looks like. And the word trans is in trans flag colors.
WEINBERGER: Where did you get that t-shirt?
D. ADAMS: Mom made it.
HARRIS: Erica's learned to embrace Drew's new identity because when he was living as a girl, she says he was really anxious and depressed.
E. ADAMS: Then after he came out as trans, it was like flipping a light switch. Suddenly, he has not had an issue with anxiety or depression pretty much since that day. He's been so confident. He's been so positive. He's so bright. That's kind of his mood all the time now.
HARRIS: She doesn't like talking about what Drew's life was like before he started transitioning. But when I asked her how she knew living as a boy was the right choice for Drew, she was blunt. She said, I'd rather have a living son than a dead daughter.
DEANNA ADKINS: Hey. How are you?
D. ADAMS: I'm great.
ADKINS: Excellent.
HARRIS: Dr. Deanna Adkins started this clinic. She's an endocrinologist, a hormone doctor. Drew is almost giddy to see her. When she walks in, his only question is, when can I start testosterone?
ADKINS: Today.
D. ADAMS: Yeah. Yeah.
ADKINS: Sound good? All right. All right. So yeah, I'll give you your prescription.
HARRIS: But going through this second puberty is controversial. Part of the reason Drew and his mom traveled here is because an endocrinologist in Jacksonville didn't feel comfortable prescribing these drugs.
When Dr. Adkins leaves to write up a prescription, the clinic's social worker comes in. She's got this packet of paper. It lists every potential side effect of testosterone. She starts reading off these statements for Drew to agree with.
UNIDENTIFIED WOMAN: Risks - I understand that the medical effects and the safety of testosterone are not completely known. There may be some long-term risks that are not yet known.
D. ADAMS: Yes.
HARRIS: Drew's required to affirm that he's heard all of them. And it's a long list. The hormones might give him headaches, high blood pressure, an inflamed liver.
UNIDENTIFIED WOMAN: Emotional changes, for example, and more aggression. I know that the effects of testosterone unfertility are unknown. I have been told that I may or may not be able to get pregnant, even if I stop taking testosterone.
HARRIS: Listening to all these side effects, I can't help but think, Drew's only 15. He can't vote, drink or drive. How does he know this treatment's right for him? Is he old enough to consent?
Some critics say teenagers are just too young to make such a huge decision. This clinic will sometimes tell kids they're not ready. But most of the time, the doctors here say they're mature enough.
Do you ever worry you're making this big decision - like, what if I change my mind?
D. ADAMS: Absolutely not. This is the happiest I've been all my life. Like, today, getting that prescription - like, probably the happiest I've been.
JAY: Hey.
HARRIS: Hello. This is Jay.
WEINBERGER: Hi. Nice to see you.
HARRIS: I'm Mary.
WEINBERGER: I'm Jillian.
HARRIS: We walk in to Jay's appointment just after lunch. Jay is an 18-year-old African-American trans woman who lives just outside Raleigh. She's here to get a prescription for estrogen.
What are you most looking forward to?
JAY: To be honest, I'm waiting for my boobies (laughter). To be honest, I'm ready. Yeah, I've been waiting a long time for, you know - to be able to develop breasts.
HARRIS: Jay is incredibly thin and perfectly styled. She has long fake eyelashes and lots of pink eye shadow. The only real sign she wasn't born a girl is the distinct shadow of hair on her neck. When she was younger, Jay thought she was gay. And when she came out, her mom was pretty supportive. But when Jay told her mom she was trans...
JAY: She was angry at me. She thought I was lying to her - I was living a lie. And it just took me by surprise that she, you know, wouldn't, you know, accept me the way I thought she would.
HARRIS: So part of the reason we're here is because North Carolina has been in the news so much because of this bathroom law.
JAY: Mhmm.
HARRIS: You got a look on your face when I said that.
JAY: Since I've lived here in North Carolina, I know how it is. And people that I know out of state - they're like, it's not that bad. I'm like, yes, it is. Like, I know a lot of discrimination, know places not to go where I could get hurt.
HARRIS: Jay can recite the names of trans women of color who have been killed over the last couple of years. She's scared that if she does something kind of normal, like make the first move with a guy, she'll get hurt physically.
How do you keep yourself safe in the outside world?
JAY: I stay home (laughter). It shouldn't be that way. But otherwise, you know, I like to travel in groups. I travel in groups. I don't like to go anywhere late at night. I don't like to - I don't seek out men. A lot of places don't feel safe. Work doesn't feel safe sometimes. Home doesn't feel safe sometimes. I'm safe when I'm by myself.
HARRIS: After seeing Jay, Dr. Adkins goes into this little work room to go over patient records and catch her breath.
ADKINS: I'm getting a little worried - I mean, not that I wasn't worried already. But I was just told by the third patient that they're moving out of state because they don't feel safe.
HARRIS: But more and more patients are coming to this place for help. The day we visited, this clinic was open for 12 hours straight.
ADKINS: The next new patient appointment's in November now.
HARRIS: And this is the beginning of June.
ADKINS: Yeah.
HARRIS: HB2 is being challenged in federal court. And Dr. Adkins is part of that case. She's hoping her testimony can help overturn the law. For NPR News, I'm Mary Harris in Durham, N.C.
MONTAGNE: And hear more from inside North Carolina's gender clinic for kids at onlyhuman.org. Transcript provided by NPR, Copyright NPR.