Our appointment was at 11.00am this morning. We arrived about ten minutes early and were shown into a waiting room. Jenny had helped her sister to achieve a more demure, younger look, wearing the pink skirt and white top that she’d bought when they went shopping with the twins in Crawley yesterday.

‘Are you feeling alright Josie?’ I asked.

‘I’m a little nervous and I’ll be relieved when it is all over, but I’m glad we’re here.’

‘Me too’ I said and squeezed her hand.

A nurse came out of the consulting room

‘Mr McLeod will see you now.’

We went in and were both invited to take a seat.

‘Ah yes, Mrs Stevenson you asked for an appointment concerning your .. er… son’.

There was just the slightest hesitation as the doctor turned to look at Josie, but then he smiled and turned to me once again.

‘So what can I do for you?’

‘This is my son Joseph, but as you can see she has expressed a wish to live and be treated as a girl.’

The doctor turned towards Josie.

‘How would you like me to address you?’

‘I would prefer to be known as Josephine or Josie please,’ she replied.

‘I presume that is fine with you, Mrs Stevenson.’

I nodded.

‘In that case I’ll refer to you as Josephine during our discussions, although I’ll have to note your original name and birth gender in my records.’

Josie nodded.

‘So, Josephine, how long have you felt this wish to live as a young woman?’ he asked.

‘I’ve been feeling unhappy and depressed for many months but it’s only about five weeks ago that I started to live as Josie. That seems to have lifted a black cloud from over me,’ she answered.

‘You are fifteen, what are your plans for the future?’ he asked.

‘I have no job ambitions, but the prospect of having to live as a boy really makes me feel ill. I want to stay as Josie if I can and live as a girl’.

‘Why don’t you like being a boy?’ he asked.

‘I don’t fit in with other boys at school and I’m not interested in the things that they are. On the other hand, I’ve had a wonderful time as Josie over the last five weeks.’

‘What sorts of things have you been doing as Josephine that you couldn’t do as Joseph?’

‘I entered a costume convention and won the first prize. I’ve also been learning all about clothes, hair styles and makeup, and meeting lots of my sister’s friends’.

‘So do you not like the company of boys?’ he asked.

‘I don’t mind them as individuals and it can be quite fun chatting to them, as long as they think I’m a girl, but I’ve never really got on well with groups of lads. Most of the time I prefer to be in the company of girls.’

‘Have you ever kissed a boy or touched one in an intimate way?’

Josie’s cheeks coloured and she looked at the floor.

‘I did once, but on reflection I realise it was wrong of me to let him do so. I only did it because I was annoyed with my sister.’

Mr McLeod wrote something down on a pad before continuing.

‘Five weeks living as a girl isn’t a very long time to make a decision that will probably affect the rest of your life, what if you were to change your mind once the novelty has worn off?’ he asked.

Josie looked a little disheartened.

‘I don’t think it will wear off, I’ve never felt so secure or content as I do now,’ she answered.

‘What does your father think about your living as Josie?’

‘He doesn’t know. He left home before I was born and I’ve never met him.’

‘Do you have any brothers or sisters?’

‘I have an older sister.’

‘How does she feel about Josephine?’

‘At first it was a little awkward for her but she has come to terms with it and now I think she prefers having me as Josie rather than Joe.’

I nodded by way of confirmation.

‘How will your friends react to your being a girl?’

‘Joe never really had many friends of his own, and it is only since I’ve been Josie that I have started to make some girl friends’.

‘What do they think?’

‘Everyone seems to accept me as a girl and I’ve received many offers to help me with my grooming.’

‘Well you certainly look the part,’ commented Dr McLeod. ‘I don’t think anyone meeting you for the first time would doubt that you were a genetic girl.’

‘Thank you; that’s what I’ve found so far.’

‘What about your schooling, would you be able to face going back to your school dressed as a girl?’

‘I’ve arranged that Josie will start a new school in September,’ I said.

‘I see,’ he replied, and made more notes.

‘I will now need to examine Josephine physically,’ he said to me, and turning to Josie: ‘Please would you follow the nurse next door and get undressed for me. I will be through to see you in a minute, and in the meanwhile there are a number of questions which I should like to ask your mother’.

Half an hour later both the interview and the physical examination were over and the doctor called us both back into his consulting room.

‘Mrs Stevenson, your child appears to be a healthy male adolescent. As a boy, his stature is a little on the small side for his age, and he is also late in starting puberty compared with most others,’ he commented, ‘but I can find no obvious physical abnormalities. We will do some blood tests, just to check. The nurse has already taken some samples.’

‘But Josie says that she cannot continue to live as a boy,’ I said.

‘Yes, I note her determination to remain living as a young woman, which appears to be deep-rooted, but I’m also a little anxious that we only have five weeks of evidence of that determination and there may be a danger of a change of mind. In all other respects she strikes me as being both intelligent and well-balanced.’

Then turning to Josie, he said: ‘I understand from your mother that you have been getting on well at school.’

‘Yes’, she said.

‘I’m most impressed with the way you present yourself as a young woman and I don’t think there is a lot of danger of your attracting unwelcome attention in everyday life, particularly once you have gained a little more experience of living in the female role’.

‘Thank you,’ she replied.

‘The most pressing problem we have is that soon you will begin your puberty when your body will start undergoing a number of irreversible physical changes as you grow into a man rather than a boy. The shape of your body will change and you will probably grow taller. Your voice will become deeper and it will be necessary for you to begin shaving. In other words if we do nothing now it will soon become much more difficult for you to pass as a young woman’.

‘I know,’ replied Josie.

‘We were hoping you would be able to delay those changes in some way,’ I said.

‘You have brought Josephine to see me at the ideal time from a physical point of view, but I’m still very concerned about the comparatively short time that she has expressed this wish,’ he said.

Then turning to Josephine he said: ‘The best I can do for you at this stage is to prescribe you some anti-androgen pills that will postpone the onset of your puberty. You can start taking them straight away. They are quite safe and do not have adverse side effects. They will block the effects of the male testosterone hormone on your body. If you stop taking them then your normal puberty will begin soon afterwards. They will delay any permanent body changes and so buy us some time whilst we decide what to do.’

‘What other courses of action would there be for us to consider later on?’ I asked.

‘If you are both still happy with the situation, and I’m convinced that Josephine is determined to live as a woman, and could do so successfully, then I will consider prescribing a course of female hormones once she is sixteen. The effects of these would gradually give her a female body shape and skin texture and stimulate the growth of breasts. However these changes would be fairly permanent and there would be other side effects. The continued use of the drug would impair Josephine’s ability to have sexual relations as a man and would make her sterile. These would not be an issue if she decided to remain living as a woman permanently, but do need to be considered. If the hormones were effective and she was still progressing well in the female role, then it would be possible to consider referring her for sex re-assignment surgery once she was eighteen, but not before,’ he replied.

‘Does that mean that I can continue living as Josephine?’

‘Yes,’ replied Dr McLeod. ‘I’ve spoken to your mother and we both agree that there would be no point in taking these drugs if you did not do so. You will have to work out how you are going to effect the change in your everyday life, and how you are going to continue with your education. I should like to see you every three months in the meanwhile to find out how you are getting on’.

‘Alright then,’ I said.

Dr McLeod handed me a prescription and asked us to make a follow-up appointment with his receptionist. We thanked him and left. He smiled at Josie and wished her good luck in her new life. The nurse showed us out, and waited briefly whilst I arranged for our next appointment.

‘Josie, I think you will turn into a lovely young woman, I hope all goes well for you over the next few months and I look forward to seeing how you get on,’ said the nurse as we left.

We left the clinic and walked to a nearby café where we ordered some lunch and began to discuss the implications of what we’d just heard.

‘So where do we go from here, Josie?’ I asked.

‘Mum I so want to live as a girl full-time and can’t to go back to being a boy again.’

‘I’ve known that for some time, but it is still something of a shock to think that I will no longer have a son,’ I replied.

‘I know, but you will have a second daughter instead, and in due course I hope you’ll come to be proud of her.’

‘I’m already very proud of you and pleased that you now feel so much happier than before. However, the problem is how we are going to manage your transition in a way that causes the least problems for yourself and Jenny’.

We spent the remainder of our lunch compiling a list of details that would need to be taken care of if Josie was going to remain as a young woman.

‘Did you find out whether I can open a bank account in my new name?’ she asked.

‘I think it should be possible to open an ordinary children’s current account as long as I countersign the application. This would give you a cash card, but we may find it a little more complicated once you are sixteen’.

‘By then I hope to be on a course of female hormones and so that should convince everybody that I’m serious about changing my sex,’ she said.

‘So that is your ultimate goal?’ I asked.

‘Yes, I suppose so.’

I took a deep breath.

‘Alright then, let us go and find a pharmacy to collect the tablets on this prescription, and then maybe we can buy something nice for you and Jenny to celebrate.’

Half an hour later Josie took the first of the little white pills that would in future prevent her from ever turning into a young man.

‘I don’t think they’ll make you feel much different. They are just intended to keep things as they are.’

‘No Mum, you are wrong’, answered Josephine smiling, ‘I now feel quite different. I feel that I’ve passed the first milepost on what may be quite a long journey.’

I squeezed my younger daughter’s hand.

‘Josie, I’ll always be proud of you whatever should happen.’

‘Thanks Mum,’ she said giving me a hug.

That’s it I’m afraid! Many thanks to Bronwen for her help with editing, to Sephrena for fixing my posting errors and many comments, to SamanthaK for posting several chapters for me whilst I was away, and to everyone who has either commented publicly or else contacted me privately regarding the story.

Louise