There was no real reason for it since Poppy—Claude—was self-sequestered, but Rosie stayed home those three days too. Rain thrummed the windows as if the whole house were weeping. Quilted clouds the color of dead mice sunk low enough to cap the hill. Claude cried and cried in his bedroom. How could Rosie go to work and treat other people’s children when her own was shut up in his room, refusing food or any other kind of comfort? She knew the suicide statistics, and she knew what unhappy almost-teenagers did to their bodies, and she knew that she could not protect her child if she was not there. Poppy and Claude had both chosen isolation from the world. How could their mother rejoin it?
On the morning of the third day, James called. “You have to come in tomorrow.”
“Things are still shaky here,” Rosie hedged.
“Trust me,” said James. “You have to come in tomorrow.”
“Howie?”
“Howie. What the hell is going on over there anyway?”
“James, I have something to…” Now everyone at Poppy’s school knew, was there any reason she couldn’t tell this close friend, fellow physician, colleague, and confidant? “Never mind. I’ll be in tomorrow. Tell Yvonne she can offer my cancellations Saturday hours this weekend.”
“Good start. You okay, Ro? What’s going on?”
“Nothing. I’ll … nothing. I’ll see you tomorrow.”
On the morning of the fourth day then, she trudged up the hill. Howie met her at the door. “Let’s take a walk.”
“Oh God. Do we have to?”
“This is not a conversation we can have in reception.”
“Let me catch my breath.”
“You’re not going to be talking anyway,” said Howie. “Listen Rosie, I know you’ve got some shit going on at home. I don’t want to bust your balls. But you’re just not pulling your weight around here.”
“Howie, how am I not pulling my weight around here? I keep thirty-five appointment hours every week, same as you. I maintain emergency appointment slots and on-call hours, same as you. My patient load is full, same as yours.”
“How can you say you’re keeping thirty-five patient hours every week? You’ve cancelled all your appointments since Monday.”
“Once. One week. This week I’ve had to cancel appointments—all of which have been rescheduled, and for each of which will I carve out time. In the four years I’ve been working here, this is the first time I’ve had to reschedule more than a day’s worth of appointments. People get sick, Howie, people’s families get sick, even doctors’. That’s why we have sick leave and personal leave and family leave.”
“Is that what’s happened this week? Sick kid?”
Rosie nodded but failed to elaborate.
“Penn can’t take care of this? He doesn’t even work.”
“Howie, how my husband and I manage our family and household responsibilities is none of your business.”
“No, my business is running this practice, which I cannot do if its members don’t honor their commitments.”
“Three days in four years is hardly failing to honor my commitments.”
“Except that meeting patients is only part of your job requirements.”
“I’m a doctor, Howie. Seeing patients is my job.”
“In a hospital setting, in a large organization, maybe that’s all there is to it. But as was made clear to you when you were hired, more is expected, more is required of you in a small practice. The rest of us are meeting our patient load and taking on extra responsibilities. You’re showing up for your patients and then going home. This means the rest of us are picking up your slack. You need to contribute to the whole of this enterprise. The rest of us have families and personal lives and patients we care about too. We need team players who can share our burden.”
“What have I been asked to do that I haven’t done?”
“Everything you’ve been asked to do you haven’t done,” he shouted. “You haven’t helped market the practice. You haven’t helped bring in new patients. You haven’t gone to conferences to represent us. You haven’t attended seminars to expand your skill set and thus our offerings. We needed someone to take on social media and the website, and you refused. We’d like someone to look into aid work and other volunteer opportunities. I actually did the work to liaise with a clinic in Thailand, but you won’t go there, even for a brief stint. Do you know how great something like that looks for a small practice? Seattle Met might do a profile on us. Maybe even NPR. We’d get recognized by the AMA. This is how people choose doctors, Rosie. There’s a thousand big and small things that go into running a business like this, and all you’re doing is meeting with patients. Except when you can’t.”
“Howie, I can’t go to Thailand—I have patients here, not to mention a family and a life. I can’t do weekly volunteer hours—I already have a full-time job. I also already have all the skills you wanted me to go to seminars to learn. We can’t attract new patients because we’re full with the ones we already have. I can’t do social media because I’m not eighteen, and I can’t do marketing because I’m a physician, not an ad exec. However, because I’m a physician, I can treat our patients, which I do, very nearly without fail, and I’m getting no complaints. The key to a successful practice isn’t volunteer work in Thailand or a Twitter feed or a staff-appreciation breakfast which I have just taken on for the fourth year in a row; it’s happy patients, and mine are happy because I am a good doctor.”
“And I’m telling you it’s not enough. If you want it to be enough, go be a doctor elsewhere.”
“Jesus, Howie. It was three days.”
“Three days plus four years. Enough is enough. Think about it.”
* * *
At lunch, she called Mr. Tongo. “Everyone knows.”
“Oh shit.” It was so unlike Mr. Tongo to curse, Rosie almost laughed. Almost. “Everyone?”
“Everyone. Well, no, nearly no one. But everyone at Poppy’s school.”
“Oh my. How did that happen?”
“Who cares?”
“I suppose. How is she taking it?”
“Bad. Very bad. She shaved her head. She’s wearing sweatpants. She put away all her stuff. She won’t talk to us. She won’t come out of her room. It’s bad.”
“Oh good.” Mr. Tongo’s voice rang with relief. “Sounds perfect.”
“Really?”
“Perfecto. Great timing. Strong work. I’m so proud of her and all of you.”
Rosie was not sure she had the patience for Mr. Tongo’s idiosyncrasies today. “What are you talking about?”
“Coming out. It’s a queer right of passage. She had to do it, and the sooner the better—the closet’s no good for anyone. She’s young now, not yet in the throes of adolescence. Shaved head. Locked door. Not speaking to her parents. It’s perfect! She’s doing great!”
“She’s not … she’s not queer,” said Rosie.
“She’s not,” Mr. Tongo agreed. “And that’s the problem. You’ve so thoroughly accepted this child from the beginning. You accepted Claude as Claude. You accepted Claude as Poppy. You made this child feel so completely, entirely, unquestionably, comfortably female. You’ve deprived her of her queer.”
“You’re saying we’ve been too loving and understanding.”
“Yes.”
“Yes?”
“Yes. She’s queer. She’s a girl with a penis. That’s wonderful, but it’s not usual. It’s weird. It’s odd. It’s queer. There’s a whole community, a whole world, a whole worldview worth of queer support that makes being a girl with a penis and any number of other less than usual things not just okay but also celebrated. And we want her to be part of that world.”
“But you said don’t tell anybody.” Rosie tried and failed to keep herself from shrieking. “You said it was nobody’s business.”
“And that worked beautifully for a little while. You didn’t think that was the plan for forever, did you?” Mr. Tongo asked, maddeningly, as if his weren’t the advice they’d been following in the first place. “Six-year-old Poppy was too young to have to educate her peers, to have to stand up for herself all the time, to have to explain about sex versus sexuality or gender identity versus gender expression. In first grade, we’re still trying to teach little boys and little girls that nothing in their pants is appropriate conversation for school. But now she’s ten. She’s almost off to middle school, almost a teenager, about to start becoming a grown-up, so it’s time for her to explore and decide and be strong, to talk about who she is, to stand up for herself, and to deal with what sets her apart.”
“How does she do that?”
“Same way everyone else does,” he crowed. “Suffering! Your small town can’t accept you so you leave. Your family can’t accept you so you find a new one. Your little life of shame and wishful thinking becomes too confining, so you strike out for something larger.”
“So you’re saying she hasn’t suffered enough.”
“Yes! Bravo!” he cheered. “That is exactly what I’m saying. You haven’t let her suffer enough. You’ve protected her too thoroughly. You’ve treated as normal something that isn’t so she hasn’t learned to live the abnormal life she actually has. You may not care, but other people will. Of course they will! For you, Poppy with a penis isn’t any more or less variant than any of your other kids’ wonderful quirks, and you love them all no matter what, and you just wake every day and raise them up. But that doesn’t help Poppy live anywhere in the world besides your house. No wonder she won’t leave her bedroom.”
“So what do I do?” She felt like she had talking to Howie, like what was being asked of her was both impossible and absurd.
“You? Nothing. You’ve done too much already. She has to do. And she’s already done. Step one is come out.”
“Done,” she conceded. “However unwillingly. What’s step two?”
“Step two is get rejected by lots of people and feel just terrible about it.”
“Also done. What’s step three?”
“Step three is where it gets fun. Step three is moving on.”
“How long does that take?” she sulked.
“It takes a whole lifetime”—Mr. Tongo sounded overjoyed as usual—“so it’s a good thing she’s starting early.”
* * *
Yvonne rescheduled Rosie’s patients well past regular office hours. Her last patient of the day finally left at 9:45. She was hungry, and she was tired, and she was eager to be home and see what lay in wait there, and she was terrified of getting home and seeing what lay in wait there, and her head was abuzz with patient complaints and treatment plans and drug regimens, and her head was also abuzz with Howie’s threats, and her head was also abuzz with Mr. Tongo’s admonishments, and it was a dark, wet, steep walk home. She had gotten used to the rain over the years. She had gotten used to the gray clouds that covered the city like a radiation apron nine months a year. But by 9:45, it had been dark already for more than five hours, and twilight at four in the afternoon was not something she’d ever gotten used to. It seemed like the middle of the night, and when she let herself in the front door, she felt nothing so much as jet-lagged.
The house was unusually quiet. No one homeworking. Everyone shut up in his or her room. His room. No one peeked out from a shut bedroom door to say hi or how was your day or you must be exhausted let me heat some leftovers for you. She knocked on Roo and Ben’s basement.
“Guys?”
“Yeah?”
“You okay?”
“Yeah.”
“How was school?”
“Fine.”
“Anything new?”
“No.”
“Did you guys eat?”
“Yeah.”
“Okay. Love you.”
“You too.”
She had a similar conversation with Rigel’s door. Orion was hanging upside down off the arm of the sofa wearing vampire teeth and a cape and playing a video game. “Before you vonder, no I don’t vant anything to eat, no I don’t vant anything to drink, yes I finished all my homevork. I am gaming upside down only because I vant to be a vampire bat, so there’s no need for you to vorry.”
She knocked on Poppy’s door.
“Poppy?”
Nothing.
“Claude?”
Nothing.
“You okay?”
“No.”
“Wanna talk?”
“No.”
“I chatted with Mr. Tongo today, and he had some thoughts. Can I share them with you?”
“No thanks.”
“Okay, baby. Whenever you’re ready. Did you eat something?”
“Yeah.”
“What?”
“Cheerios.”
“Want something a little more substantial? I haven’t eaten yet either. We could heat up a pizza or something.”
“No thanks.”
“Okay, love. Anything I can do to help?” Please? Please please please please please.
“You could stop asking me that question and go away.”
In her bedroom, she found all the lights off and Penn’s glowing laptop open on the bed, but Penn himself was absent.
“Penn?”
“Bathroom,” he called. “Sorry, I didn’t hear you come in. Long day?”
“Very. What’s new here?”
“Not much. Quiet night. Leftover pasta in the fridge if you want.”
“Thanks. What are you doing in here?”
He hesitated. “Uh … work. I just wanted a little privacy so I’m doing it in here.”
She looked at his laptop. Vaginas. A plethora of vaginas. Insides and outsides. Close-ups, glamour shots, selfies. Films of vaginas in action. Please God, Rosie prayed, let him be looking at porn.
He came out of the bathroom, looked at her looking and looked sheepish.
“Feeling randy?” she asked hopefully. “Just wanted a little alone time?”
“Vagina shopping,” he admitted.
“Oh, Penn.”
“Just … looking.”
“She’s ten. No surgeon in the world is going to cut off her penis.”
“They don’t cut it off. They more like … turn it inside out.”
“No surgeon in the world is going to turn a ten-year-old’s penis inside out.”
“Not yet, obviously. I’m just starting the research. There are some really remarkable doctors who—”
“You’re getting way, way ahead of yourself here.”
“I’m just starting the process.”
“Why?”
“Why?”
“Yes, Penn, why? She’s got another year, maybe more, she can be free of medical intervention at all. She’d have years, who knows how many, on hormone blockers if that’s the direction she and we decide to go. There are a zillion possibilities between here and vaginoplasty. What you’re doing right now makes about as much sense as shopping for a suit for Roo’s wedding.”
“It’s just … well, it’s pretty exciting, Rosie. Do you know a lot about sex-reassignment surgeries? They can make her a working vagina. It can do everything yours can. Her lovers won’t be able to tell the difference. Her gynecologist won’t even be able to tell the difference. They’re doing it on minors in other countries. We could get this done before she went to college. Talk about a fresh start. It’s some kind of miracle. You should see these sites. They—”
“You didn’t answer the question, Penn.”
“What question?”
“She’s ten. Why are you doing this now?”
“I don’t know if you’ve noticed, Rosie, but push has crossed right over to shove here. In between, half-assed, secretly, just socially, it’s not cutting it anymore. We have to commit. We have to go all the way. Otherwise, she’s just a guy in a dress.”
“I don’t know if you’ve noticed, Penn, but he cut off all his hair, put away all his girl clothes and toys, and is, as we speak, reverting to Claude with Cheerios.”
“And she hasn’t come out of her room in a week. That’s how depressed she is about it.”
“Or scared. Or confused. Or worried about disappointing us. Or worried about changing her mind. Or maybe she is depressed, but it’s not clear to me why. It could be that she’s depressed about not being all-girl. Or it could be that she’s depressed about everyone finding out, which is not the same thing. Or it could be she’s depressed because she doesn’t know who she is or who she wants to be, and she can’t stand thinking about it anymore.”
“No, I think that’s you.” Penn closed his laptop.
“But instead of trying to figure out all that might be going on, you just want to do surgery.”
“I don’t just want to do surgery. I want to look into the option of surgery. And I want to do it long before we think we need it because it’s not a minor undertaking, and that’s how seriously I’m taking this.”
Without the laptop glow, it was suddenly very dark in the room. “I get that, Penn. I do. But even thinking about this right now is part of the problem.”
“How can that be? How can doing research and having more information and thinking through complicated issues with time to spare possibly be a problem?”
“Because she’s having doubts”—Rosie held her arms out from her sides like her daughter did when she was upset—“so we have to live in the doubt place with her. She’s undecided, so we have to be undecided too. If she doesn’t know, we can’t tell her, can’t even have something in mind. These are her decisions to make.”
“How can she make this decision, Rosie?” Penn’s voice was shaking. “She’s ten. She doesn’t know what genitalia is for beyond peeing with. She can’t make decisions about sex, about the importance of sensitivity, lubrication, dilation, reproduction. She can’t consider what a sexual partner will make of what’s under her pants. We don’t even know if she’s going to be gay or straight. She can’t possibly make these decisions. As you keep saying, she’s ten. So we’re going to have to do it for her.”
“We can’t. Penn, we can’t. These aren’t our decisions to make. If she can’t make these decisions for herself, she’s going to have to wait until she can.”
“She can’t wait.” Penn was surprised to find his hands clasped in front of his chest, not quite pleading but not so far off either. “The younger you do it, the less of the wrong puberty she goes through, the better it works, right? If we wait until she can decide for herself, we’ve taken the choice away from her because we waited too long.”
“Penn, there are reasons they don’t do surgeries like this on minors, and only some of them are physical.” It felt like playing dirty to pull doctor rank, but this was important. “She cannot consent right now. She has to consent before procedures like these. So she has to wait. And so do you.”
“This is our job as parents, Rosie. You didn’t say we couldn’t pull Roo’s wisdom teeth because he was a minor. You didn’t say Ben couldn’t get his ear pierced because he was only fifteen. As parents, we make a thousand decisions a year with life-altering impact whose implications our kids couldn’t possibly get their heads around. That’s our job. That’s what parenting is. We decided to move across the country via some insane calculus that concluded Poppy being safer outweighed Roo being crankier because Ben might be happier and Orion and Rigel were a wash. We had no idea if it would work. We had no idea if it was the best thing. We researched. We thought about it. We discussed. And we made the best guess we could with the information we had on behalf of our children whose lives we thus changed indelibly forever.”
“Penn, tell me you see how vaginoplasty is different from ear piercing. Tell me you see how removing a penis is different from removing wisdom teeth. Tell me you see that equating gender reassignment with address reassignment is an absurd comparison.”
“Of course. Clearly. I’m just saying we make decisions for our kids all the time. We do this because we know they aren’t as smart or experienced or informed as we are, so they can’t make these decisions for themselves. That’s what we’re supposed to do.”
“You’re scaring the shit out of me, Penn.”
“Why?”
“You’re going too fast. She’s just decided to re-become Claude, and your response is to turn her into Linda Lovelace. Maybe she doesn’t mean it. Maybe she’s not really changing her mind. But we have to slow down and figure it out, let her figure it out. You’re ticking off boxes here because it’s something you can do, and I get that, believe me, but she’s got to be lost for a bit, and she can’t be lost if we’re leading her out of the woods.”
“She isn’t lost, Rosie.” Penn took her hands and, though she tried, would not let her pull away. “We made this decision long ago. We made it when Claude was in kindergarten, and Poppy’s never regretted it, not for a day, and neither have I.”
“Then why’d she shave her head?”
“I don’t know.” His face looked worn, wan.
“Penn, in so many ways, we’re so lucky. In so many ways, I’m grateful this is what our kid got, gender dysphoria instead of cancer or diabetes or heart disease or any of the other shit kids get. The treatment for those isn’t necessarily clearer. The drugs are harsher and the prognosis scarier and the options life-and-death but never black-and-white, and my heart breaks every time for those kids and those parents. But those are more or less medical issues. This is a medical issue, but mostly it’s a cultural issue. It’s a social issue and an emotional issue and a family dynamic issue and a community issue. Maybe we need to medically intervene so Poppy doesn’t grow a beard. Or maybe the world needs to learn to love a person with a beard who goes by ‘she’ and wears a skirt.”
“But that’s not going to happen.” Penn spoke so softly she wouldn’t have heard him if she didn’t already know what he was going to say.
“In which case maybe she—and you and I—need to learn to live in a world that refuses to accept a person with a beard who goes by ‘she’ and wears a skirt and be happy anyway. Maybe our response to that world should not necessarily be to drug and operate on our daughter.”
“How?” He looked up at her. It felt like a long time since their eyes had met.
“How what?”
“How do we learn to live in that world and be happy anyway?”
* * *
Rosie woke from fitful sleep sometime well predawn to send Howie a text: WILL GO TO THAILAND. IF I CAN BRING POPPY.