How young is too young to change sex? Dateline reports on the complex issues surrounding transgender children.
Now, how many times have you heard the saying girls will be girls and boys will be boys? Well our next story turns that adage on its head. In the US more young people are defining themselves as transgender, throwing up any number of complex questions. For example, what is the appropriate age to undergo a sex change operation? As Jeannette Francis discovers, there is even controversy over which bathroom to use.
REPORTER: Jeannette Francis
Shopping with the Mathis family is a boisterous affair, it's little wonder - mum and dad have five children in tow including triplets.
JEREMY MATHIS, FATHER: It is so pretty. I love the polka-dots.
COY MATHIS: Look dad I want these to hold my hair up - these match my boots dad.
Coy is the eldest of the trio and gravitates towards all things pink and shiny.
COY MATHIS: I got a dress that matches my boots and a headband that also matches my boots.
But Coy wasn't always wearing dresses. The 7-year-old was born a boy but lives as a girl.
JEREMY MATHIS: I would much rather have a good relationship with the daughter that I have than a poor relationship with the son that doesn't really exist.
For Coy's doting parents Jeremy and Kathryn it's been an eye opening journey.
COY MATHIS: This is not my size.
KATHRYN MATHIS: She was two here, I think. That's just who she was. It's who she has always been. Really as soon as she could talk she was showing us and telling us that she felt like a girl. And it wasn't until she was closer to two and a half and three that she started saying, you know, I don't want to be a girl, I am a girl. She was trying so hard to tell us how she felt and we were ignoring her. So she started sinking to into a depression and started having a bunch of anxiety about going anywhere where people would know she was a boy.
Coy's parents hoped it was a phase that would pass but as the years went by their son's insistence that he was a she grew stronger.
KATHRYN MATHIS: Are you happy?
COY MATHIS: Yes.
KATHRYN MATHIS: She was constantly devastated because people didn't know who she really was. So we took her back to the various medical professionals and they all agreed she was transgender.
COY MATHIS: I want to be when I grow up, a worker, a fire fighter and I want to be a cowboy - girl.
Coy was diagnosed with gender identity disorder - it's a condition characterised by overwhelming feelings of identification with the opposite sex, of being born into the wrong body.
COY MATHIS: You can be anybody. You can be anything you want.
For the past year Coy has been living openly as a girl after making what experts calling a social transition to the other gender.
KATHRYN MATHIS: She went from being anxious and depressed and not wanting to go anywhere to almost overnight being thrilled with herself and wanting everybody to see her and who she was. It was just this huge difference in her just because people were finally listening and knew that she was a girl.
NEWS READER: Born a boy, now identified as a girl, a six-year-old from Colorado now at the centre of a media frenzy in a lawsuit for being transgender...
NEWS READER 2: They say the decision to ban Coy from the girls bathrooms at Eagleside Elementary was plain wrong.
NEWS READER 3: The letter stated that Coy was born a male and at least some parents and students are likely to become uncomfortable with his conditioned use of the girls rest room.
KATHRYN MATHIS: Just language arts? Whatever, we can do the other ones tomorrow.
COY MATHIS: This is fun.
Infuriated by the bathroom ban, Kathryn and Jeremy lodged a discrimination complaint with the state of Colorado and started home schooling their children. The case has become an unlikely rallying point for transgender rights.
KATHRYN MATHIS: I don't even see why the school thinks it's their responsibility to try to talk about Coy's body at all. It's completely inappropriate to me. They're not her doctors. They should not be talking about her body.
COY MATHIS: It's a boy that was hoping he was a girl and he was a girl in the mirror and a boy outside.
REPORTER: What is the name of the book?
COY MATHIS: Be who you are. It says right here, "Be who you are." I changed gender - girl.
REPORTER: What does that mean?
COY MATHIS: I'm a girl instead of a boy.
REPORTER: What happened when you wanted to use the bathroom?
COY MATHIS: The girls one - they said I had to used doctor's rest room or the boy's rest room.
REPORTER: Then what did you think about that?
COY MATHIS: I thought it was mean.
In Seattle Eli and Max are enjoying some retail therapy.
MAX: I know but these are so awesome.
Like most 17-year-olds they like shopping and hanging out. At the bowling alley they barely draw a second glance and that's the way they like it. For them it's an affirmation of their gender journey.
ELI: Now it's so much easier and everything is a lot better.
Eli was born a boy but lives as a girl and Max was born a girl but lives as a boy.
MAX: I think part of the reason for people coming out younger is because there is more visibility. Like I talk to older transgender people sometimes who came out really late and a lot of times they said they came out that late because they didn't even know that trans was a thing or they could be trans.
Both have been following the case of the Mathis family closely.
ELI: I think the parents are doing the right thing and the school has no right to take away her bathroom rights.
Eli has first-hand experience of what Coy is going through.
ELI: I couldn't use the rest rooms at my school for six years even after - I was in third grade and I was wearing dresses and lip gloss and they wouldn't let me use either bathroom.
REPORTER: So how long have you been living as a girl for?
ELI: I have been living with a girl since I was 13 and so it has been four years now. This is my make-up counter. I have always really been into make-up.
Like many transgender kids Eli also learnt to mask the pain. Throughout her life she has faced prejudice, bullying and harassment.
ELI: In elementary and middle schools it was very difficult. I couldn't participate with the girls and I was always singled out and I didn't have very many friends then because of it.
Eli has taken female hormones since the age of 15. Three months ago she went under the knife, becoming one of the youngest people ever to undergo gender reassignment surgery.
REPORTER: Does it feel strange that you now don't have something that you had for 17 years, a part of your body?
ELI: Um, strangely no. I was expecting to, but it just feels natural this way.
DR MARCI BOWERS, SURGEON: Eli... I haven't seen you in ages.
Eli hasn't seen her surgeon Marci Bowers since her operation.
DR MARCI BOWERS: The breast has it come along a little bit?
A pioneer in her field Marci herself was born as Mark. She is regarded as one of the leading transgender surgeons in the US.
REPORTER: Are you see more transgender patients particularly young people and children?
DR MARCI BOWERS: What we are seeing more but because society is becoming more permissive and not pushing people into the closet or worse, into antisocial behaviour or chemical dependency or suicide. We do know still that 50% of transgender youth attempt or commit suicide and so that's still a troubling statistic.
WALT HEYER: Hi, Bella, how are you?
These days Walt Heyer is a man's man and a deep skeptic, particularly when it comes to transgender surgery.
WALT HEYER: Most of the people suffering from gender issues are suffering from psychological disorders that need treatment and not surgery. So, you know, my life is just a testimony to the fact that you can't change somebody's gender with surgery.
Throughout life Walt had felt uncomfortable in his own skin. He went on to get married and have a family but in his 40s realised he was living a lie.
WALT HEYER: This is Laura, after the gender change.
At 42 Walt underwent surgery and became Laura. Eight years later, depressed and despairing he changed back. In the process he lost his wife, became estranged from his children and was left with the results of an operation that was irreversible.
WALT HEYER: The way I betrayed my children by switching genders is reprehensible. It meant how selfish I was.
Walt has been married to his second wife, Casey, for 17 years.
REPORTER: What goes through your mind, Casey, when you see pictures of Walt looking so different?
CASEY HEYER: You know what, it's really shocking. I mean, I didn't know him then. And I can't - you know, I can't even imagine what it's like to have the same Walt, the same kidding around, the same sense of humour but dressed as a female. It just - it blows my mind.
WALT HEYER: This river here is gorgeous. You know. She wanted somebody tall, dark and handsome and got somebody who is very short, old and not all that handsome. But you can't have everything.
CASEY HEYER: You're adorable.
These days Walt is the happiest he has ever been. No longer Laura, at 72 years old he is finally comfortable with being a man. While regret is rare in the world of transgender surgery, Walt says his story should serve as a warning to others.
WALT HEYER: Why all of a sudden do we have all these people with gender issues? I can tell you - because we're promoting it - we're making it fashionable. Kids are gonna be left without a real childhood because people aren't reinforcing who they are in their gender that they were born with.
Since kid Max Jannsen has loved his weekly drumming lesson, a student who has transformed before his teacher's eyes.
TEACHER: Even with the change it's the same person. I don't see a difference. It's still Max. Well, it used to be Mac. Come on Max.
Born a girl named Mackenzie, Max began living as a boy at age 8. He started taking male hormones at 14 and had surgery to remove his breasts a year ago. Today the 16-year-old is planning to march to the beat of a different drum. Max is on his way with his mum Tammy to the annual Pride Parade in Phoenix, Arizona.
REPORTER: Are there a lot of transgender people here in Phoenix.
MAX: There are quite a few trans-people, they are really coming out of the woodwork and becoming a community. I'm just coming out here to remind people that there are trans-people and that they do deserve rights.
Max is in his element, as are the 70 other marchers from the transgender community. This year they have plenty to shout about.
CROWD: We're here, we're trans and we're gonna use your cans.
Once again it's the contentious issues of bathroom use that's front and centre.
MAN: We are trans and we're proud and we're not going anywhere and SB1045 hurts everyone not just trans-people.
MAN 2: I stand before you today to see that the targeted and hateful proposal SB1045 is struck down.
SB1045 is a state bill that would have made it an offence for a transgender person to use the bathroom of their choice, with a penalty of up to six months in jail and a fine of up to $2,500.
MAN 3: If the authors of the bill came to know a real transgender person they would come to know we are just people, we're good, honest, caring talented and creative people.
As architect of the bathroom bill Arizona State Legislator John Kavanagh has become the transgender community's enemy number 1.
JOHN KAVANAGH: The problem is when such a person goes into a shower at a swimming pool or a locker room at a gym which this bill covers they often will become totally undressed and they would be exposed their entire body to females or perhaps even young girls. This is not acceptable. So I ran a bill to prevent that from happening. The bottom line is that transgender people represent an extremely minute fraction of the population, I'm not really sure if I want to make 90% of the people really upset and concerned especially when children are involved to placate a minority.
MAN 4: So please for the sake of my safety and for the sake of my rights for my community vote no.
MAN 5: OK, thank you.
Amid the outcry the bill has been watered down but it still allows business owners to dictate their own rules for private bathrooms.
MAN 6: Committee members, I beg you, please do not pass this, I am scared to go into a men's bathroom.
CROWD: Change, - shame, shame, shame.
MAX: When you use the rest room, think about what if someone confronted you while you were in there and said, "You shouldn't be in here because you don't look like the gender thank you say you are." That's a scary thing for a person that has to deal with every day.
Use of the bathroom is just one of the many challenges awaiting Coy Mathis and transgender kids like her, but Coy's proud mum Kathryn says she wouldn't have it any other way.
KATHRYN MATHIS: We would rather have a child that is happy and a little bit different than what we imagined than have a child that's depressed and unhappy. Being transgender shouldn't be something to be ashamed of, you're just a little bit different and we just kind of need to get to that point in society that it's OK to be who you are, even if you're not the ideal.
Original Music Composed by VICKI HANSEN
30th April 2013