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Now advocates like Empire State Pride Agenda are fighting for coverage at an earlier age, beginning with hormone blockers at the onset of puberty, saying it is more seamless for a teenage boy to transition to becoming an adult woman, for example, if he does not first become a full-bodied man.

McGinn said it was not unusual for patients to become depressed after surgery and compared this to postpartum depression.

"We cannot move back to the past.

"They told me when the client is there, I have to wear short shorts and a skimpy top," says Kieu.

In the fall of junior year, she showed up at school wanting to be called Katherine, or Kat, because she likes cats.

"I did not know what the job was," says Kieu, now 14 and living in a safehouse.

Boone, an operations and project manager, had a harder time, but was brought around for the sake of his child.

In recent years, various crackdowns in Svay Pak have dented the trade, but also pushed it underground.

Her goal was to start college as a woman.

" For that reason, the researchers propose allotting public funding to increase maternal education as a way to reduce early sexual promiscuity among their children.

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