i think that it is time to consider the parents of these struggling children, perhaps a munchausen syndrome situation. this is not normal behavior. if you are born a boy, you belong in the men's room, born a girl, in the women's. all the nip and tuck in the world will not change your dna. that being said, studies have shown even in the most liberal and accepting settings, these folks have high suicide rates. (now, there are folks out there that will say this is not civil, and that will be a lie)