I was born in the very rural south in the 1950s. Growing up I had a friend; I’ll call him Sam. My mothers was friends with his mother. In my small town basketball was the only sport my school had enough people for, so everybody played. In middle school we had shared practice with the middle schooler and high school kids. And shared showers with them. It was obvious that Sam was built differently than most of the rest of us. When this was commented on, Sam responded that he “had been bit by a spider when he was a baby.”

When I mentioned this to my mother (how that came up in conversation I do not remember), she told me that when Sam was born “the doctors had to make a decision.”

With middle school came puberty and with puberty came changes. While the most of the rest of his teammates became more angular and awkward, Sam became more soft and round.

Along with his genital differences, Sams changes were seen as an opportunity for taunting and crude ridicule from his testosterone-laden colleagues. I won’t repeat the words, I’m sure that you will have heard them, although perhaps not with the vernacular mispronunciation of pseudo-scientific categories I heard.

Things went on. In high school Sam began acting out a bit, getting in fights and trying to out macho his persecutors.

For his 18th birthday, his parents bought him a motorcycle. A powerful one. An impressive machine. After some Saturday night of rejection and humiliation, Sam revved it up as high as it would go and drove straight into a bridge abutment. He did not survive.

I don’t know enough about medical knowledge and practices in the rural 1950s south to judge whatever decisions were made. But I do know that they were not Sam’s decisions. Sam made different ones and we are all the poorer for the options that availed him.

Let’s not re-create through law and policy the losses produced by ignorance and lack of knowledge.