The Missing Piece:

James Kaplan, 9, left, gets his vitals taken while sitting next to his dad Ben Kaplan during a medical appointment to determine if he is starting puberty at UCSF Benioff Children's Hospital's Child and Adolescent Gender Center Clinic March 15, 2017 in Oakland, Calif. James will be put on hormone blockers to stop the effects of puberty until he is a young teen. If he still insists on his current gender identity, he will then be put on cross-hormone therapy which will allow him to experience development that aligns with his gender identity.

James Kaplan, 9, left, gets his vitals taken while sitting next to his dad Ben Kaplan during a medical appointment to determine if he is starting puberty at UCSF Benioff Children's Hospital's Child and Adolescent Gender Center Clinic March 15, 2017 in Oakland, Calif. James will be put on hormone blockers to stop the effects of puberty until he is a young teen. If he still insists on his current gender identity, he will then be put on cross-hormone therapy which will allow him to experience development that aligns with his gender identity.