Psychiatrist Scott Leibowitz is a renowned leader in the field of treating transgender youth

It looks like any waiting room: minimal art on the walls, children’s toys and playthings scattered about, plastic chairs, the ubiquitous TV. But what goes on beyond the reception area for Nationwide Children’s Hospital’s THRIVE program is anything but generic. The acronym stands for Team-driven Healthcare that Respects Individuals and Values Emotions, and it stands at the forefront of medical research in the burgeoning field of treating transgender youth.

Equally ordinary is the office of psychiatrist Scott Leibowitz, THRIVE’s medical director of behavioral health and gender and sex development. Decorated with an abundance of books, papers, chairs and an oversized desk, the setting conceals the man’s growing national reputation. The only hint that his patients and their families are dealing with the physical and emotional challenges of gender dysphoria—the conflict between one’s gender identity and one’s biological sex—is a drawing on the filing cabinet. A disembodied arm and hand point accusingly at a frowning child in a pink box labeled with the female symbol. The word “STAY!” is circled in a black cartoon bubble.

“So many kids who come here look at that picture and say, ‘Oh my gosh, that is me,’” Leibowitz says.

The number of youth who are questioning their gender is growing. According to UCLA’s Williams Institute, which specializes in research on lesbian, gay, bisexual and transgender issues, one in 137 American teenagers identifies as transgender, if asked. Since 2000, transgender-affirming surgeries have increased fourfold, sparked in part by the Affordable Care Act, which banned discrimination on the basis of gender identity, paving the way for coverage by insurance companies. And in recent years, youth gender clinics in the U.S. such as THRIVE have grown from just a handful to about 40, although exact figures vary.

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