ADAM WAS TORN between male and female. He was born a perfectly healthy boy and grew up in a middle-class family in a small city in central California. His father was a contractor and his mother a nurse; Adam described her as an “angel.” He excelled in academics and was a star runner in high school and college—tall, lean, and blond. He was gregarious and funny, so he was equally popular with boys and girls. He dated and had sex with girls in high school and college.
But Adam had a secret side. In adolescence he had discovered internet porn. (What kid hasn’t in the past two decades?) But he had rapidly gravitated to porn with “she-males” (biological males who have breasts and a penis, and present themselves socially as female). At first it was a kinky supplement to dating and sex with women, but it grew into a more confusing and time-consuming obsession. Initially, he just fantasized that he played the female role in these porn scenes, but after a few years he started cross-dressing to get turned on. After college (and thanks to phone apps), he started hooking up with men while cross-dressed to engage in anal sex as a bottom. All the while he was still dating women. Leading a double life—plagued by guilt—was painful enough, but he also found himself squandering vast amounts of time masturbating to on-line porn or driving around trying to hook up with men. He would leave his job early or not show up at all, until he was fired. Utterly distraught and financially crippled, he attempted suicide. He was unsuccessful and promptly returned home for several months to recover. His parents were stunned and confused when he revealed his gender conundrum, but they were generally supportive—even about his decision to return to Los Angeles.