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Throughout history and across many cultures, children and adolescents have, through their gender expression and gender identity, transcended cultural expectations about the meaning of being a girl or a boy.1,4 In some times and places, as these children and youths grew into adulthood, they became respected and even revered members of their societies. In others, including the current culture in many parts of the United States, they have been seen as legitimate targets of discrimination and persecution. Issues related to gender expression and gender identity are highly controversial, and the understanding of them is evolving based on...

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