binary this or that idea. but for some, as a journey. it's tonight's "inside story". welcome to "inside story". i'm ray suarez. the idea that a person's gerpd is fixed ot birth -- gender is fixed at birth defined on the birth certificate is undergoing investigation. for some there's a life-time struggle between what your body says you are, and who you are. the whole idea of gender doesn't fit the true sense of themselves, but nature has, from the day of birth, made things ambivalent. for a long time intersex infants, where genders ambiguous at birth were given a gender by parents, told to choose male or female. al jazeera's ashar quraishi profiled an adult who felt the approach could force parents to make the wrong choice. >> reporter: today this person does not identify as he or she, preferring to be called they. >> i thought i was a girl. people called me she, i was jen fer. that's my name. >> reporter: until the age of 18 she identified as time ail. living as a girl believing she was one. but she never had ovaries, and, in fact, genetically has xy chromosomes, typical in boys. it's known as intersex. >> it is an individual born with not just uniform male or female parts, but can have combinations of both. doctors and parents decide what sex a child could be and the genitalia could be modified. >> i wish with all my being and heart that they would have left me like how i was born. >> reporter: choosing surgery at an early stage is controversial. activists and bioethicists say they should be consulted once old enough to choose for themselves. >> we are bad at predicting how the patient will identify sexually, will they identify in a male role or a female role, and that kind of choice, it seems, we have learnt is best left up to the patient him or herself. >> reporter: it's one reason a programme at a hospital in chicago began what it says was a wholistic approach to dsd treatment. the gender and sex development programme includes consultation with neuroologieses, surgeons and psychologists. >> the decision that is appropriate is the one they feel comfortable with. >> in a perfect world we wouldn't do surgery unless there was a medical reason it had to be done. >> it's a debate raising questions about consent. gender identity and patient rites and ashar quraishi joins us now from chicago. have things changed uniformly in terms of the way intersex infants are treated. we saw a forward-looking programme in chicago, is that widely held best practice? >> well activists say that's the best practice. there should be a waiting period. parents thu not drive the treatment, surgery, until a child is old enough as to whether or not they want the surgery. malta became the first country in the world banning surgery on intersex surgery until they make it for themselves. again, a lot of people talk about the research when it comes to how we look at intersex individuals, how you treat them and a wholistic approach is what is used in chicago. they have psychologists who work with endo-cronnologists and surgeons to discuss with parents before going ahead and performing irreversible surgeries. >> does a newborn baby belong to its parents, is it the parents' call whether to go with the new way of looking at intercept birth, rather than intervening with surgery? >> well that's the big question. where do the patients rights start. that is something that activists on the intercept side say needs to happen at an early stage. these discussions are physician based in terms of the direction. physicians say this is what needs to be happening, what needs to happen and this is how to proceed forward. when parents listen to a doctor they say a doctor must know best. pigeon said that the parents in that case decided early on, because they said that's what the physicians said they should do. again, sociologists psych olss are saying it is -- psychologists say it's something that doesn't need to be determined. one activist said it's about buying a computer when your child goes to college, doesn't mean you can buy it now, you can wait and decide later. that's one of the fundamental questions, though is that this idea that parents want to know "do i have a boy? do i have a girl?" and determining that with a doctor, without the interaction of a child is something activists say choount happen until later when they understand what is happening, and they can make decisions about the surgeries. >> we heard an expression of regret that surgery had been done at the time that pigeon was born. what is - what does he want to do now? live the rest of his life as a male, down a chromosomal level that you might determine that he is, or as young people are deciding be gender ambivalent. pushing through the barriers and not defining him as anything in particular? >> yes, in this case pij job, as you mentioned. regretted the decision that happened early on and prefers to be called they not he or she. chromosomally pigeon is a male. surgeries performed early in their life made it an impossibility, and for the rest of pigeon's life, hormones have to be taken. they remove the testes early on and also performed further surgeries later on, and those things have long-lasting impacts on pigeon's life. so pigeon is still in a very sort of difficult situation when it comes to how pigeon wants to identify. definitely doesn't identify as a gir, but not quite as a boy either. that is something that pigeon says to us they would have liked to have been able to decide for themselves but they are made early on without pigeon's consent. >> thank you for joining us. thank you. >> along with an evolving approach to intersex children america is under going a gradual reconsideration when children declare themselves to be a different gender from their legal identity. it challenges families medical profession teachers and schools. gender and journey is tonight's "inside story". welcome back to "inside story". in recent weeks americans watched bruce jenner's public transition. the former olympic champion on the cover of the new "vanity fair," with a new hairdo face and identity - kaitlin. if over 50 you may remember renae richards born richard raskin fighting the u.s. tennis association to play as a woman, and over 60. jor gen sen was the first american known as to overcoming gender reassignment surgery. >> our notions are so rigid for so long that legal systems, schools, and the medical profession have not always known how to handle someone straining against the boundaries of one gender or another. it's changing. the founder of a service organization serving l.g.b.t., and molly hatcher is the director of youth services. when did you start to think that may be who you were outwardly, legally was not who you were up here? >> for me, the thought started coming about the age of 16. i wasn't fully able to express myself due to living in my father's house, and my father was typically not a very caring man but certain issues in his household - you couldn't be gay or show a sign of femininity because that was a weakness, so i wasn't allowed to become who i wanted to be. after being thrown out of my home. i was able to start to become the woman that i'm supposed to be that by the grace of god me being alive because i did have to do things to take care of myself. and i am where i am now. >> were there steps were there sort of threshold moments where you didn't just think well maybe i'm not like other men. but maybe i'm not man at all? >> i remember i was different by society's standards of a regular homosexual male. the fact that - i felt i was one of the girls, i wanted to do what a lot of females did, and i come to realise i don't feel right. there was things like i never wanted to play football. i danced. a lot of people said it was a stereotype for a homosexual person. it's not necessarily true. >> do you know people were you cut off from family ties people not willing to accept who you had come to realise what you were. >> i currently do not speak to 75% of my family. >> is that a common story? >> unfortunately, it is. it is something - i consider that kids are supposed to be loved, embraced and we are supposed to do that but it's not what happens when they are young and different. >> are you seeing changes, more families reacting with concern instead of scorn, wanting to understand this, instead of saying it's something we have to fix or beat out of you? >> unfortunately, because society defines men and women as one or the other, i see the conversation, but i don't see a change that are making the lives of the youth better than when i transitioned. it is concerning to me because many kids appear on my doorstep because parent drop them off, their legal system refers them to me, or someone else in the street tell them that someone will love them, and that is me. it is concerning to me because it's a growing number or places are full and these are families that rejected their kids throwing them away because of who they wanted to be or appeared to be different. >> is there a class that may be we are uncomfortable talking about. on the cover of this month's "vanity fair," there is kaitlin jenner who is a millionaire. one of the kapows, and i brothers who made the matrix movies, and became wealthy doing that, became a woman. there's stories of this happening. these are people who can still have a place in society even if they publicly make this change but a kid in the bathroom may not have the privilege. >> correct. and i don't see that distinction in terms of where they come from but the examples were adults that transitioned and had a level of comfort in their life. most of the kids that i see, they are young, they are people who have not had the opportunity to make it in life. yet, they decide that... >> they don't have the access to the medical treatment, and that part of it the psychological counselling, hormone therapy. >> i had a young girl two months ago, from bethesda maryland. you would think parents educated median income was high, they would understand their kids because, you know they have access to knowledge, right. that is not the case. unfortunately there are kids coming to our organization in the wealthy suburbs where parents do not want to deal with the issue. rather to them, they'd rather throw them away than give their children an opportunity to grow and become someone. to me, they are my treasure. >> how old are you? >> i'm 21, 22 this year. >> okay, 21. your whole future is ahead of you, quite a long time to be around in our society, and make a life for yourself, what stands in the way of you being the person you want to be and living the life you live? well there are a few obstacles when there is oppression obstacles standing in the way of the community, there's this - i can't - i think where you have to go and see a therapist for a year be homeless for a year before you engage. to me, why should i as a transgender woman be pretty much thrown through hoops to achieve the body that i should have been born in versus a person going to a doctor saying "i want my boobs done", or "this taken away". >> a quick answer is because it's irreversible they want to be sure it's something you want to do. >> that's understandable. but if a person says this is how i want to live my life, this is how i present, it's something that wouldn't want to be reversed. generally when you make that decision, it's something that is pretty much finite. >> molly, ruby thank you for being with us. one of the battlefields where the difficulties growing up transgender is playing out - the public school system. teachers and administrators who refuse to use a new name modify records and not to mention the rough and tumble world of classmates that may not be accepting of change of gender as journey is tonight's inside story. tonight on al jazeera america, we are focussing on gender as journey if you are a gender non-conforming young person what is waiting for you out there on the bus to school in the classroom at the family dinner table. the chief strategy and research office for the gay lesbian and straight education network joins me. young people have a presumed different set of legal rights. it must be more challenging for someone trying to live in another gender. >> i think i - they can face many challenges at school. lesbian, gay bisexual students in u.s. schools experience difficulty with their peers victimisation, and teachers not necessarily being supportive. and it is even more so for transgender and non-conforming students in schools. about almost three quarters of transgender students in our research. we have been doing research. it's been around for 25 years, and they've been really examining the experiences of l.g.b.t., and transgender students. three-quarters do not feel safe in the school they feel unsafe because of gender expression. and that is - that's very high. they are experiencing high levels of harassment. name calling and victimisation in school. >> there are things that schools can do to make it a better positive climate. whether or not you have your own parent or parents in your corner makes a difference if you go up against the school and ask them to be treated as someone in another gender from one you entered the school as using the schools and so on. if your parents are on the verge of throwing them out of house, it's one road. if they have your back it's probably another. >> yes, having parent support can make a strong difference to have the allies supporting them. i think students often - when you think about it adolescence are exploring identities. this is a level of identity exploration, that schools have been dealing with for a long time. in many different ways. for schools to accommodate a nickname versus a gender or their new name and gender identity, it is pretty common behaviour that teachers and school leaders have been doing in other circumstances. i think it's about becoming comfortable and seeing it as an experience of something going on in schools, and something that happens with adolescents. is it a tougher batting, where simply resistance from school authorities to making any change at all? >> in our national school climate, we do a bi-annual survey and we find l.b.g.t. students and transstudents are experiencing discrimination and are not treated in the same way, they are subjected to discipline and targeted for the school not accommodating them around their gender presentation. when you think about dress codes, dress codes are gendered and sometimes students are more disciplined. a transgender is more disciplined following the schools, where is a non-transgender girl would not. it's important to provide schools with the resources, the professional development. the policies and everything. they have model policies on how to address gender non-conforming and transgender students in school that can make a difference in affirming their experience. i believe that there are areas in the country, that fewer school support for students. they are less likely to have alliance, and clubs supporting l.g.b.t. students teachers and policies. in rural school district southern regions, areas were understand resources i think it's important in particular to pay attention to education at resources for those - for those. it's something that happens all across the country is the law playing catch up in this area if someone is fully undergoing transition friendships, at the end pointed are states will to rejustify people, and do school systems have to recognise that? >> well schools do have to recognise the legal gender of a student. so it is an issue. their preferred gender is not necessarily their legal gender a school may say the legal gender needs to be on the test form, or on the school records. that doesn't prevent them from being able to call them by a preferred name in class, or student i.d. which is not an official document that reflects the student's chosen name. there is recently from the department of education, u.s. department of education, guidance that came out at the end of last year talking about how title 9 which addresses gender discrimination, and how that should and needs to be addressed when it came to transgender students. i think schools are learning to pay attention to it joseph is chief strategy officer. i'll be back in a moment with final thoughts on sexual minorities, nature and the difficulty of being different. want to comment on something you saw or heard on "inside story". follow me and share your thoughts on our facebook page. we'll be right back. >> what was is like to do selma? >> selma was a blessing? >> acclaimed actor wendell pierce talks big screen politics and taking a stand >> do you think it cost you the oscar? >> ahh...yeah... >> do you regret it? >> absoloutely not... >> and his home town ten years after katrina... >> what's the biggest problem right now. >> crime...jobs, stop bullets... >> every tuesday night. go one on one with america's movers and shakers. gripping. inspiring. entertaining. only on al jazeera america >> on al jazeera america >> technology...it's a vital part of who we are... >>they had some dynamic fire behavior... >> and what we do... don't try this at home! >> tech know where technology meets humanity... only on al jazeera america i saw an old friend for the first time in a long time and asked her offhandedly how her 28-year-old son was doing. still living with his girlfriend but now he was no longer known by the name i called him since he was a teenager. now he was amy. i asked in no purposeful order whether my friend was okay and the newly realized amy was okay. both were she said. i mean i cried, i worried about him, my friend said. what worried me most of all was the idea he would have been unhappy all this time until he decided to make the change. that was the breakthrough moment looking back on it. of course, my friend was worried about her child, the complex challenges that might be ahead. but in a moment of clarity and decency, worried that her child, runs her son now her daughter had been happy all her life, until now. that is love. the kind of love any skilled would want from any parent. i hope i'my realises how lucky she is. i'm ray suarez. thanks for joining us for "inside story". pass rescuers search for survivors of a ferry accident in southern china. hello, welcome. you're watching al jazeera. i'm darren jordon in doha. also coming up the prime minister set to lay out a plan to defeat i.s.i.l. at a meeting in paris. new evidence of russia's military presence on a boarder where russia denies it will help receptionists of the and paris