Paige's Story

ALIX SPIEGEL, HOST:

From NPR News, this is INVISIBILIA. And today, we're going to start with a question that was recently asked of the customers of the Rize coffee shop in Midtown Manhattan. Lulu, what's the question?

LULU MILLER, HOST:

It's a very hard-hitting question.

SPIEGEL: It is.

MILLER: Do you like puppies or kittens?

UNIDENTIFIED MAN #1: Puppies are cute. Doesn't everybody like puppies?

UNIDENTIFIED MAN #2: Kittens. I like kittens. I think they're cuter.

UNIDENTIFIED WOMAN #1: Oh, for sure puppies.

UNIDENTIFIED MAN #3: Puppies. The dog is always happy to see you. It just - he wags its tail. Cats man - they won't - come here, come here, come here - nothing.

(SOUNDBITE OF MUSIC)

MILLER: Now, the reason these people are talking about this is because up at the register at this place Rize, they always put out two tip jars, two big glass jars with little chalkboards in front. And every day, they write on the little chalkboards two different categories to choose from. So one day it might be cassette tape versus vinyl.

SPIEGEL: Another day it might be Samsung versus Apple.

MILLER: Or...

SPIEGEL: ...Kittens

MILLER: ...Versus

SPIEGEL: Puppies.

MILLER: Puppies.

UNIDENTIFIED MAN #4: Puppies all the way.

UNIDENTIFIED MAN #5: I'm a kitten person.

UNIDENTIFIED MAN #6: I am definitely a cat person.

UNIDENTIFIED WOMAN #2: For sure puppies. I hate cats. There's been one cat that's like more of a dog than a cat, I enjoyed that cat.

MILLER: Rize started doing this about two years ago. And Danielle Cloutier (ph), one of the baristas there, said it completely changed the amount of tips people were giving.

DANIELLE CLOUTIER: Oh definitely. It's definitely getting us more tips.

MILLER: Inadvertently they seemed to have stumbled on this powerful impulse which is written into people. This urge to want to clearly differentiate themselves, declare their category.

UNIDENTIFIED MAN #6: I am definitely a cat person.

UNIDENTIFIED MAN #7: I'm a dog person.

MILLER: Yeah, and the categories themselves were so clearly defined. It was like there, right below the surface, was this whole world of qualities associated with what it means to be a cat person or a dog person.

UNIDENTIFIED MAN #5: Dog people are chatty. They like to talk to people on the street.

UNIDENTIFIED WOMAN #3: A cat person likes to stay at home. Maybe they don't want to go out as much.

UNIDENTIFIED MAN #8: Dog lovers are also, like, fun-loving and loyal.

UNIDENTIFIED MAN #9: Most people who are more in touch to cats, from my experience more - only think about themselves.

MILLER: So what is that? The seemingly irresistible drive we all have to cast the quarter and define a category. What is that impulse all about?

(SOUNDBITE OF BABY CRYING)

MILLER: Which brings us to babies.

LISA OAKES: Look at this. Look at this.

SPIEGEL: This is sound from a study of 4-month-old babies done by a psychologist named Lisa Oakes. It's one of a handful of studies that Oakes has done which looks at categorization in young babies, the most famous of which looked specifically at how babies think about cats and dogs.

MILLER: We actually first heard about this work from another developmental psychologist - Fei Xu at Berkeley.

SPIEGEL: Yeah, Xu told us about this cat and dog study Oakes did where babies were shown cat and dog pictures, beginning with a series of pictures of only cats - all different kinds of cats in all different kinds of positions.

FEI XU: First picture, young babies will look for a long time. When you show the next picture - so a picture of a cat - they will still be pretty interested. But over time, you show them five, six, seven pictures of cats, they get bored over time.

MILLER: Just another cat?

XU: Exactly. Who cares?

MILLER: And it's at that point that subtly, without fanfare, a picture of a dog is slipped in.

SPIEGEL: So let's pause for a moment and think about the dog. A dog - it's a lot like a cat.

XU: It's still a four-legged animal. It still has two eyes, furry etc.

SPIEGEL: And remember, you're a 4-month-old baby. Like, a little while ago, you probably could not tell the difference between your toe and a chew toy. You came out and everything was a wash. But there you are, and there is this cute, furry thing with four legs. So how do the babies respond?

XU: They say oh, this is new and interesting and they look longer at the dog. So that tells us they're distinguishing between the categories, say, cats and dogs, at a fairly young age.

(MUSIC)

MILLER: The ability to form categories, it doesn't get a huge amount of respect in the parenting world. It's not like your first step or your first tooth. Nobody is taking a picture. But as Fei Xu and any self-respecting developmental researcher will tell you, if you want to be a human being and you want to make it through your day, you need it.

XU: To categorize objects around us is extremely important.

MILLER: Because when you're able to recognize an object as a member of a particular category, all your knowledge about that category guides your response to that thing, which means you don't have to figure out everything from scratch every time you encounter something new.

XU: So it will really save us a lot of time and energy because then we can say oh, I know about cups. I know how to use them. I know what they're made out of.

MILLER: But imagine if you couldn't make categories. And there are people with brain damage who can't. Then suddenly even the most basic things in life are a challenge. You walk into a new room and there's a couch you've never seen before, and you don't have the category couch.

XU: You might think oh, gee, the couch looks very strange. It's a shape I don't recognize. And you might start to think OK, maybe something I should avoid.

MILLER: It could be a bomb, could be a sinkhole.

XU: Because, you know, we do tend to be a little bit scared of things that we don't know anything about.

MILLER: So if you didn't have categories organizing the world around you, everything you encountered would be like that.

XU: Kind of like stepping off onto a new planet. Look at their clock - what's that? Coffee pot - what do I do with it?

MILLER: Microphone - do I eat you?

SPIEGEL: Lulu. This is INVISIBILIA, a show from NPR News that looks at the invisible forces that shape human behavior.

MILLER: And today the invisible thing we are looking at is categories and how they shape our lives.

SPIEGEL: And now is the time that we do the we-sound-a-lot-alike disclaimer. We do sound a lot alike. But, you know...

MILLER: You know, feel free to enjoy the wash until eventually over time you'll learn to differentiate our voices.

SPIEGEL: Anyway, today we've decided to think about categories. We're looking at social categories, racial categories, personality type categories.

MILLER: Because the odd thing about categories is once they are set out there in the world, boy do we obey them.

SPIEGEL: OK, Lulu, so I'm going to get us started off with a story about the most basic, primary category, the very first category we are ever placed in. Lulu, what is the first question that people ask when they hear that someone has just had a baby?

MILLER: What is it, a boy or a girl?

SPIEGEL: Yeah, those are your options. You can be a boy or you can be a girl. And so much of our lives is shaped by that first distinction. You know, from that category flow radically different lives.

So this is a story about someone who has changed dramatically over the last couple of years. But who, when I first started talking to them two years ago, found themselves kind of slipping between those two categories, boy and girl, really in a way that I had never heard of before.

PAIGE ABENDROTH: Oh, hey, how's it going? Come on in.

SPIEGEL: This is a person I met named Paige Abendroth.

ABENDROTH: Abendroth means the color of the sky when it's that deep red right before the sun sets.

SPIEGEL: Paige had bright blue eyes, long, black hair in a ponytail.

ABENDROTH: Come in. Make yourself comfortable.

SPIEGEL: Thanks.

We were in San Diego, by the way, setting ourselves up to talk.

I'm going to make you scoot - scoot, scoot, scoot, scoot, scoot, scoot, scoot, scoot.

So after we sat down, I asked Paige to show me some pictures of herself from about a decade before.

ABENDROTH: So there aren't many.

SPIEGEL: In the pictures was a man, a man in a Naval uniform. He was very buff, strapping.

ABENDROTH: Yeah, very military. I had a high and tight haircut.

SPIEGEL: And there they were - those bright blue eyes.

You look pretty conservative here, too.

ABENDROTH: Yes, I do.

SPIEGEL: Photos from a time in Paige's life when Paige was male. Paige spent the first three decades of her life as a man. But let me be clear from the top. Paige's story is not the transgender story that you typically hear. Typically, people who are transgender feel like they are one gender trapped in the body of the other gender. Their internal gender identity is misaligned with their biological sex, but it's static. It stays the same. But when I was talking to Paige, that didn't capture her experience at all. Because when I met her, Paige was flipping, flipping between the category male and the category female.

ABENDROTH: I flipped back and forth multiple times a day. I'll say maybe spend 20 percent of my time in guy mode and the rest of it in female mode.

SPIEGEL: One morning, Paige would wake up feeling strongly that the gender at the core of her being was female. But then suddenly...

ABENDROTH: It's just kind of like (snapping).

SPIEGEL: There was a change. And Paige was in guy mode. When that happened, all kinds of things about Paige changed. Her posture changed.

ABENDROTH: And my weight kind of moves up to my shoulders. Like my center of gravity is kind of up here.

SPIEGEL: More significantly, she told me, there was a real psychological shift.

ABENDROTH: The way I see the world and the way I interpret the world is different.

SPIEGEL: When Paige was in male mode, Paige was less interested in people - in talking to them, in making eye contact with them.

ABENDROTH: I'm a lot more introverted. I'm a lot more - I'm quieter.

SPIEGEL: But in female mode, she was much more expansive. And sights, sounds, smells, likes, dislikes, they were all different.

ABENDROTH: When I'm female, all my emotions are like just really vivid, like colors.

SPIEGEL: Basically, Paige was constantly and very abruptly bounced between two starkly different ways of being in and filtering the world. Paige wasn't able to dictate when or where this happened.

ABENDROTH: I really have no control over it.

SPIEGEL: She'd be sitting in her office, talking to her boss and bam, she'd be walking down the street - bam. Now, when this happened, it wasn't like Paige was an entirely different person.

ABENDROTH: I'm always the same person. I experience the world differently. But I'm still me. I still am in control of myself. I still have my same wants and desires.

SPIEGEL: There was just this profound difference beneath everything.

ABENDROTH: It's just a sense of knowing, like the way that you know you're a female right now without having to be told, it's the same way that I know that I'm a female. And when I'm a guy, it's the same way I know I'm a guy. It's just this instinctual knowing of what I am.

SPIEGEL: By the way, right now are you male or female?

ABENDROTH: Definitely in girl mode, yeah.

SPIEGEL: And how long have you been in girl mode right now?

ABENDROTH: About an hour, I'd say.

SPIEGEL: So maybe you're thinking that Paige seems nuts. Paige herself has had that thought.

ABENDROTH: I thought that I was going crazy.

LAURA CASE: Yeah, I mean, some people first hear about this. You know, they may wonder if it's dissociative identity disorder, which is formerly known as multiple personality disorder, or a form of psychosis.

SPIEGEL: This is Laura Case, a researcher who has worked in the lab of a very famous neurologist - a man named V. S. Ramachandran.

CASE: At UCSD.

SPIEGEL: And a couple years ago, they got an email from a woman describing exactly the same kind of experience that Paige describes.

CASE: Someone who experiences the switching back and forth.

SPIEGEL: And while on the one hand, they were dubious.

CASE: We get a lot of interesting emails in our lab - emails from people claiming all kinds of wild sounding experiences.

SPIEGEL: On the other hand, they study the brain. And they have seen brains do all kinds of things. They've seen brains that suddenly stop recognizing faces, brains that think their owner has a mysterious limb. So they were curious.

CASE: Here's a person who goes back and forth in terms of what their brain seems to be telling them about whether they're male or female. How fascinating would that be to look and see what could be changing in the brain or in their environment to be causing that shift and identity.

SPIEGEL: So they decided to look into it. Over the past couple years, Case has found dozens of people with this experience. And Case has started testing them in different ways, including giving them psychological screenings. And what she found was that as a group, these people are not mentally unstable.

CASE: They simply don't have dissociative identity disorder. None of them had any form of psychosis or anything like that.

SPIEGEL: They ruled out bipolar, schizophrenia and saw some other interesting things.

CASE: They were actually a little bit more ambidextrous than the general population.

SPIEGEL: Basically, they found enough to suggest that there might be something neurological going on. So they published a very, very small study.

CASE: A preliminary sort of report in a journal called Medical Hypotheses.

SPIEGEL: And then started on another study.

CASE: But we're not ready to talk about the data from that study.

SPIEGEL: I did, though, get one tidbit about this from Case. And again, this is very, very, very, very preliminary. But she found that the same person will perform differently on certain tests depending on whether they are in male or female mode. For example, she gave the same person these mental puzzles.

CASE: That test spatial and language abilities.

SPIEGEL: And, Lulu, you know how men are really good at - supposedly - men are really good at kind of spatial...

MILLER: Directions?

SPIEGEL: No, like, spatial manipulation.

MILLER: What does that mean?

SPIEGEL: I don't know how to explain it exactly, but like...

MILLER: You're a woman, so you wouldn't understand it very well.

SPIEGEL: I'm a woman, so I wouldn't understand it very well. Right. Like, take a geometric shape, rotate it in your mind - stuff like that.

MILLER: OK.

SPIEGEL: They found when they gave these tests to these people when they were in their different states, they had different abilities. So, like, when they were men, they performed more as men, and when they were women, they performed more as women.

CASE: Yeah. We did see some differences between gender states that were intriguing but not conclusive.

SPIEGEL: Anyway, here's the point. There's some evidence that the shifts these people say that they are experiencing could be real, which brings us back to Paige.

ABENDROTH: You know, I wake up in the morning, I'm like, am I male? Am I female?

SPIEGEL: I wanted to talk to her about what it was like to move in this way between categories.

So let's just start with, like, your childhood.

Now, Paige didn't start off this way. She started off as a he, and really didn't even have that experience that you sometimes hear about where people describe feeling, from a very early age, like they're trapped in the wrong body. That wasn't Paige's experience.

ABENDROTH: I mean, loved playing with G.I. Joes.

SPIEGEL: And as teen, too, he was a boy obsessed with the things that most boys are obsessed with.

ABENDROTH: I always thought about women.

SPIEGEL: You never thought you were gay?

ABENDROTH: Uh-uh.

SPIEGEL: Still, Paige says, there were these strange momentary flashes that were disturbing.

ABENDROTH: I remember looking at girls and not just being attracted to them, but thinking that I was supposed to be them and wishing that I could kind of go over to the girl group and be accepted because that's where I felt I should be. But these thoughts were really inconsistent. It's not - I didn't always feel that way.

SPIEGEL: So Paige grows up, graduates from high school, goes to college and then really starts to struggle. The flashes are still there. College is hard. Paige drops out and begins to feel really, really lost. And then, in a somewhat odd place, Paige finds relief in the Navy.

ABENDROTH: I love the discipline of it, the structure of it.

SPIEGEL: First of all, for some reason, those flashes go way down.

Why?

ABENDROTH: I don't know. I saw myself as being more of a guy than I ever did before.

SPIEGEL: But really, it was while stationed at a naval base in Japan that Paige found relief in a way that will be familiar to many of you.

ABENDROTH: I walked around the corner and I saw her. And she was just kind of bouncing around, and she was very energetic. And...

SPIEGEL: It was love at first sight.

ABENDROTH: Immediately, I knew that there was something, like, special about her.

SPIEGEL: And even though Paige had never been a very aggressive person, Paige completely went after this girl.

ABENDROTH: I was smitten. I was immediately smitten.

SPIEGEL: And it worked.

ABENDROTH: We were just like this. We were so in tune with one another. I mean, we knew each other so good we could communicate, like, with a series of clicks.

SPIEGEL: Like, what do you mean?

ABENDROTH: We just - (clicking) - and like, the other person would answer back, and we'd know what we were, like - (clicking) - getting at.

SPIEGEL: And sometimes, it would mean, like...

ABENDROTH: It could mean, like, how are you? Or it could just be acknowledging that, you know, you're there. (Clicking).

SPIEGEL: So began the best chapter in Paige's life.

ABENDROTH: (Clicking) I can't believe you're recording this.

SPIEGEL: They get married. They move to California.

ABENDROTH: Got a home, had a car, had a steady job. I had everything that I ever wanted (clicking).

SPIEGEL: OK, what does that mean?

ABENDROTH: It depends on the context (laughter).

SPIEGEL: And then Paige turns 30, and all of a sudden, starts feeling really, really tired.

ABENDROTH: I'd - I mean, just coming up the steps, I would run out of breath.

SPIEGEL: So Paige goes to see the doctor.

ABENDROTH: And eventually, what they finally figured out was that my body thought it'd be a really fun joke on me to stop producing testosterone. Basically, at 30 years old, I had the testosterone level of an 80-plus-year-old man.

SPIEGEL: So the doctors put Paige on testosterone replacement therapy, and very quickly, the exhaustion went away.

ABENDROTH: Physically, I felt like I had before.

SPIEGEL: But the flashes - they're back with a vengeance.

ABENDROTH: I would have those feelings again where I thought I was supposed to be female, except there wasn't anything subtle about it. It was a very strong feeling that something had gone terribly wrong and that I was not supposed to be male.

(SOUNDBITE OF MUSIC)

SPIEGEL: In these moments, Paige would look down at her body - this hard torso, covered in hair - and feel utter disgust.

ABENDROTH: Imagine you woke up and your body was a cockroach. It was really unsettling.

SPIEGEL: Did you - so did you start talking to your wife about it?

ABENDROTH: No, I was terrified. I thought I was going crazy. I didn't want her to think less of me, and it was something that I kept inside.

(SOUNDBITE OF MUSIC)

SPIEGEL: Paige started telling me that occasionally during this period, to ease this feeling of disgust that came over her when she flipped into female mode but had a male body, she would secretly put on women's clothing. She felt a need to cover this body that felt so wrong with clothes from the right sex.

ABENDROTH: I was just trying to do anything I could to make myself feel more female.

SPIEGEL: So I started asking questions about this.

Do you remember the first time you decided to do that?

ABENDROTH: Mhm.

SPIEGEL: But suddenly, the whole tone of the conversation changed.

ABENDROTH: I don't want to talk about it.

SPIEGEL: OK, all right. So when was - so after that, what happened? So like, you - do need to take a break?

ABENDROTH: Yeah, I'm cool.

SPIEGEL: Yes, you're cool, you want to take a break (laughter), or yes, you're not cool.

ABENDROTH: Yeah, I (inaudible).

SPIEGEL: OK, sure.

Paige got up and disappeared around the corner. I could hear the faucet running in the bathroom. And when she came back, she wanted me to know something.

ABENDROTH: If it matters, I flipped back into guy mode.

SPIEGEL: OK, so is that why you don't want to talk?

ABENDROTH: It's just kind of like (snapping). It's just different now.

SPIEGEL: You flipped into guy mode. Was it when your eyes closed that you flipped into guy mode?

ABENDROTH: I don't know.

SPIEGEL: So are you in guy mode right this second?

ABENDROTH: Mhm.

SPIEGEL: So is it hard to answer questions?

ABENDROTH: Mhm.

SPIEGEL: OK.

ABENDROTH: I can - I'll be OK. I just need, like, a little bit.

SPIEGEL: We sat awkwardly for a while, neither of us quite sure what to do. It did feel like there was a difference in Paige, even in the way that she talked.

So how are you doing?

ABENDROTH: I'm good.

SPIEGEL: Are you male or female?

ABENDROTH: Male.

SPIEGEL: OK, is that OK?

ABENDROTH: Yeah, let's do this.

SPIEGEL: Paige explained that the next chapter of her life involved finding a name for what was going on with her - bi-gender, people who consider themselves both female and male at the same time. She found it on a bi-gender website and though only a small portion of the people on the website described flipping like Paige, it felt like this could be an explanation.

ABENDROTH: The way I felt was - other people felt that way, and it was real. It wasn't, you know, just some weird psychological construct.

SPIEGEL: But with this validation, came a horrible realization. Paige had to tell her wife.

ABENDROTH: I told her that we needed to talk, and so we sat down in separate chairs. I think I was on the couch and she was on her recliner.

SPIEGEL: Paige was terrified. She was certain that her marriage would be over.

ABENDROTH: She was very visibly upset. I'm sorry. I was just - God - I was just begging her to not leave and to accept me for who I was. I couldn't - I had lived for her for so long, and I didn't know how I could live without her.

SPIEGEL: But to Paige's surprise, her wife said it's OK.

ABENDROTH: She told me that everything was going to be OK and that, you know, we're going to make this work and she wasn't going to give up on me. (Clicking).

SPIEGEL: Paige couldn't believe how lucky she was.

ABENDROTH: (Clicking).

SPIEGEL: Together, they walked into the space between categories.

ABENDROTH: (Clicking).

SPIEGEL: Some mornings, Paige would wake up male, the husband her wife had married. That man would put on male clothes, go to work. Other mornings, Paige would wake up female, a woman trapped in this strange body. And they were doing it - helping each other through life in this odd space.

ABENDROTH: (Clicking).

SPIEGEL: But one problem remained. As much as the two of them could get used to the idea of flipping, Paige couldn't get used to the physical experience of it.

ABENDROTH: I came out of the shower one day and I'd gone in in guy mode and I came out in female mode.

SPIEGEL: She was standing there, beginning to dry off.

ABENDROTH: And I saw myself in the mirror and I was so disgusted that I threw up.

SPIEGEL: These kinds of feelings happened all the time. Now, Paige had come across a potential cure for this, a sort of homespun remedy that some of the bi-gender folks had written about online. It involved hormones. Paige would go on estrogen to make her body more androgynous.

ABENDROTH: Bring my body to an androgynous point where I could present both as either male or female.

SPIEGEL: Apparently, it would reduce the shock of being thrown between categories so violently if her body was in a permanent state of in-between. So Paige decided to try it. She began estrogen treatments, and it worked.

ABENDROTH: The first time I got my first injection I just felt this immense relief like I was finally on the right track.

SPIEGEL: There was no longer the same physical discomfort. But as Paige finally was becoming comfortable in her own body, Paige's wife started to turn away. They began sleeping in different bedrooms.

ABENDROTH: It was almost like we were becoming strangers. And one - there came a point where I realized that, you know, she wasn't suddenly going to - I don't know.

SPIEGEL: Accept you?

ABENDROTH: She tried really hard.

SPIEGEL: But it's really difficult. Think about what developmental researcher Fay Hsu said at the beginning of the program - when things don't have a clear category, that's scary for us all. They're a shape we don't recognize. Is the lump in the middle of the living room a couch or is the lump a bomb?

ABENDROTH: I felt like a monster. And I felt like this terrible, like, alien creature that had come down and taken over her husband's life and taken him away from her. One night I heard her crying in the bathroom, and I asked her if everything was OK and she said no. And she said, it's over, isn't it? And I think the next day she told me to move out. I mourn for my marriage the same way I would mourn for, like, you know, the death of, you know, my mother or someone who I was really, really close with. You can kind of see (laughter) right now. It's really hard to talk about still.

SPIEGEL: Sitting there in Paige's apartment, the afternoon light fading in the window behind her, I was just struck by how hard her situation was. It's not just the fact that Paige wasn't in one clear gender category. She was stuck between categories in other ways as well.

In the weeks before and after our visit, I had called around, trying to get a handle on how to make sense of this experience that people like Paige describe. I had spoken to all kinds of people - therapists, historians, gender researchers. But it seemed like a lot of the people that I spoke to were convinced that the experience I was describing didn't really exist. There's no way they're actually flipping between genders, I was told by two different gender researchers in two different European countries. These people are just psychotic. Both of the men who told me this had worked in gender research for their entire professional careers, and they sounded extremely confident.

A gender therapist in San Francisco was also skeptical, but she had a different reason. These people are actually just normal transgendered people, she explained, in the sense that they are experiencing the same things that any transgender person experiences. They've just developed a different way of describing it. Same experience, different label seemed to be her argument. In other words, it's not just that Paige was existing between genders. The problem was even more profound. Most of the people that I talked to didn't seem to believe that the experience that Paige was saying that she had was real.

Like why do you think this happened to you? Like where does this come from in you?

ABENDROTH: I don't know. I have stopped asking myself that because it doesn't matter anymore where it came from. I just kind of am what I am.

SPIEGEL: When we talked, Paige seemed as mystified by what was happening to her as anyone else. But her experience, she concluded, was her experience. There wasn't that much she could do about it.

ABENDROTH: Like my biggest worry is that I'm never going to really fit in to, like, female spaces or male spaces. I'm afraid that I'm going to be living the rest of my life in some kind of weird gender twilight zone.

SPIEGEL: And what will you do then?

ABENDROTH: I don't know. I'll keep on doing my best.

SPIEGEL: More than a year after we first met, I called Paige up on the phone. I wanted to check in and see how she was doing. And it was clear from the very first moment she answered that something was different. Her voice sounded different - higher.

ABENDROTH: Hello?

SPIEGEL: Hi, can you hear me?

ABENDROTH: Yeah, I can.

SPIEGEL: Turns out, about six months after I went to San Diego, the flipping started to fade. And eventually, Paige had settled full-time into being a woman. The last time Paige had flipped into being psychologically male was in the fast-food restaurant Five Guys, and she said it took her completely by surprise.

ABENDROTH: I had gotten so used to constantly staying like I am now, as a woman, that I thought it had stopped. And I remember I flipped really hard. It was really bizarre. I felt like I was wearing a really uncomfortable sweater or something like that.

SPIEGEL: Now, Paige couldn't really explain why the flipping had stopped any better than she could explain why it had started. She said she thought the estrogen hormones she'd taken to make her body more androgynous probably had affected her.

And Laura Case, the researcher who's been studying people like Paige, agrees that hormones do affect the brain. But still, there was no way to be absolutely certain. But there was one thing that Paige seemed absolutely clear about - living in one category, even if it's a category that's often discriminated against, like transgender women, is way better than having no category.

ABENDROTH: Oh, my goodness, yes. It's so much easier. It's so much more manageable. The world, to me, just - it makes so much more sense.

SPIEGEL: Now Paige knew what she was supposed to do, where she could place her foot. She didn't have a wife, but she had that. INVISIBILIA will be back in a moment.

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