The suicide of a 14-year-old trans boy in small-town middle America leaves a community grappling with questions about the nature of gender. There are 1.4 million transgender adults living in the United States, a staggering 41 percent of which have reported attempting suicide at least once in their lifetime. The second episode of Thread the Needle explores the question—what do we need to understand about gender and how it influences our sense of self in order to better support this vulnerable population?

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In this episode, we’ll explore commonly asked questions including:

Is gender something that’s taught, or is it an innate part of our identity?
Can gender dysphoria be a phase?
At what age should parents teach their kids what transgender and nonbinary mean?
When is the right time to consider putting kids on hormones, treatments that can have irreversible effects?
Why is the suicide rate so high for people who are transgender?

This episode is dedicated to the memory of Finn Winn Bousquet.

Episode Guests:

Theresa Thorn, Co-Host of One Bad Mother podcast and author of It Feels Good To Be Yourself: A Book About Gender Identity

Tamlin Day, Transgender activist

Heidi Winn, mother of Finn Winn Bousquet

Thanks to Molly Bloom of American Public Radio for mentoring this project!

Hosted and produced by: Donna Cleveland

Original music by: Meara Oberdieck, Taylor Ross

Episode artwork by: Chosie Titus

Recording and audio mastering by: Cody Olivas, Nicholas Naioti

Additional music from: Free Internet Archive

Sources cited in this episode:

Follow Thread the Needle on Instagram @theneedlepod.

Episode 2 transcript:

DONNA CLEVELAND (HOST): This story includes discussion of suicide and other self-harming behavior, and might not be appropriate for younger listeners.

I was in 7th grade when a boy in my class, Alex Grace, was diagnosed with brain cancer. I heard news whispered by teachers and classmates in the hallways—he was going to be having surgery soon, he’d be staying in the hospital for a while recovering.

That year, Alex was in and out of the hospital, fitting in ballet performances and class when he could. His hair fell out from chemotherapy until he was completely bald, and you could see a big scar running up the back of his head. I remember him still smiling a lot, his small features looking perfect and exposed. A year later, he was gone.

A couple of years ago, a 14-year-old boy named Finn who went to the same middle school as me won the Alex Grace Award for kindness, integrity, courage, and wisdom.

CHRIS GRACE: We look forward to seeing what this young man can show us in high school. Congratulations to Finn Winn Bousquet.

FINN WINN BOUSQUET: I’m here today to sincerely thank the faculty and staff of this amazing school…

CLEVELAND: Like Alex, Finn died young. Finn was transgender, and in the year leading up to his death, he’d socially transitioned from a girl to a boy. By all accounts, Finn received a lot of support in the community and had thrived at school. But just days after he graduated eighth grade, Finn walked out in front of a train and ended his life.

You’re listening to Thread the Needle, a monthly podcast that explores the meeting place between feminist ideals and the realities of women’s lives. I’m Donna Cleveland, a journalist and cisgender woman who’s trying to understand how gender influences our sense of self. Finn’s death was a huge loss in my town, a small community of 10,000 people in rural Iowa. Unfortunately, Finn’s story fits into a larger trend.

There are 1.4 million transgender and gender nonconforming adults living in the US, according to the latest government data. A staggering 41 percent have reported attempting suicide at least once in their lifetime according to research conducted by the American Foundation for Suicide Prevention and the Williams Institute. That’s far higher than the national average of 4.6 percent.

In this episode, we’ll try to answer the question: What does our society need to understand about gender and how it influences our sense of identity in order to better support this vulnerable population?

We’ll follow the life of Finn, who inspired this episode, and we’ll gain insights from the author of a children’s book on gender identity Theresa Thorn, and transgender activist Tamlin Day.

Finn’s death started a lot of conversations in my town, and highlighted how little many of us know about gender identities that fall outside of the familiar two options of girl and boy.

In this episode as we work our way through Finn’s story, I’ll share the answers I found to the most commonly asked questions I’ve come across.

#1: Is gender something that’s taught, or is it an inherant part of our identity?

#2: Can gender dysphoria be a phase?

#3: At what age should parents teach their kids what transgender and nonbinary mean?

#4: When is the right time to consider putting kids on hormones, treatments that can have irreversible effects?

#5: Why is the suicide rate so high for people who are transgender?

The first person I spoke to was Finn’s mom Heidi Winn. As we sat down in her living room, Heidi began to tell me about how she came to live in Fairfield. In 2008, she packed up her minivan and her two kids and drove from Portland, Maine, all the way to Fairfield. Her brother had convinced her to move to Fairfield to put her kids in Maharishi School, the same school I’d gone to, where kids meditate twice a day using the technique taught by Maharishi, an Indian guru who the Beatles used to follow. Side note: there’s a lot more I could tell you about Fairfield, but I’ll save that for another podcast.

Heidi appreciated the simple life she found in Fairfield, and it seemed like her kids did too. She found work in the mental health field, and she began seeing a man named Jean, who she went on to marry in 2012.

Then in 2015, things began to change for her youngest child, who would later identify as Finn. He was in sixth grade at the time and had recently turned 12. He came in to Heidi’s room to cuddle before bed, something he did often.

HEIDI WINN: This particular night, my hand felt his wrist for some reason under his sweatshirt, and I felt scarring. And I went up further on his arm, and I went all the way up to his elbow, and I turned on the light, and Finn had been cutting.

CLEVELAND: Although Heidi had seen this type of self-harming behavior as a therapist, she hadn’t suspected it was happening right under her nose.

WINN: How could I not be knowing this? As a mother, where was my intuition? I didn’t know it, but Finn was having a lot of anxiety and a lot of suffering.

CLEVELAND: Over the course of the next year, Finn would be in and out of the hospital for suicide attempts. When he made his first attempt in October, Heidi pulled him out of school. She tried putting him on antidepressants, including Prozac and Lexapro, and even consulted a psychic, but nothing seemed to help. On New Year’s Eve, Heidi said Finn took muscle relaxers she’d had in the house from an old tennis injury. Then in February, he ended up in the ICU after taking 50 Benadryl.

WINN: This kid was trying to die over and over, and I didn't want him to die. In between hospital times, he would curl up to me and he'd say, 'I feel like I'm on a mission to die,’ and I would say, 'How can you say that I couldn't live without', I would just be like on a mission to die, your 12-year-old is on a mission to die,' I was like what? Where is this coming from, and I was at a loss.

CLEVELAND: Finn was back in the hospital in May, a year after Heidi first discovered Finn had been cutting. One day, Finn called her from the hospital with an announcement.

WINN: He said I had a moment of clarity last night, I'm a boy inside and I want to be called Finn.

CLEVELAND: I asked Heidi if she was surprised by the news. In hindsight, she said there were a few small signs, like the fact that he liked to wear boxers when he was seven and wanted a short haircut above his ears. But for the most part, she didn’t see it coming.

WINN: It was a surprise. Although I didn't let myself stop to feel the surprise, because I was all about validating this kid and helping this kid whatever he was going through to have whatever support he needed.

CLEVELAND: But why the sudden lightning bolt? It turns out, months before that in the hospital, Finn has shared a room one night with a transgender boy who went by Hectar.

WINN: They stayed up all night talking. That was Finn's first time ever really knowing about transgender. He didn’t know it until he knew it, sort of like he didn't know he had the right to claim it until he did.

CLEVELAND: Heidi didn’t know much about being transgender at the time, but she was quick to get on board.

WINN: He could have called me up and said I'm a pineapple and I would have said welcome whatever you are I mean it was life or death. The next day we went up, I smuggled my phone in and we ordered on my phone some boy teenage boy clothes and then when they came in I brought them up and within a couple of weeks one of my best friends went up there we had to get special permission, she had scissors and cut his hair into a savvy kind of long bang short all over side hair-cut and he loved it.

CLEVELAND: Coming out seemed to provide Finn some relief from his inner turmoil.

WINN: In U of I hospital and probably every hospital, they have these purple assessment cards that go from 0 to 7 and they're suicide assessments. Are you having thoughts about suicide? Do you have a plan? Do you have intention? Do you have the means? All of this. The whole time that Finn was in the hospital there he was at a 6 or 7 every single time three times a day until the day he came out as a boy it went to zero and it stayed zero.

CLEVELAND: At this point in Finn’s story, the questions I set out to answer at the beginning of this episode were beginning to resurface. Finn’s mental health at the time made the need to socially transition Finn urgent. But for other parents, I wondered how much time seemed appropriate to wait before going forward with a gender transition? I realized this question was just another way of asking the common question—can gender dysphoria be a phase?
I also wondered, if Finn had never met Hectar, would questioning his gender have ever come up? This ties in to question #2: Is gender something that’s taught, or is it an inherent part of our identity? And finally, when is the right time for parents and teachers to explain to kids what transgender and nonbinary mean?

I’m going to pause Finn’s story here to explore these questions.

On the West Coast, around the same time Heidi discovered Finn had been cutting, across the country, a four-year-old child was beginning to explore their gender identity. Theresa and Jesse Thorn, who are both podcasters living in the San Francisco bay area, thought that the oldest of their three kids was a boy at the time. Their child would ask:

THERESA THORN: Why do girls have vaginas and boys have penises? And I said, 'well some boys have vaginas and some girls have penises', and then she said, ' Well I'm a girl with the penis'.

CLEVELAND: It took them a while to catch on. They were aware of and open to the possibility of different gender identities, but still it didn’t occur to them that their child, who would later become Grace, was trans.

THORN: At no point did I think I had a trans kid. I think just nobody expects that to be their child because that's not the way our culture is.

CLEVELAND: As months passed, it began to become more clear.

THORN: She would ask me, 'you know Mommy can I grow my hair out long or you know I want barrets like that,” you know she would just she always wanted things that were pink or she just really liked to express herself in a way that in our culture, we would think of as being typically a girl style of expression.

THORN: By the time she was five, the conversation around gender increased a lot to the point where she basically just told me that she thinks she's a girl.

CLEVELAND: Around this time, Theresa and her husband began having more serious conversations about the potential of socially transitioning Grace from a boy to a girl. They found themselves wrestling with a lot of the same questions I’d been having. Firstly, could this be a phase?

Before exploring this, I want to take a moment to acknowledge that this is a loaded question. Parents have been known to ask this question when their kid comes out as gay, which shows not only a lack of support but of understanding of how sexual orientation works. While gender identity and sexual orientation are not the same thing, they both are important aspects of who a person is, and they both have been (and continue to be) stigmatized instead of celebrated as part of a diverse society. So because sexual orientation and gender identity are both important parts of who a person is, asking if it could be a phase, can be pretty insulting.

However, unlike with sexual orientation, affirming gender identity once a child reaches puberty involves making medical decisions that have lasting effects. So here, we’ll take a moment to understand how gender dysphoria works in kids, according to the available research.

According to the American Academy of Pediatrics, gender identity emerges between the age of 2 and 4. By the time a child is 5 years old, they’ll likely express a clear gender identity. At that age, a child may begin expressing gender dysphoria, a sense that their body and assigned gender doesn’t match how they feel inside.

There have been a few studies that have followed patients experiencing gender dysphoria from early childhood into adulthood to see what happened over time. The studies concluded that the majority of these kids didn’t mature into transgender adults.

Some people look at these studies as evidence that children simply can’t know their gender identity at such a young age. But there's a strong reason to believe that’s a misguided conclusion. Researchers from an organization called the TransYouth Project have pointed out that there are some problems with the way these studies were conducted. They say there’s evidence that most of the children in these studies weren’t actually trans to begin with and that people’s lack of understanding at the time of how gender works is likely to blame. In a 1995 study, they found that when children were asked in an intake questionaire whether they were a boy or a girl, 90 percent answered with their sex assigned at birth. Only 10 percent reported being a gender that didn’t match their sex assigned at birth. As the TransYouth project pointed out, there’s a difference between wishing you were a girl, and actually feeling that you’re a girl. It’s entirely possible that only a small fraction of kids from this study were trans to begin with. A 2008 study supports this conclusion. The stronger the dysphoria expressed at a young age, the more likely it was to persist into adolescence and adulthood.

Secondly, the studies only counted dysphoria as persisting into adulthood if patients went through with hormones and surgery once they became an adult. We now know you can be trans and still opt to forego hormones and surgery.

According to the TransYouth Project, it’s safest to say that it’s unknown at this time whether gender dysphoria in children can be a phase.

At around the age of 10, however, as kids get closer to hitting puberty, research shows very conclusively that gender dysphoria is extremely unlikely to be a phase. In fact, a 2010 study of 70 kids who were hitting puberty and were diagnosed with gender dysphoria and given puberty-suppressing hormones, all continued with actual sex reassignment, beginning with hormone therapy.

So what should parents do with this information?

The general consensus among medical professionals is that supporting your child in expressing the gender that feels most real and comfortable for them is hugely important to a child’s mental health and wellbeing.

Studies have found that children who experience rejection or disapproval from people close to them are at higher risk of a battery of other negative life outcomes, from self harm to suicide. In light of these studies, it becomes more evident why even asking if a child’s gender dysphoria is a phase can be dangerous.

This is especially true when you consider the relatively low risk of affirming young children’s gender identity. You’d be supporting the child in changing pronouns, hairstyles, clothes, and a first name in everyday life.

An increasing number of hospitals and clinics nationwide are using the gender affirmative model to treat children and adolescents with gender dysphoria. The model centers around a few tenets, including the idea that gender variations are not disorders and that gender may be fluid and is not binary. The model holds that any pathology seen in the trans community is most often due to discrimination and is not inherant to this population.

WPATH, the medical protocol that’s basically the bible of transgender healthcare, says the most important thing is for parents to make their child feel safe in exploring their feelings about gender. If a child is experiencing gender dysphoria, the model calls to take measures to alleviate the dysphoria step by step until a comfortable expression has been found. If a child socially transitions, they also caution parents to make sure to let their child know it’s OK if their gender identity changes in the future too. For adolescents considering hormone therapy or surgery, WPATH calls for extensive psychological evaluation first.

Grace began her social transition at the age of 5.

THORN: Our fear was that, oh, if we allow her to be a girl, then we're encouraging her to be trans. What we came to understand just purely by educating ourselves was that kids’ families can't make them a gender other than what their gender is. Gender identity is very innate, and it's a part of who that person is, and parents can't make a kid trans, they can't make a kid be another gender than the gender that they are, we can only just accept them and support them.

CLEVELAND: Theresa pointed out that as awareness and acceptance of gender diversity increases, socially transitioning a young child shouldn’t be a binding decision.

THORN: Grace says she is a girl, so from my perspective, she is a girl. But if she were to ever say, you know I'm actually non-binary or I'm actually you know I mean there's so many different ways she may choose to describe herself and her life growing up. That is okay too, and that doesn't make now any less real. She is who she is now, and that’s beautiful.

CLEVELAND: It’s been 2.5 years now that their daughter Grace has been living as a girl. They said they knew they were on the right track when they saw her distress dissolve away.

THORN: She loved it, she was so happy. It was like turning on the light, you know, it was just easy. She never wanted to get dressed in the morning. And she never said I hate this stuff because it’s boy stuff. She said that later once she had a whole closet full of girl stuff too. She just hated getting dressed in the morning it was just a pain in the butt to get her dressed every day it was really hard. Once she had clothes that she liked and felt good in she got herself dressed, we didn't have to help her get dressed, we didn't have to encourage her to get dressed, she just dressed, she was ready.

There was one particular night that stands out in my mind where we were going to a friend’s wedding reception. And my daughter wanted to wear a dress like me to the wedding reception, but the only dresses that we had in her closet were like play dresses. We would have been fine with her wearing a dress to that, but we didn't have the right thing and so we had to explain to her like look this is not appropriate this like My Little Pony dress that you have that you love is like it's kind of trash for one thing and secondly, it's not appropriate. So she had to wear like a dressy boy's shirt and pants and she was really upset and there was like a tantrum, and we finally like got her on board for going by, I let her pick out a necklace of mine that she got to wear and we put a bow in her hair we'd like tucked her bangs—she had a very traditional boys haircut at the time—we tucked her bangs back into barrette and she wore that for the wedding and she was happy. I remember so clearly, my husband was like, “Oh you look so cool,” and she was like, “I don’t want to look cool, I want to look pretty.”

When we can express who we are, things tend to go easily. But when we're kind of like forced to express something that is not true for ourselves, things come to a screeching halt.

CLEVELAND: Theresa learned so much through Grace’s transition about how important it is to allow children to explore their gender identity. She decided to write a children’s book called It Feels Good to Be Yourself designed for kids age 4 through 8. While other books focused on one kid who was different, she instead created a narrative following a variety of kids who express their gender in different ways.

THORN: One thing I heard a lot was I just think they're too young to know right now. I think it just genuinely comes from a place of not understanding that gender identity is different from sexual orientation. We because as a culture we're still learning a lot of people still connect in their mind gender with sexuality and so it freaks people out when they think about little kids having having an open mind about their gender and their gender identity because somehow in their minds, it's wrapped up in sexuality when in reality we know that it's not but just a lot of people aren't there yet so thinking about a young kid who has a sense of their own gender that is different from what the world thought it was is very confusing to people at first.

CLEVELAND: So far, Theresa said Grace is living a happy and fulfilled life as a girl. Her friends and parents have embraced her new identity and she seems more at ease with her new identity.

While Grace discovered her gender identity at 5, and Finn at 13, transgender activist Tamlin Day, who is also my coworker and friend, didn’t come out as transgender until his 30s. Tamlin grew up in the eighties in a conservative Christian family in a small town in New York.

TAMLIN DAY: I knew what I was supposed to do. I was supposed to wear dresses and play with dolls and go to book clubs with other girls and sit in the girls' Sunday school classroom, things like that.

CLEVELAND: He said he never heard of transgender let alone meet an openly transgender person until he was well into his 20s. Like Finn, Tamlin made several suicide attempts as a teenager.

DAY: I think a lot of the stories that people like from transgender people are the ones where either you always knew or you have this sudden epiphany. And for me, it just didn't work that way. I always knew that I didn't fit in, and sure everybody feels that way to a certain extent, and I always felt like there was something wrong with me. And that is what it came down to. I didn’t know how I was doomed, I just knew that I was. I just knew that there was something wrong with me, but I didn't have the language to tell anyone what was wrong. Like I didn't even have a way to conceptualize for myself what was wrong. So I was left me feeling very broken and like I was a different species from other people.

CLEVELAND: Talking to Tamlin, I realized that perhaps I’d set up a false dichotomy when I’d been asking if gender was innate or a social construct. Perhaps it was a complicated web of both.

DAY: Everybody has some block of traits of who they are naturally, who they would be regardless of interference and who in spite of that interference still hold on to those traits. Maybe you were stubborn or you really liked the color blue. And then maybe later you met other people who also really liked the color blue. And that sort of confirmed for you that it was okay to like the color blue. Those social interactions are a form of confirmation of identity. And if you don't have those social interactions, you can't confirm an identity that you haven't been able to form, because you haven't been around other people who served as role models.

CLEVELAND: While gender may be innate, I was beginning to appreciate the importance of seeing positive examples represented in society.

DAY: Our gender identity is there and how we express our gender forms out of how we're socialized. I think one of the reasons I didn't realize I was transgender it was because I'd never met a nonbinary person. I knew men and I knew women and to my knowledge didn't know anybody who is non-binary, who knows, maybe I did and they were just like me, confused and lost and terrified.

CLEVELAND: Because Tamlin had more of a gradual awakening to his gender identity instead of a sudden realization like Finn, he tried one small change at a time, as recommended by WPATH, the medical protocol recommended for people experiencing gender dysphoria, recommends. He cut his hair short, and that felt good. He wore loose-fitting clothing, that felt good too.

DAY: It's hard to describe, I think, to somebody who hasn't had the experience of Dysphoria, what euphoria is like in terms of gender. Um, other than that, it was the opposite of how I'd always felt.

CLEVELAND: The idea was to continue taking steps until you settle into an identity that feels right for you.

DAY: I am certain now, um, that I'm transmasculine, but non-binary, my pronouns are, he has him, I take hormones, I would like to get top surgery at some point. Um, and that feels right, but I also am not a man. It's the identity that lets me be in Tamblyn without having to conform to someone’s expectations.

CLEVELAND: A common misconception that Tamlin said trans people get all the time is that they’re obsessed with gender.

DAY: Gender identity is really important to cisgender people. if you don't conform to somebodies expectation of what you're, of what they expected, um, there's a really strong reaction. . . People will do this thing well. They'll look at my boobs and my beard and my boobs and my beard and my boobs and my beard. And it's like those little bird toys that if you put the water on the nose, they Bob up and down. I've gotten everything from um, somebody coming up and asking me straight up what my genitals look like, how, yeah. To, uh, a hotel clerk who didn't want to give me the room that I had rented because I didn't look like exactly like I looked in the, um, I didn't look the way I sounded on the phone to him. We have a narrative about each other, really kind of constantly going. And that narrative is based on our own projection of what gender is supposed to look like or how men behave, how men look, how women behave, how women look. So I've found that everybody is really attached to gender identity, but transgender people are in general more willing to admit that we're attached because we have to in order to assert ourselves.

CLEVELAND: We’ve just explored some of the questions Finn’s story raised so far about the nature of gender. Now’ we’ll return to his story as he begins his life as Finn. Coming out as transgender was a positive turning point for Finn’s mental health. Heidi said she was struck by how natural the transition was for him.

WINN: When we would go to a restaurant or even grocery shopping, and I would say I go to the bathroom. Finn would get up and go to the men's room without a thought and I guess he didn't realize it like of course he would go in the men's room, there wasn't a hesitancy. He was clear that's where he belonged.

CLEVELAND: After the past months filled with suicide attempts, Heidi’s confidence was too shaken to have Finn come home quite yet. She’d locked up all the pills in her house, scissors, and anything else she could think of, but by now she didn’t want to take any chances. She had him transferred to Tanager Place, a long term psychiatric facility for adolescents. He spent a few months there stabilizing. While he wasn’t suicidal anymore, he was still struggling with other mental health issues, like fear of rape or of burning down someone’s house. Heidi was touched by Finn’s classmate’s response to finding out he was transgender.

WINN: All of the kids were crying because they love Finn, Finn has been their beloved and hasn't been at school. They've missed Finn and they've been through the fear of all the suicide attempts So, the response was, I just get chills when I'm telling this. The response was overwhelmingly open-hearted love.

CLEVELAND: By October, Finn said he wanted to come home and back to school with his friends. He joined 8th grade right after Halloween.

Maharishi School is a small private school, so Heidi wanted to make sure they were set up to support Finn.

The school made a big effort to be supportive of Finn’s transition. Research has shown that acceptance and support from family and community has a large effect on the wellbeing of transgender people. A survey of 6,400 transgender or gender nonconforming respondents by the American Foundation for Suicide Prevention and the Williams Institute at UCLA School of Law found that the risk of attempting suicide was especially severe if they’d suffered discrimination, such as not being accepted by family or school, physical or sexual violence, or being turned away by a doctor. Heidi was aware of the importance of Finn being in a supportive environment and said she was happy with the school’s response.

WINN: The school called in a national gender specialist to come in and talk to the staff and faculty to educate them on the necessity of being sensitive to pronouns, educating on the difference between sexual identity and gender identity. This school was ready for zero tolerance of any bullying or any harassment of gender identity and they were ready to embrace Finn with open arms and with any accommodation needed. . . He thrived that year. He had a couple of blips you know he slipped back into cutting a couple of times. We thought that this plant was really taking root in the earth.

CLEVELAND: Finn’s eighth-grade year culminated in him getting the Alex Grace Award. He even got up and gave a speech about it.

WINN: He was really proud of it, really proud of it and then school ended.

CLEVELAND: That’s when things got difficult again.

WINN: He didn't have the structure and not being a boy his whole life he didn't have the kind of old friendships with the boys in his class he had known, he knew them as a girl but he had known them as a girl and now he's a boy and the way the boys hang out is a little different than girls and when you get to be 13 for 14 it's a little different there his girlfriends that he hung out his whole life here in Fairfield were just you know they were just shifting a little, they weren't hanging out in the same way.

remember he laid across the couch here on my lap and he just in June he said, 'I'm so lonesome', and I you know that's part of being a kid is part of growing up that emptiness, that lonesome, that lostness and I just support him in that but I mean now I wish that I would've stopped everything I was really busy with work, I wish I was stopped everything and on a road trip. I wish I would have found him a camp for transgender and I don't know found some way to pay for it. I just wish that I could have done differently.

CLEVELAND: On June 19th a few days later, there was more bad news. Right around when Finn turned 14, Heidi had gotten him in to see a pediatric endocrinologist who treated transgender teens. The doctor had put Finn on a puberty blocker, which he took as a monthly shot. The plan was to buy some time until Finn was old enough to begin taking testosterone.

Throughout this process, Heidi had begun doing a lot of research online in order to educate herself so she could better support Finn. She joined a Facebook group for parents of trans kids and started learning about things like binders, which allowed trans boys to safely conceal their breasts, and she learned about how to go about hormone therapies.

WINN: My early on conversations with my friends, and I said this to Finn, I said I'm not doing anything till he's eighteen until I began to get more informed until I saw the severity of body dysphoria. If you're born into a body that has parts that don't fit with your identity if you're you have a vagina and breasts and you feel you your truth is that you're a boy then when you're in the locker room you're not going you know. You're all around it's in your face all the time when you get your period, I mean Finn would go to school and have his period. Fortunately, he had beloved classmates girl classmates who would you know help him dispose of his pad. It can be very upsetting to have the constant reminder that something's off about you that you're born wrong is how it feels to them. So I didn't realize until I did how delaying to eighteen was really unkind.

CLEVELAND: This brings us back to one of the questions from the beginning of the episode: When is the right time to consider putting kids on hormones? While timing can be different for every kid, getting on puberty blockers and beginning hormone therapy can help transgender youth more easily pass as the gender they identify with.

Finn was a couple of years away from considering going on testosterone, but puberty blockers could help him delay from developing a more feminine body. The only problem was that the puberty blocker was expensive. Heidi had just started working full time, and so she no longer qualified for Medicaid.

Under her insurance plan, she was going to have to pay out of pocket $1600 month. They scraped up the money to pay for the first shot and began applying for the medication’s patient assistance program and state aid program called Hawkeye.

That day on June 19th, Heidi came home to a second denial for the Medicaid assistance program. She was going to have to tell Finn they couldn’t afford it.

WINN: We had dinner, Jean made him, he wanted maple beans or something I don't know. And I told him about it and we had discussion after dinner and I said you know we're probably going to have to go to something else besides the puberty blocker, like some kind of a birth control shot that stops your period, but you know, we can't continue, we can't afford this. He said, ‘But this is for my happiness! Can’t you do a GoFundMe?’ And I said, ‘No, we've already done it when you were going through a lot, we’ve done a GoFundMe, Imean you could do one but I can't, and I don't know how my peers who might be contributing feel about hormone therapy replacement therapy in a teenager, I mean they’re open to you, but I don’t know. He was working at Everybody's, the local organic grocery store, and I said, ‘you know, you have customers you could put out something, that you know you could do a fundraiser for yourself,’ and he was just, he was angry . . . I said, ‘I'm sorry, we’ll call the doctor we'll find out what we can do.’ And he got mad and he went up to his room. And that's the last time I saw him.

CLEVELAND: Heidi was taking Jon to the airport early the next morning. He was going to France to visit their daughter who was studying abroad.

WINN: My phone rings, and I pick it up and it's my coworker, I had taken the day off he said, 'Heidi I have a police officer in the medical examiner here and they want to talk to you.’ So the medical examiner gets the on the phone and he says, 'When are you going to be back', and I will not till midnight tonight and he's like oh this is awkward and I said, 'Why? What happened?’ He said, '’I’d really rather tell you when you get back', and I said, 'No you have to tell me is Finn alive? And he said, 'No.' And I said, 'Where did you find him', and he said, 'by the railroad tracks.,

So we start the drive back, and the first thing I do is go straight up to his room I want to see if he left a note. And I open the door and it's dark as he kept it dark and the air conditioners going. I see a sleeping kid for a second it was like, ‘Oh they have the wrong person. It's not, my Finn right here.’ I go up there and I put my hand on the shoulder and turn him and he had put a basketball inside a hoodie sweatshirt and put clothing blankets to make it looked like a body.

So, he didn't leave a note, his phone was plugged in and charged in the charger, his computer was open. Oddly, oddly the page that it was open to was an Ellen De Generes Interview with amazing kids have been bullied and by his bed was an article written by one of his classmates on the effects of bullying. Now I don’t know, in my experience Finn wasn't bullied. that has not been the thing we've led with was that he was bullied, but it's one thing that he must have felt that on some level.

CLEVELAND: It’s now been more than two years since Finn died. Heidi said the grief she’s felt has actually been more intense in the second year in many ways.

WINN: I’m still learning to walk this earth without Finn.

CLEVELAND: After Finn died, she commemorated him as well as a child she lost in childbirth before she ever had Finn or his older sister Beatrice.

WINN: We planted a tree with Finn's ashes we also put my baby Maddy's ashes in there too and you know Finn's friend friends came around the tree on his birthday last week and put flowers and one of the mothers took pictures it's very with Finn's friend's cat hung around with them. It's very special to me.

CLEVELAND: Heidi is still trying to understand why Finn chose to end his life. She said she’s not convinced his suicide was solely about being transgender but knows it was part of it.

WINN: I think it's complicated. I think Finn had big feelings, and I don't think he was bullied because of being transgender, because in the whole year he was there Being transgender in this world at this time is not an easy thing, and with the technical difficulties for instance with the medication and the money and the peer relationships it was really challenging for him, really challenging. Now I wish that I would have called the doctor first she probably would have put him straight on testosterone. She would probably say, ‘Get him in, we'll start him on T.’ When I called the doctor and told her she burst into tears, she said, ‘Oh I wish we would have done things, we had other options.’

CLEVELAND: Tamlin didn’t know Finn personally, but had seen him at a couple of LGBTQ meetings that Tamlin had helped organized. He’d heard about Finn’s award and the acceptance speech he’d given.

DAY: It was a really positive speech, but I knew from my own experiences of being a college student who is an activist, that it's incredibly lonely.

CLEVELAND: A few days later, Tamlin got a text from one of his friends who is also transgender. The text said:

DAY: ‘We lost somebody in the community.’ I don't know why I immediately thought, Oh, God, Finn like I, I couldn't tell you exactly why that happened. It hit me pretty hard because I was that kid, like pretty much every transgender person I know was that kid. And so it's easy to look at that and think, that could've been me. Yeah. Very easily, several times. And so that sort of brings the gravity home, I think of what a big deal. That experience sort of propelled me to do more activism. Just to reach out to that portion of the community to kind of reach and also sort of reach back to myself as a kid and just give myself the things that I didn't have that I would've wanted.

CLEVELAND: Looking at Finn’s life, it’s clear he had a lot going for him. He was a bright student, and he had a lot of people who loved him. But unfortunately, coming out as transgender doesn’t necessarily lower your risk of suicide. In some ways, you’re more vulnerable once you’re out, living openly as different in a world that caters to two genders. Theresa said she never used to think about it much, but now she notices the limiting ways we talk about gender everywhere she turns.

THORN: It just drives me crazy when I hear teachers at my kids' school saying like, ‘Okay boys and girls,’ or ‘Let's count how many boys are in this group? And how many girls,’ because it can just be so incredibly limiting and as a result, some kids are hurt by that. For a kid who's non-binary and they're being forced to choose you're either a boy or a girl that's very stressful and secondly, if you are, if you're a child who is you know assigned male at birth and you're feeling like you might actually be female and you're being continually labeled a boy or told to line up at boys or told to only use the boys' bathroom or whatever, that is also very stressful and nobody is doing it to stress anyone out it's just the way things are.

CLEVELAND: Theresa said in her book, she wanted the main takeaway to be that we celebrate the diversity of ways that people naturally express their gender. When Theresa took Grace shopping for girls clothes for the first time, she said there was nothing like watching her daughter have this experience. Up until then, Grace had fought getting dressed in the morning. She couldn’t explain to her parents at the time why she didn’t want to put on boy’s clothes. This was completely different.

THORN: All of my emotions are in my throat right now. It was really, I don't even know what the words are I was scared and I felt like crying the whole time we were in the store not out of any sort of like mourning but just, just the realness of her like kind of just seeing really just seeing her and giving her the chance to be her I mean I don't know I don't have better words for it. I will never forget that day.

CLEVELAND: I’m Donna Cleveland, and you’ve been listening to Thread the Needle, a monthly podcast that explores the meeting place between feminist ideals and the realities of women’s lives.

This show was edited by me, with production help from Cody Olivas and scoring by Meara Oberdieck. The episode artwork is by Chosie Titus. Thank you to Molly Bloom for being my advisor.Before I go, I have a big favor to ask of you. If you enjoy the show please subscribe through the Apple Podcasts app and leave a review. That will help other people who might enjoy the show find it as well.

If you have a story you’d like to see featured in a future episode, please email me at podcast@theneedle.co. The next episode of Thread the Needle will be available Wednesday, December 4.