This ‘gender-affirmative’ approach is championed by the most influential clinicians. One is Diane Ehrensaft, the director of the University of California, San Francisco children’s hospital gender clinic, who sits on the board of Gender Spectrum, an activist group in San Francisco. Her book, The Gender Creative Child, is a manual for early transition. At an event in 2016 run by Gender Spectrum, Ehrensaft claimed that a toddler can indicate a trans identity to parents with non-verbal ‘gender messages’. One born male may unpop the fasteners on a bodysuit to make it look like a dress; one born
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