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Published: 00:00 BST, 23 July 2013 | Updated: 10:59 BST, 10 January 2014
Teenagers Arin Andrews and Katie Hill look like any normal young couple posing in their swimwear.
It is hard to believe that just two years ago Arin was a girl called Emerald, and Katie was a boy called Luke.
Arin, 17, and Katie, 19, from Tulsa, Oklahoma, have both undergone surgeries to change their gender and now are enjoying being in their bodies they always wished for.
Young and in love: Transgender teens Arin Andrews, 17, seen posing for a picture with sweetheart Katie Hill, 19, at the Oologah Lake in Tulsa, Oklahoma
Living life to the fullest: The teenage couple have been bullied and lost friends but have been able to support each other through their gender treatment
Just over a year ago Katie, a university student, had gender reassignment surgery, thanks to an amazing $35,000 donation from an anonymous donor who read her story in a local newspaper.
Now, Arin, who is still at school, has undergone an operation to remove both of his breasts, and is proudly showing off his new male physique.
For the last year, Arin has been binding up his chest to try to hide his female body, but can now go topless for the first time after his surgery in Cleveland, Ohio, in June.
He said: 'Now I can wear a tank top, which I couldn't before, I can go swimming shirtless, I can walk outside, I can just be a regular guy now.
'I hated my breasts, I always felt like they didn't belong - now I can finally be comfortable in my own body.'
He added: 'Now when I'm out in a public pool, or lifting weights, no-one raises an eyebrow, they just think I'm a guy - just a skinny dude in the gym trying to build some muscle.
Enjoying life: The teenagers say that they are now both comfortable in their own bodies
Defining themselves: Last year Katie had a $35,000 sex change surgery to turn her into a woman - and now Arin has followed his dream to have a flat, male chest following an operation
'My family have really surprised me with how supportive they have been throughout the surgery. I'm so lucky to have them and Katie to rely on.'
Katie and Arin met nearly two years ago at a support group for transgender teenagers and bonded through their shared experiences.
Katie said: 'To me, Arin's just my Arin, he's always looked manly to me. But now he's had the surgery he's much more confident and comfortable with himself.'
But now that the teens' physical appearance matches their gender, both of them are excited to be able to go swimming, boating and sunbathe like other couples.
Katie added: 'Being transgender myself, I understand Arin probably better than anybody else, how good he feels and how complete he feels.'
True love: The couple have been able to rely on each other through their transformation
Happy and healthy: Arin and Katie pose in their swimwear at the lake and later looking casual at home
Light at the end of the tunnel: The couple were both bullied and lost friends who could not cope with their changes
In the future, Arin might consider having genital surgery, but this can be complicated, and for now he's delighted with his new body.
Both the couple's families are supportive of their relationship and say the way the way the teenagers have supported each other has helped in their transition.
Arin's mum Denise Andrews said: 'Seeing Katie go through her surgery was helpful to Arin.
'It was being around it and seeing her getting to transform. And being a couple at the time was I think just the cherry on the cake.
Changed lives: Emerald Andrews, before she became Arin, at the age of five in Tulsa, Oklahoma (left) and Luke Hill (right), before he became Katie, aged seven
'Every transgender person would love to have the transformation physically because it just completes them as a person.'
The last two years have been very difficult for the teenagers.
Katie was bullied at school, and Arin had to change to a different high school when he revealed he was transgender, and has lost friends in the process.
'I lost one of my best friends through the transition,' said Arin. 'We used to go on vacations together and were like sisters.
Making a splash: The couple met at a group that supports transgender teens
'But I got the chance to open her eyes and show her I'm still a good person. I'm still the person I was, I just look different.
'She was gone for a while but then she came back.
'It taught me that the people who really love you need some time, but they'll always come back around.'
Happy: Arin had an operation to remove his breasts and is proud of his new physique
After he began dressing as a boy, Arin also lost a new male friend who learned about his past as a girl.
'He said: ''I pictured you as a girl, and I can't do it anymore,''' said Arin, adding: 'You can't just force people to be your friends.'
Katie started her degree course at an Oklahoma university last autumn but has struggled to make new friends because of prejudices against transgender people in the traditional Southern State.
She said: 'I had quite a lot of friends in college that were really close to me and then all of a sudden they just stopped talking to me.
'I think what happened is they found out I was trans through a story or word of mouth and they decided that was too much for them.'
The last two years have also been difficult for the teenager's families as they've come to terms with losing their son and daughter, and also some of their own friends.
Arin's mum Denise said: 'There are still a group of people we don't interact with any more. I know that they questioned me as a parent, they're not comfortable with it.'
But she added: 'A lot of people worry about losing the gender of their child. But as you look through albums and realise your babies are growing up, we also watched them grow up and turn into somebody different.
'Whether they stay the same gender or not, they become independent.'
Now their outward transformation is complete, the teenagers hope people will accept them as their new genders, and their difficulties will become a thing of the past.
Young romance: The couple have been together for two years
Carefree teens: Katie and Arin have both had the loving support of their families while they made the life-altering decision
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Published by Associated Newspapers Ltd
Part of the Daily Mail, The Mail on Sunday & Metro Media Group

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Published August 28, 1999 4:00PM (EDT)

Related Topics ------------------------------------------
Love And Sex
Sex
Teenagers

I na's story may be unusual but it's no longer guaranteed to shock. During an isolated childhood in rural Oklahoma, Ina knew she was a girl from
her early years, even though her body seemed to be a boy's. "It was always
clear to me that this boy identity and body were incorrect." She
remembers a childhood spent "tending to my inner awareness of myself and avoiding other
people a lot of the time."
Then puberty hit: "That was the hardest. My own body was staging a mutiny,
even." At 16, after an eating disorder had brought her to several
psychiatrists, Ina finally confessed her secret. The doctor
gave her a book about gay and lesbian youth, which Ina found devastating.
Having finally worked up the courage to talk about it, she was still
misunderstood. She soon found another doctor who explained the
particulars of "transitioning" from one sex to the other. But he wouldn't help
her. Eighteen is the accepted age for beginning to transition, and
she was just shy of 17. Synthetic hormones, the first step to altering the
course of sexual development, became her holy grail. "I knew I couldn't be
happy letting my body masculinize on and on. And so at 17 I graduated from
high school and found hormones on the street."
Things turned out OK for Ina: She's now 24, post-op and a graduate student
in American studies living in a small Oklahoma city. But the years she
endured living as a burgeoning adult in the wrong body still seem like an
unnecessary burden added to an already painful existence.
If Ina were 17 today and near a big city, she'd probably be able to find a
doctor willing to make her an exception to the 18-year-old threshold for
hormones. The treatment protocol of the Harry Benjamin International Gender
Dysphoria Association, the standard-bearing organization for transgender
medicine, allows exceptions in cases of "clear maturity." At the very
least, Ina would be prescribed hormone blockers, which would stop the path of testosterone without giving the feminizing effects of estrogen. This way, in case she changed her mind, permanent alterations wouldn't have taken place. (Estrogen produces breast and hip development, while testosterone brings facial and chest hair and increased muscle mass.)
No one compiles official statistics on transgender youth, but those who work with
them agree that their numbers are rising. In the last year, for example,
the number of transgender people under 22 in the "gender reassignment"
program at New York's Michael Callen-Audre Lorde Community Health Center has tripled. Partly this is the result of increased access to information. A
kid today with "gender dysphoria," the catch-all term for disconnect
between body and gender identity, will likely know about transsexualism
from puberty or younger. Eighteen-year-old Christian, a college freshman in
western Pennsylvania who was born female but is just starting to live as a male, is a
typical example. At 16, after learning from the Jerry Springer show that there was a
name for the way he felt, he "went online and looked up anything and
everything about transsexuals." To his astonishment he found chat rooms
filled with "people just like me." Recently he met his first fellow
transsexual in person -- a 21-year-old he'd met in a chat room, who lives two
hours away and has introduced him to a group of trans guys who meet
regularly.
As more young transsexuals push to begin transitioning at a younger age,
the social workers and medical providers who work with them are confronting
a new frontier in gender ethics. What's the best way to help kids who say
they want to switch sexes? Should we make them wait as long as possible, to
be sure their decisions are not simply adolescent rebellion? Or take them at
their word and let them begin hormones during puberty? "Every day, I feel
torn between wanting to empower my patients and wanting to be sure not to
harm them," says Jayne Jordan, a physician assistant in the Callen-Lorde
Center's transgender medicine program.
Ina and Christian are part of a new generation of transsexuals who are
taking their fate into their own hands and changing the face of gender shifting.
Transgender pioneers like Renee Richards, whose sex change in 1975 made headlines around the world, had navigated the mental health system for years before
transitioning. While those agonizing years (or decades) were full of suffering, they also guaranteed that the decision to transition was not a whim or an act of passing rebellion.
But adolescents are, well, adolescent. Adults often have difficulty interpreting
their behavior. A teenage would-be transsexual's anguish and determination
may look like standard-issue rebellion in an extreme version. Now that
tattooing and piercing have lost their shock value, couldn't transsexualism
turn out to be the ultimate way to etch defiance onto one's body? There's
the nightmarish prospect of a teenager going through with a sex change and
deciding later that it was a mistake. Jayne Jordan knows of one such case
-- a biological male who identified as female and had taken estrogen from
age 16. He had breast implants and was surgically castrated, then decided
he wanted to go back to being male. He had the implants removed -- but since
he has no testicles, he'll be taking testosterone for the rest of his life.
So at what age should children wield the power to change their sex? It's
one thing to experiment with homosexuality; people can always change their minds later
on. But by law a minor cannot undergo any voluntary medical procedure
without parental consent, except STD-related care, contraception and (in
some states) abortion. There are ways around this; an emancipated
minor, or someone who claimed she would be abused if she confronted her
parents, can make medical decisions independently. Should there be laws
preventing all minors from putting themselves through sex reassignment? Should more be done to stop transgender kids from getting hormones illegally?
Ina acknowledges the potential for mixed-up teenagers to do themselves
harm, but she maintains that for the most part, slowing the transition
process for minors serves mainly to make the adults involved more
comfortable. It is true, after all, that sex-changing hormones have a
mood-stabilizing, antidepressant effect on transgender people, who have
astronomic suicide rates. Given such high stakes, Ina assails the belief
that "there's nothing you can do but endure puberty until you're all grown,
and if you don't kill yourself by then, knock wood, many opportunities will
magically become available and you'll have a lovely life."
The very turbulence of adolescence should make transitioning a more natural
concept, she says. The "normal" life passages from boy to man, girl to
woman, she argues, "are also gender transitions, and just as disruptive and
traumatic as the transgender experience." Why let puberty run its course
knowing that it will require several expensive surgeries, not to mention
electrolysis, to undo it?
Ironically, Ina's position faces some unlikely opposition. Gay and lesbian
advocates, who have been at the forefront of the transgender rights movement, often find it troubling to think that people may choose
transsexualism as an alternative to being gay. As a lesbian, Jayne Jordan says, "it crosses my mind a lot that some of my patients may choose sex changes out of internalized homophobia."
Some gay advocates argue that in a society in which gender roles were not
policed with such vehemence, transgender teens would not feel the need
to transition at all. These activists seem hopeful that sex changes will
become a relic of a less enlightened era, that transgender people -- and
everyone else -- will be able to live in the bodies assigned them by nature
and inhabit whatever gender feels right at any given moment. Some
transgender youth do say they're comfortable in an ambiguous, sliding place
in the gender spectrum. Twenty-one-year-old Angelica, for example, only does
hormones. "I don't fully identify as female, but rather a feminine
androgynous male -- no surgery for me."
Perhaps even more troubling than these ideological
issues is the fact that many of the teenagers who show up on the doorsteps of sex-change organizations are street kids. Lost, broke and helpless, they may be looking for a magical
escape from their loneliness and poverty as well as their gender
alienation. "Some young male-to-female patients actually believe they'll be
able to get pregnant," says Jordan. Often, she says, transgender street
kids come in thinking all their problems will go away and they'll be
accepted as women or men. She has to explain that they'll probably face
discrimination their whole lives.
But as compelling as it may be to think of eliminating the need for sex
reassignment, many transgender people just want to get safely to the other side of the gender dichotomy. As Ina puts it, "at a certain point I just wanted to take off my costume and go home." Far from making a political statement or changing the world, she simply yearned to feel
comfort and pleasure in her body. "I thought I would never have that," Ina
says. "Many times I still don't. But there are certain things about the
physical body that are rewarding, and I can say, OK, yes, this was worth
the pain I had to go through to get here."
The more I talk to transsexuals about what adolescence was like for them,
the more my own transformation from scraggly tomboy to woman comes back to
me. But as I watched my body turn into something
new and strange, I found social roles and cultural images that I could use
to create a future version of myself. What would it feel like to grow up
without those images? Or with images that seemed everyday to become more
distant as your body develops? As Ina and I talked over the course of several
weeks,
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