>> from our studios in new york city, this is "charlie rose." charlie: tonight, we continue our look at gender identity and the biology of the brain area and gender identity is a person's subjective experience of gender. it may or may not mash the one ascribes them at birth. it is estimated that about 700,000 transgender people live in the united states. one of them jointly today to share his experience.

he is a professor of neurobiology at stanford. also here, a remarkable group of scientists. i am pleased to have all of them here. and to begin this conversation with my colleague, what are we going to talk about? >> we're going to speak about gender identity and the biology of the brain area and this is a marvelous topic and i like it in particular because it shows how brain science can be liberating. as we understand the biology of our own gender identity better and become comfortable with ourselves, would become more empathic to some of the else's gender identity area and we can understand it all of a sudden at age 89 or 10, a person says i'm in the wrong body.

we really can sympathize with them and say what's going on? this is not only an interesting topic, it's an unbelievably tiny -- unbelievably timely topic. when you and i first began talking about the six months ago, it was not on the radar's green. we were ahead of our time. but now, you cannot take up an issue of the new york times identity fair without having a discussion of gender identity. charlie: 17 million people watched the diane sawyer interview. >> this is not only a deep discussion of size of -- psychological and sociological, but the underpinnings of that. when we began to talk about the biological underpinnings, we want to distinguish as you already implied two different concepts. anatomical sex, and gender identity. anatomical sex is the body parts

, gender identity is the more subtle and complex image of one's person -- of oneself as male-female or something else. anatomical sex is determined, not surprisingly five genes. we have 23 pairs of chromosomes. we get half from our father. we get one from our father and one from our mother. 22 of these are called otis owns. -- otosomes. the differences are real but modest. for the sex chromosomes, the difference is really quite profound area women are exact and men are ex-wife. the chromosomes are really quite different than the other zones. they have a really important function in determining sex. let's begin with the y chromosome and see how that determines the sex of the mail.

we are born with an undifferentiated gonad they can move in either direction. he can either develop into testes or ovaries. if there is a y chromosome there, it has a region and it which is called the sex determining region that contains a gene that activates the differentiation of the undifferentiated gonad into the testes. if that why jean is not there you haven't asked ask. you have a female gonads develop. each of those has profound consequences. look at the mail differentiation first. the testes develop within the first seven weeks in utero. and if it matures it releases a massive amount of testosterone. comparable to the level that you have a puberty in the adult. that is responsible for giving you the male body form, the brain care to restate of mail

functioning as well as having actions and sort of every aspect of human being. if this determining region is not there, you had develop into the ovary, and the 03 turn secrete estrogen and progesterone and gives you the female body form. it gives you changes in the brain. clearly, these are extremely important changes. that's the easy part. this is the anatomical part. the more subtle and elaborate part is the gender identity. that's why we brought together the spectacular group of people to talk about that. as you pointed out we have been. he is a long-term colleague and a major scientist in my field in brain science. he is chairman, as you pointed out at stanford. he's a member of the national academy of sciences. he's a transgender person.

he made a decision in the 40's to undergo bodily change. and he can tell us what it was like before when he felt he was in the wrong body and how he feels now area cannot only can tell how he feels, but interestingly enough since the fun of him as a scientist beforehand or would this change they could discover what it was like interacting with him as a woman, and now interacting with him as a man area he is one of the pioneers in the united states of pediatric endocrinology. he could help people make a decision as to whether or not they should go on with their idea that they are in the wrong body and actually -- actually seek a transformation. he's a pioneer postponing puberty so people can think through what they want to do. the reason he wants to delay puberty is that once it forms, it is a much more radical procedure than if the seat for puberty.

she is interested in how sex is represented in the brain. she has founded debt found amazingly that in the male mouse, there is representation of the female and in the female there is representation of the mail. this is not a completely novel idea freud, not working with mice but with people suggested we are all bisexual and we developed that way in one aspect of the sexuality matures but the other remains. we certainly feel indifferent about it in parenting that there are men, e-mail components and there are women with mail components even an adult life. we have with this melissa hines who is interested in how kids differ boys and girls and the games they play and how they interact with each other. she is interested in how hormonal levels affect child play and the games that can

involve. and we have janet highest. she is interested in seeing what the difference is in cognitive capabilities between men and women. in computer science, and mathematics, and engineering. her data pretty much suggests that there is very little difference between them, but as i've gotten to know genital little bit better, i think that is incorrect. the more i speak to her, she majored in mathematics, i've come to the conclusion that women are superior in mathematics and engineering. charlie: let me begin with them. tell me the experience you went through. share with us as much as you can about what led up to your decision and how you went forward with it and the impact it has had on your life. ben: i think in many ways, my

sprint is typical for other transgender people. i think i was only for five years old when i started to have strong feelings that i felt more like a boy. i was born as a girl, barbara. i felt like a boy. i played with little boys, i preferred boys toys. our member dreadfully wishing i could be in the cub scouts and boy scouts. every halloween i would just that as an army man or football player. this all seems very normal to me. they got into my early teen years, i started to feel more and more comfortable with this area i did not feel i should have breasts. i did not feel at all comfortable wearing dresses makeup, jewelry. it became increasingly uncomfortable when i got in the high school. i started to be teased more, i had a lot of confusion about my gender. i felt very ashamed of it. i never spoke with friends or family about it at all.

i felt very ashamed and very confused. this is the days before the internet, so there was not a lot of information about this sort of. as i got into my 20's, i was doing well. i was doing well in my career, i was doing medical training and research training. i was increasingly and comfortable, and like many trans people i started to think about suicide area i never actually considered, but i thought about it a lot. this is a picture of me back when i was barbara. i think i was 30 at that point area that i was a bridesmaid in my little sister's wedding. i can still remember vividly even though that was 30 years ago the agony that i felt the discomfort of putting on a dress. wearing jewelry, wearing makeup. i still remember that. i did complete my training and begin a job at stanford about 20 years ago and i was 40. about two years into that, i

developed breast cancer. i was still very confused about my gender identity, but i knew that he did not like to have breasts, so when the doctor said he needed to do a mastectomy i sit while you're there, please take off the other breast. he was quite horrified by this perhaps it was the first one i share my feelings about gender identity with. since his cancer runs in my family, he did agree to remove the other breast. i can't tell you how therapeutic that was. i felt so relieved to have those breasts removed. i recognized that that was a very different response to my mom had when she had her mastectomy. she said this was a huge blow to her femininity. after the surgery, the doctor started talking to me about reconstructing the breast, and i was absolutely horrified. there's no way of putting this insight on me. this increasingly was a clue to

me that there was something different about my gender. it was a year later i was reading the san francisco chronicle when i read it several page article about the life of james green, and openly female to male transgender person in the area area i realize for the first time in my life that there were other people who had experienced the same sorts of gender confusion. there were other people like me and that i might be transgender. i went to see a sex change pioneer in stanford who runs a gender clinic. indeed, after they evaluated me and they told me that they thought it was transgender and they offered me the possibility of changing micex. which was immediately a resistible to me. we, within weeks i decided to change next. i don't have the upper surgery the mastectomies. i did not want lower surgery, so all that was needed was to take some testosterone, and you can see the effects that it had only area it's powerful stuff. one of the most surprising things about the testosterone

was that's actually, to my great surprise he became much harder for me to cry. male to female's report that it now becomes much easier for them to cry. that was perhaps surprising. i think the main experience i had is that i felt after changed sex i can't -- it's hard to explain the intense belief -- relief that i felt. i've never had another suicidal thought. i have to say that at the time i decided to do this, as i did a scientist at stanford for several years, i was very worried the changing sex would alter my -- car my career. this was 20 years ago. i have to say that everybody, all of my colleagues and friends and family were immediately supportive. i been very fortunate to have my career continue and to have lots of wonderful students and so forth. i guess the other thing that i would like to say is i think the

other surprise after changing micex is that i found living as a man has dramatically change the way that people react to me. i can tell you story about an experience that happen to me shortly after i change sex a couple of years later, i was invited to give a seminar about my research at m.i.t.. one of my friends told me that after i gave a seminar, one of his colleagues was talking to them about the seminar. he said gee, that then his work is so much better than his sister barbara's. i think that that experience points out something that all of the trans-people whether we're female to male or male to female, we lived like a buzz -- as both genders and we all share an intense anger at the different ways that society treats men and women simply based on their gender. i think in general, we would all say that in general society --

with a man, assumes that their confidence in suburban otherwise. and with women that their considered incompetent in suburban otherwise. this creates barriers to women in science, so i noted with some of my time to try to help women in their careers. charlie: listening to that story, i assume this is typical in terms of both someone is questioning and to go from questioning to looking for solutions and the experience of the reaction after you have changed area and what does it say about gender identity? >> i wish we knew more. we certainly know it when we see it. i want to show you a very powerful example of identical twins who, in this case one of the male twins and we proven that these twins are indeed i -- absolutely identical. born male. one of them at age three started

to say everything about being a girl. in fact, if there was any issue that came up, she turned it into an issue of gender. she did some of those things that we consider hallmarks. like preferring to wear female underwear and female pajamas etc.. by the age of seven, the family decided with the help of a counselor to change her name to a female name and to have the child assume a female role. here are, is twin sister with twin brother. at the age of just about nine to 10 years of age. they were fourth grade.

what i want to point out is that if i switch all of the attachments to them, the hearing scum of the clothing, the hairstyle. issues you could basically switch one for the other. the fact of the matter is, kids with their close on our virtually interchangeable pre-puberty. and actually their hormonal levels are virtually -- at that particular point interchangeable. everything happens really at puberty. here they are at age 14. because it is so difficult to live in a gender different from your biologic sex when you have the toxic effects of your genetically hormone driven -- driven huberty which would basically make twin sister look exactly like an brother, and you can see. she looks almost like a nine or

10-year-old, and there's a good reason for it. she's had her puberty suppressed. the next slide shows the level of sex hormones across the human my span area look at the blue line which is the main level of testosterone. the hormone that ben was receiving. and that some of us make. but that during fetal life especially in the mid trimester the level of testosterone in the fetus rises to a level close to the full adult range. and then it falls, and then there's another blip up right after birth. a kind of second puberty. and then things go completely dormant. in fact, if they didn't go dormant we would have a whole bunch of pubertal looking fifth-graders running around. because everything is suppressed, when were thinking about possible causes, -- x

wouldn't it be possible that some aberration in testosterone secretion in your example during intrauterine development might be one of the contributed factors? >> it's certainly possible. it's a very dynamic stage. we still don't know what that second bump is right after birth. what role it plays, or whether boys who are born without testes that are otherwise normal show any differences. the problem -- the problem there is that when we want to look at a hormone, we have to be able to measure it. we have to get it out and measure it. can't get it out of the brain, the other problem is sometimes it is in the hormone level is important, but the affinity of the receptor. it's very difficult to measure such things.

>> this is really fascinating to see what the biological underpinning of transgender identity is. as you point out, it's so important because kids who are in the wrong act -- their incidence of suicide attempt is very serious. >> it's one of the highest risks of any. >> this is really something we need to understand. >> and in puberty, this whole system reawakens again. it certainly comes that. it causes the release of other hormones that strike the ovary or the testes area and cause the relief -- release of what we call steroids. those things produce the differences between the body of the male and female so, we have

been able to probably since the 1980's, we have been able to block the release of the hormone from the hypothalamus to the pituitary. once you do that so far upstream, everything downstream goes down to zero area we have a record of this medication being completely successful in shutting them down until the appropriate time. and also the fact that it's completely reversible. come revealing this is. the twin sister affirms a female identity, and a few pretty blocks for two years. two years to get more time for counseling without the pressure of body change. that's very important area of if are going to get her estrogen, that's going to have permanent effects. take a look at what would happen to her if she had not been given this blockade. she would look exactly like twin brother. he is in early puberty for 14-year-old. but so would she have been. because they are identical.

here are the twins at age 17. at age 14, just after that picture was taken. she began estrogen. while at the same time having her male hormones blocked. with that, our patients don't need breast surgery. when they feminize. because it is so effective. she is now in that picture injuring the junior high school as is her brother. she is absolutely fabulous. this past october, the dutch who taught us this reported that -- the first follow-up of the patients. 55 perfume -- of whom whose puberty was blocked. the dutch group all had surgery 18 at which point their gender dysphoria, their total uncomfortableness with their gender disappeared.

the dutch found that the kids treated this way has -- our psycho socially functioning as well or better than the control group of non-trans kids. the dutch gave me their protocol in 2006 and we started using it and boston children's hospital at which time we were the only major medical center to do so but were not that many years since 2006, and over 40 programs now do this. it's now becoming the standard of care.

charlie: let's talk about whether this is wired. >> is it just heard, humans have a very early and very strong sense of their gender identity area did this is really a critical component. and animals, as in humans, male and female display clear differences in behaviors. mostly, but not exclusively relating to sexual and social behavior. for example, males and females have very distinct sexual and aggressive displays, and we've

seen in the previous episode that mothers of females are usually maternal and in mammals are usually attacking the pots. how are these differences established? the main mechanism by which the brain controls gender behavior cannot be studied a very mentally and humans. instead, my lab uses the mouse as a model system. mice display clear differences -- gender specific behavior. the mechanism by which the brain controls gender specific behavior in the mouse can be studied using all of the modern tools of neuroscience. six typical behaviors including sexual, aggressive and parental behavior are extremely maintained across different animal species. that success -- that suggests that the brain controls -- the

brain control of those behaviors is very maintained across animals. in contrast, the signals the trigger these behaviors are usually extremely specific in a given species. for example, in one species of birds, there's only one sign that matters to trigger gender specific behavior and that is the black mustache on the face of the male. if you remove the black mustache from the face of the male the older males will attempt to copulate with that mail without a mustache because they will assume it's a female. similarly, if you paint a mustache on the face of a female, the older males will attack that female because they will assume it's a male. i will mustache in the mail. i don't have a mustache on a female. mice, in contrast use mainly old

factory qs. humans are particularly sensitive to visual and auditory cues. the fact that has been exploded very successfully by the pornography industry. once we know what the signals are the trigger specific behavior, we can look into the brain and how it's processing the signals and establishing these gender specific behaviors. as we have heard, in young males, they use varying -- there is a very important relief of testosterone. this release of testosterone has been shown to be absolutely essential to masculine eyes the brain. in contrast, females do not have that. in males, the simplest interpretation is that testosterone is essential to

establish and maintain a very specific set underlying male specific behaviors. females organize their brain in a different way and order -- in order to control female specific behavior. in our lab, we performed a number of genetic experiments that show the situation is a little bit more complex. the experiment we did is actually very simple. we looked at mutants for fairmont detection which is indicated by this little hard here. this animal is simply insensitive to sex specific pheromone all cues. when we look at their behavior we found something extremely surprising. here in gray is a female mutants. and in black is a male. as you can see, this female is mounting the mail which is a

very male specific behavior. these females -- is displaying a male typical behavior. if we now look at the mutant male, this mail instead of attacking her is now retrieving an infant and bringing it to the nest that this mail is built. here again, the mail is displaying a female specific parental behavior. out of this? what we learn is that the brain of both male and female contain the right present -- the representation of male and female behavior area in females in normal animals, the mail behaves -- behavior is repressed at the fair model system.

in males, similarly, the female specific behaviors are normally repressed. in the mutant that we observed what is happening is that the repression of the opposite brain and opposite sex, behaves separately. it no longer exists area did therefore, the female now is able to display both male specific behavior and female specific behavior. similarly, the mail is able to display both female and male is a big hit her. >> i think this is so beautiful. not only because this is something i've been struggling with but it really provides a way we can begin thinking and exploring transgender identity if in fact we have both kinds of behavior, you can see how slight tilt could contribute to wanting to be another gender. i think this is very profound. >> i think that exactly as eric

mentioned, what this shows is that the brain of male and female are largely similar and that a specific hormonal and genetic regulation leads to the predominant, but not exclusive display of the behavior of a given sex area and this is physiologically extremely important because animals occasionally need to display the behavior of the other sex. we've seen that males are occasionally able to display parental behavior. similarly, in many species, females are displaying mounting behavior as a sign of dominance. and so, the brain has actually been shown to be bisexual in rish, many years ago and reptiles. more recently now in mice. we think that this ability to have those representations of male and female could also be totally relevant to the problem of gender identity and humans.

charlie: let's talk more about defining gender identity and sexual orientation and gender role behavior area >> i study the role of testosterone in human gender development area we study genetic conditions that cause people to have either higher or lower levels of testosterone area evidence from those people suggests that testosterone in humans also influences gender development. including gender identity. and to start it's useful to put this in context. to expand our understanding of the dimensions of gender related behavior. we talked about anatomical sex and gender identity which is ours of the self is male and female or something else. but also, people have sexual orientation, and this is separate to gender identity. it refers to our erotic interest in males females both, or in some people neither.

and finally, there is a third class of behavior called gender role behavior and these are all the other characteristics that differ on the average for males and females. among these, some are bigger than others. some of the biggest ones are seen and child twin toy and activity preferences. the next activity shows the sex difference in height. we are all from you with this. males tend to be taller than females, but there is some overlap. the males are the blue distribution in the females are the orange. the people were the overlap is our people you would not either gender from knowing their height. the next images show that these gender differences in play play with toys like vehicles or boys toys like dolls or girls toys are similar in size to the sex difference in height. and finally, we see the gender

difference in identifying with the male gender. we can see that this gender differences even bigger. there is almost no overlap between males and females. but there are some people who are in the other distribution. these include the people who want to change their gender. how does this come to be? we talked about the sex differences in testosterone some of which occur very early in life. this corresponds to a. of very rapid brain development area so it provides an opportunity for hormones to program the brain in ways that might have enduring influences across the lifespan, including for instance gender identification. the next image shows data about women who had very high levels of testosterone before birth. about 2% of women who have very high levels of testosterone before birth in adulthood decide to live his men. you might say, that's not very many.

but it's hundreds of times more than would otherwise do so area this has increased many times over. the next image shows men. in this case, ask why individuals who are actually ask why females because their cells cannot respond to testosterone. to their testes, they're producing male typical levels of testosterone including prenatally because their cells can't respond, they look like girls at birth and their racist girls. in adulthood, almost a hundred percent of them 99.9% want to live as women. >> such profound findings because although we don't really know in the vast majority of cases what causes the desire, here we find one concrete biological explanation. it makes one realize this is not a social fact, it is really a biological factor on a and

probably with time we will be able to identify a significant number of other ones. i think having one paradigmatic example is very powerful. >> also, going back to the toys, when i began this work, people thought that these different interesting girls and boys were completely socially determined. it turns out, these are altered to buy prenatal testosterone. the next slide shows the toy choices of girls and boys in general versus those in girls exposed to testosterone. boys spend most of their time playing with toys like vehicles shown by the blue. girls spend most of their time playing with toys like dolls shown by the orange. girls exposed to testosterone prenatally are in between. they said about half their time playing with toys for boys only choose and about 30% of their time playing with the toys they girls only choose. these are different dimensions

of behavior. the influence of gender identity is less powerful, it appears on the influence of testosterone on child at play. that leaves a lot of unidentified factors, perhaps genetic factors are social factors that contribute to gender identity outcomes. finally, this is not just testosterone acting on the brain before birth. but also, children who have had thai levels of testosterone engage in different behaviors, this has the feedback effect on their brain development. this becomes an increasing mechanism where their behavior is increasingly masculinist as they go through life. charlie: thank you. let's talk about measuring cognitive performance and ability. >> in our culture, we have lots of stereotypes of gender differences and abilities. people believe that boys and men are better at math.

the girls are better verbal skills and the boys are veteran special performance. those are the stereotypes. what do the real data show? once again, we are at distribution for male and female performance. blue for male and orange for female. what you see is that the most recent data show that girls are tied with boys in mathematical performance. many people find this surprising, but i data from millions of people showing as. in regard to verbal performance, you can see that there is a female advantage, at its teeny tiny. you can hardly see it on the graph. is a very subtle slight differences. for special performance, the difference is a little larger.

instituting a special curricula might a lot to help. i also want to emphasize the importance of cultural context.

it turns out even in the 1890's, 11% of the phd's were going to women. you can see it enters up a little bit in the 1930's, and then the percentage plummets in the 1950's there is not some single biological force that causes women to be good. it has more to do with cultural context. in findings like these that led

me to propose what i call the principle of gender similarities. you saw it for math and verbal performance which are widely stereotyped to show gender differences area of course, this has implications for women and technology, engineering and math. this graph shows essentially what the gender similarities hypothesis is. again, we have overlapping distributions. you can see, there is a huge overlap where males and females are quite similar. let me turn now to looking at psychological disorders, because for some psychological disorders, we do get very lopsided gender ratios. on the left part of this graph

you can see disorders where more men than women are affected. those are alcoholism and autism. that's not to say that we don't have women alcoholics or girls with autism, but it is a preponderance of males. if we look at the right, we can see for depression and eating disorder anorexia we have a preponderance of women shown in the orange bar. we do have these lopsided gender ratios, we wonder why those are. i am most familiar, my research has been on gender differences in depression. we can see the gender difference in -- in depression is not present in childhood but it begins to emerge between 13 and 15 years of age. as you can see the orange bar is going up there. and then it widens between 15 and 18 years of age. gender differences in depression emerge in adolescence. it's a two to one ratio.

twice as many women to men depressed. if we're going to crack this question, we need to understand why the gender difference emerges. many factors are doubtless involved, it may have something to do with jeans. we have a few genes that have been identified that have to do with depression. it may have to do with pubertal hormones because of the difference emerges just as puberty is coming on. it may have to do with other factors such as the media's instant -- emphasis on high skinny models and girls as they go through puberty, their bottles -- bodies get further away, boys had the advantage because they are adding muscle and that's the way the models look. that may be a factor, we also know there is idea pure sexual harassment in schools. that also may contribute. >> ♪

we live in a pick and choose world. choose choose choose. but at bedtime? ...why settle for this? enter sleep number don't miss the final days of the lowest prices of the season. sleepiq technology tells you how well you slept and what adjustments you can make. you like the bed soft. he's more hardcore. so your sleep goes from good to great to wow! only at a sleep number store. don't miss the final days of the lowest prices of the season. save $300 to $700 on selected mattress sets. ends sunday! know better sleep with sleep number.

charlie: let's go back to this idea about how society is responding. we know from vanity fair and time magazine, transgender is right behind the pope. >> it's unfortunate that society

often considers transsexuality to be a mental illness or an immoral choice. and because of this transgender people are still often denied basic human rights. there often subject to violence, and in many states, transgender people can so be fired just for being transgender. as we've heard today on this program, the brain has been eighth circuit that determines our gender identity. being transgender is not a choice that i made. it's how i was born. i should mention, it's we have not really brought out yet that there is a broad spectrum of transgender people. some of them prefer just prefer not to change sex or even to be identified as male or female. but for some of us, there is a compelling in a need to change sex and, deny the possibility, 40% of us attempt suicide. that's why i think that by helping transgender teens to

avoid this agony, the dutch pioneers are such great heroes. charlie: what did your parents -- what should parents do? >> i think the first thing parents should do as with most things, is sit down and take a deep breath. and realize that the prepubertal child is in a state of exploration. it's no accident that both boys and girls go to the boy toys and the girl toys in kindergarten. this is not gender identity expression by and large. this is almost always a gender role play which is normal for children. of children who are fairly persistent in their cross gender play better prepubertal, only

about 20% will go on to be transgender. 80% are not going to be transgender. what i would say to parents is if your child is getting close to puberty or worse is already in and is showing this kind of behavior particularly underwear wearing and saying i'm the wrong gender and binding breast etc.. then you need to get help for that child fast. and that may be calling your pediatrician and asking for a gender specialist to meet with your child. a child who is according to the dutch and us and others, a child who holds on to the belief that they are in the wrong body at the onset of puberty feels like pinocchio becoming a donkey. they will take their life.

these are the kids who are the real deal. >> over the series, you and i have found a range of things that we've traced to the brain and understood. and some levels, in some cases will be understood about what was taking place within the brain was large and in some cases small. where do you put this? in terms of understanding what's going on? >> i think where the very early stages of understanding what's going on. i think the wonderful thing about this discussion is it without number one there really is a biology. it's a challenging problem and it's extremely fundamental area but our understanding is very very modest. we talked of this before. many times people about charlie and me how long before you think we'll have a really satisfactory understanding of the brain? our position has been a century. we made a lot of progress in the last three years in the brain

series alone, but we're a long way to really understanding the brain system. >> gender identity is so essential to we are and our ability to be happy area we have a duty to be able to provide some type of explanation. but there's something really important to is to understand that it is not all black and white. >> i think it's important to remember the differences are not disorders. i'm proud to be transgender. i think that the different -- brains drive innovation and different perspectives. i think the real question is why society persists in thinking that male brains are better brains. which as we've heard tonight is definitely not the case. >> i think one thing that would be interesting to see is as you function in a way to your comfortable with it's impossible on a single case into this, has it increase your creativity?

>> i think it released a lot of mental energy that was devoted to confusion and feeling suicidal, so i would say yes. i felt so much happier and more productive as a person. charlie: what percent of people also undergo anatomical change? >> we are now in a state of flux about operations, they cost $25,000 for a male to female genital plasty. the reason i say that is because insurance companies are waking up to the idea that this is a medical condition. that is entitled to be billable for surgical and medical aspects of their care can be covered by insurance. it's going to change everything. up until now, people had to save all of that up to have the surgery. it starts from the top down.

first you have to not make it a mental illness. you have to define it as a physical problem, which it is. but hiding it -- as being gay was prior to 1973, what freed up people starting to see gay people as not having a psychiatric illness it was having it removed from the diagnosis and statistical manual. that's happening now. we will just see. colleges are doing it, the self-insured, maybe even ecology went to is paying for peoples everything. i'm going over to some of them and seeing it done. charlie: thank each of you very much for coming. there is enormous interest as you can see in the publications that are devoting attention to it. i remember, when the subject was

introduced in terms of television program, one came up to me and identified themselves as transgender. and said, they said that to me the fact that it is getting so much attention made all the difference in their life. and so they felt not so isolated and not so different. they felt like they had been identified so that they can have an appreciation of where they stood and what their options were. what we do next time? >> we're going to continue to discuss child development. what are the consequences of growing up under very difficult circumstances, how does it affect cognitive development of children? and does this by phone from generation to generation? we will learn a lot more about child development next time. take you. thank all of you.

>> is behind some of the biggest successes and tech history. greylock opened its doors involved in 50 years ago but since landing in silicon valley in 1999, is backed it after hit. the venture capital firm has backed 170 now public -- now public companies. joining me today on this edition of studio 1.0, greylock partners. david, you've been at the firm