States drive a wave of bills affecting transgender youth Shutterstock At age 14, Indigo Giles realized they preferred to identify as nonbinary—neither female nor male—a realization that led to gender dysphoria, which is the psychological distress felt when someone’s gender identity does not match the sex assigned at birth. Giles obtained gender-affirming medical care in the form of a breast reduction at age 17 with the help of supportive parents. But before undergoing the surgery, Giles endured many psychiatric evaluations and bouts of depression. These experiences motivated Giles, who completed their freshman year at the University of Texas at Austin in the spring, to testify in April before the Texas legislature against two bills that would deny gender-affirming medical care to transgender minors.