There is also a constant, low-level anxiety about the potential for a hate crime. Michelle picks up Hannah and her little brother Tristan, 10, from their schools now, rather than let them walk home.
But Hannah's return to the classroom, a big source of anxiety over the summer, has turned out remarkably well.
Staff from the superintendent on down have been supportive. The school system has changed all its documentation to read "S. Hannah Rini" — no confusion for substitute teachers and the like. And Hannah is allowed to use the nurse's restroom.
One friend, Kenny, has backed off a bit. He says he's uncomfortable with her transition. But that is the exception, thus far. Hannah says the girls in her class have been "awesome." The mother of one friend, a boy, gave Hannah a bracelet and painted her nails.
This level of support — from peers and family — is hardly a universal experience. Dr. Forcier has stories of parents in great distress — one suicidal, another who passed out discussing a child's gender identity.
The pediatrician tells the Brown students that she's just seen a kid, earlier in the day, who said "you're the first person who's actually made an effort." And the young people Dr. Forcier worries most about are those she doesn't see: the true castoffs, pushed out by family and church, selling sex, buying dangerous street hormones.
But the Rinis' experience suggests that a cultural revolution, of sorts, is sprouting up alongside the medical one. If we, as a society, still insist on a firm wall between male and female, we're beginning to poke some holes in it. We're beginning to make some accommodations.
And for kids like Hannah, those accommodations may be as important as any hormone injected into her body.
David Scharfenberg can be reached at firstname.lastname@example.org. Follow him on Twitter @d_scharfenberg.