After Jamie Harper's son began middle school in Loudoun County, Virginia, the teenager has only been known as a boy. His friends don't know that he was actually born a girl and his family has had to fight to keep it that way.
In the sixth grade, his birth name showed up on his computer during a keyboarding class. The school ultimately agreed to change his name in the system, but required his parents to obtain a court order to do so.
The teenager still is not allowed to change in the boy's locker room. He doesn't like using the staff bathroom as required by the school, so he resorts to waiting until he gets home.
"It's always like, what's coming next?" Ms Harper said. "Every day we're worrying about the safety of our kid, every single day."
Then over the weekend, Ms Harper saw the news that the Trump administration was considering changing the way it treats transgender people like her son under the law, seeking to deny claims that gender identity, rather than biological gender, can be used for protection under federal civil rights laws such as Title IX.
"It gives you this sinking feeling in your gut," Ms Harper said.
She and other parents of transgender children across the country described feelings of numbness and dread following the news of the proposed shift in policy from the Health and Human Services Department.
While it's unclear what the change would entail, or whether such regulations would even be adopted, parents quickly jumped to the defensive. Some began scrambling to finalise name and gender changes on their children's birth certificates and passports, seeking every possible safety net.
Ms Harper worried that her son's school might feel emboldened to tighten its restrictions on the teenager even more. What if his classmates were to find out his birth gender? What if, two years from now, he were forced to use his birth gender on his driver's license? She thought about the transgender children she knows who have been hospitalised for severe mental health problems. Would her son be next?
Transgender adolescents attempt suicide at a much higher rate than young people whose identity matches the gender on their birth certificates, according to a study in the September issue of Pediatrics, from the American Academy of Pediatrics. Transgender male teens are especially vulnerable - 55 percent reported at least one suicide attempt, compared to 30 percent of transgender female youth and 42 percent of young people who are non-binary, identifying as neither male or female.
Calls to crisis hotline Trans Lifeline more than doubled in the 24 hours following the news. Trans Lifeline's executive director, Sam Ames, said it was "particularly sickening" that the potential impact of the Trump administration guidance "falls especially heavily on our youth, who are often isolated and deprived of the autonomy that some of the older members of our community have."
The mother of a transgender teenager in New Hampshire said her daughter had already endured too much to suffer such a setback.
"I am overwhelmingly concerned that if somehow all of this goes away, and Skylar is forced to have male documents, and lose her legal identity as female, my child will die," said Jennifer Elizabeth, who asked only to be identified by her first and middle name out of safety concerns. "She already deals with so much, and this would be too much."
Cori Lathan's 12-year-old daughter already suffers from anxiety attacks. Earlier this week, Ms Lathan went to pick her up early from her public middle school in Silver Spring, Maryland, because she was stricken again.
While driving in the car later that day, Ms Lathan asked her if she was aware of what had happened in the news. Her daughter said she had seen references to the #Won'tBeErased campaign on Instagram. Ms Lathan told her she was thinking about changing her name and gender on her birth certificate, to "make sure that we have everything backed up."
Her daughter said she wasn't too worried about it, "because I'm still going to be who I am," Ms Lathan recalled. "She's more concerned about making it through middle school," as a transgender girl, Lathan added.
But the mother worried about her daughter's social anxiety, and began wondering if she should, for example, consider homeschooling. "It's such a punch to the gut," Lathan said. "I knew there was a long way to go but . . . it's just horrifying to think that we have to go backwards."
Amy Bonnett, a 51-year-old mother of a 16-year-old transgender boy in Scottsdale, Arizona, worried that changes in the federal protections could prevent her son from getting medical care or insurance, or could embolden a future employer to decide not to hire him, especially in a more conservative state like Arizona. "My worry would be that this is just the start of it," she said.
Heidi Miracle, a 49-year-old biostatistician in a suburb of Atlanta, has doubled down researching states with better anti-discrimination policies around jobs, health insurance, housing and bathroom use. Her transgender teenage daughter is currently applying for college and Ms Miracle feels that staying in Georgia would be too much of a risk for her, especially if the Trump administration follows through with this shift in policy.
"I do fear choosing someplace and finding these new rules filtering down to colleges and then finding out there's no place safe for her to go," she said.
The unknowns around the Trump administration proposal have left parents like Sarah Watson, a Bethesda, Maryland mother of a non-binary teenager, wondering what might come next.
"We've been very purposeful and worked really hard daily to affirm our child, to make sure our child is happy and safe and alive," Watson said. "But no matter how hard we work, I feel there's more being undone at a higher level that we can't control, and we cant protect them."
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