16 Katelyn is a16-year-old girl who presents for therapy with her

mother and father. Katelyn was born with male genitalia but has felt like a female “all of her life.” She says she knew something was different as far back as she can remember. She always wanted to wear her mother’s clothes and makeup and play with other girls. Katelyn started dressing and openly identifying as a girl when she was 13 years old, and her parents are trying to be supportive but they are struggling. Most recently Katelyn has developed an intimate partner relationship with Jennifer, a 15-yearold girl who was gender-assigned female at birth and identifies as a female. Katelyn’s father does not understand the relationship. The PMHNP explains that Katelyn:
A. Is responding to the male hormonal surges of puberty and will ultimately identify with her physiologic gender
B. Does not have a clear sense of gender identity and may be a candidate for reparative therapy to correct her gender identity issues
C. Is a transgender female who identifies as lesbian
D. Is a heterosexual male with transvestic disorder