Our culture, though, remains deeply uneasy about the blurring of male and female. Gender, here, is something like a foundational concept: so central to our sense of self and social order, that disrupting it disorients like little else.
It is Dr. Forcier's ease with the subject, then, her eager leap over the Barrier We Must Not Cross that is the most striking element of her professional persona.
The pediatrician, whose practice also touches on adolescent sexual health, birth control, abortion, and safe and pleasurable sex, says her attraction to "taboo subjects" is in part a reaction to her straitlaced childhood in Groton, Connecticut.
"I came from a family of very strong Catholics," she says. "We didn't talk about sexuality at all. This was not a comfortable topic."
Indeed, her medical career can be read as an attempt to surface a sexuality that, as she puts it, "people stigmatize and make dirty in this culture." Her rhetoric is frank, supportive — and occasionally ribald.
Speaking to those Brown University medical students a couple of weeks ago, she described the difference between gender identity and sexual orientation this way: "Gender is who I am, sex is who I want to fuck."
But if Forcier signals her own comfort with the subject — in age-appropriate ways — she also aims to get her patients talking. And her central tool, here, is the question — including this simple, profound query of many of her new, young patients: are you a boy, a girl, or in-between?
Some patients "look at you like you have three heads," she says, "and you're like, 'I ask everybody this question, because I make no assumptions about anyone. I make no assumptions about who you are. I ask, and that opens the door for you to talk more about where you're coming from. And isn't it really wonderful that in my clinic, and in this world, we have so many different kinds of people who are figuring out who they want to be and who they are?' "
It can sound, in isolation, like a parody of tolerant, multi-culti urbanity. But in context — a warm affirmation from an authority figure, an offer of help for a kid pushing up against our culture's last immovable object — it can be something far more powerful.
THE KID Hannah, a few months into her transition.
Sebastian Rini, 11, was riding with his grandparents to Edaville Railroad amusement park in South Carver, Massachusetts in December when he heard something on the radio about a sex change operation. He asked his grandparents to explain. And shortly thereafter, standing on the purple carpet in his Pawtucket living room, he announced to his family that he was ready for one.
His mother Michelle, an overnight counselor at a girls' group home, says she didn't take the proclamation seriously at first. Sebastian had always been a little sensitive, a little effeminate. His parents had wondered if he might be gay. But when she suggested that, Sebastian had "a very visceral reaction."
"No, I'm not," Sebastian insisted. He was a she.
Over the next few months, it kept coming up. Sebastian, the middle of three children, asked to be called Crystal, before settling on Hannah after the kids' television character Hannah Montana.