It concluded that children who experienced distress with their sexed bodies often started out as merely gender-atypical, with the distress developing only as they learned that their feelings and behaviour were unacceptable to others. ‘Your framework for understanding these things depends on the cultural context,’ he says. ‘If you’re growing up in Samoa they don’t mean you change your body, whereas if you grow up in Canada or England the pool of possible interpretations that you draw on includes, “I’m a transsexual and have to undergo medical intervention and pretty radical surgery.” ’
