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Brooks bristled at being called a lady—evidence that her own search for a safe space is complicated not only by her autism but also by her rejection of the gender binary altogether. By seventh grade he told his friends; by eighth grade he told his parents. And to truly create an inclusive, competent health care experience for transgender patients, all health care workers—not just doctors—need basic education and training, says Elizabeth Samuels, lead author of the emergency room study and a postdoc with the Yale National Clinician Scholars Program. Ham said the growing acceptance of gender fluidity is a symptom of a culture that has taken the Bible out of public schools and promoted the theory of evolution, and also the result of the church being lax in teaching the truth of creation. Jackson, who calls her home-schooled daughter "smart, fearless and a natural entertainer," was hit by the enormity of the magazine cover photo and how confident and secure Avery seemed.

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Photographer Robin Hammond with Avery Jackson after the photo shoot.

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When we met in May in New York City at an end-of-the-year show for her high school speech team, E was wearing a tailored Brooks Brothers suit and a bow tie from her vast collection. Gender expression is typically categorized as masculine, feminine, or androgynous. Share This Story!

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E might be seen by others as male, Jane wrote, now that her hair was so short and her clothing so androgynous.

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