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Thank you for this. You have described my thoughts about gender-affirming care, but far more eloquently than what I could have written. As a father and caregiver for my adult transgender daughter, who also has a psychotic disorder, a transition in gender identity is just one more parenting experience that I did not anticipate. But if I look back on my daughter's childhood, I do recall her preference for activities that are stereotypically associated with females--she has always enjoyed cooking and writing. She wanted us to read her Nancy Drew books as a child, rather than Hardy Boys book series. She never enjoyed playing or watching sports, working with tools, or other typical boy activities. Maybe these preferences are irrelevant given the diversity of human interests, or maybe not. It was years later, as a 22-year-old adult, that she expressed her desire to identify as a woman. My daughter is clearly happier and her personal hygiene is much better since she changed her gender identity. She is now 27 and is being treated with testosterone blocker and estrogen by her primary care physician.

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