dr. margaret moon is a pediatrician and bioethics professor at johns hopkins university.drugs that delay puberty, blockers, may be helpful in some extreme cases. but that second step, giving opposite sex hormones, is alarming at josie's age. the changes are irreversible and include rend, the child sterile as an adult. >> any change you make that's irreversible is harder to justify when the child is young. >> reporter: even among the doctors who specialize in treating transgender kids, there is debate about when and whether opposite sex hormone therapy is okay. >> we have lots of very well-informed, very well-intentioned people looking at the same data and coming away with very different ideas. >> is this an overdiagnosis issue? >> potentially. it's potentially an overdiagnosis issue. >> reporter: for vanessa there was no debate. she felt certain that not only would female hormones help joe says, but forcing her to go through male puberty could be psychologically devastating. transgender young people are five times more likely than their peers to attempt suicide. >> whenev