"Would I have the courage to do what these people are getting ready to do today?" Oprah says. "I doubt if I would."
According to the National Center for Transgender Equality, transgender is an umbrella term used to describe a wide range of identities and experiences and is used to refer to many types of people, including transsexual people and cross-dressers. In its broadest sense, "transgender" encompasses anyone whose identity or behavior falls outside stereotypical gender expectations.
Angelika, a 21-year-old transgender female, spent the first 15 years of her life living as a boy. "Everybody knew that my mother had a boy, but I wasn't masculine," she says. "I was never masculine. I was more feminine than anything, and they saw that. … My mother was embarrassed by it. I was told that my family was embarrassed by me."
When Angelika was just 3 or 4 years old, she says she began to have conflicting feelings about her gender. "There was this one point in time when I was little that I looked in a mirror, and I was just wishing that I was a girl," she says. "I couldn't really understand why I had a boy part, but my mind was like a girl. I was so confused."
While other boys in her New York City neighborhood were interested in sports, Angelika says she liked playing with girls' toys and longed for girls' clothes. "I wished that I could hang out with the girls and play Barbies with them, but I wasn't really allowed to," she says. "It was very frustrating and upsetting for me."
Angelika says she came out as a homosexual male to her mother, but something still didn't feel right. "When I was younger, I used to just lie in bed, and I prayed and I prayed and I prayed for God to somehow immaculately change me into a girl," she says. "I was just really so heartbroken that I was born in a body that I shouldn't have been born into."
While Angelika prayed for a miracle in New York City, a young girl in California faced the same internal struggle.
As Julia got older, she realized that something wasn't right. "It's confusing … because you wake up and [see] that's not [the same genitalia] my brother has."
Then, Julia had a life-changing conversation with her mother. "When I was, like, 7 maybe, I went up to my mom and I said, 'Hey Mom, I'm a boy in a girl's body.' And that's when it really, like, occurred to me that I was different."
Before transitioning, Jake, who was still living as Julia, says she thought she might be a lesbian. "But then I met a friend who was transgender and I was, like, 'Oh, what's transgender?' And he's like, 'I was born a girl but I'm a boy.' And I said, 'Oh my God, that sounds just like me,'" he says. "It's not that I just want to be someone's girlfriend. I want to be their husband. I wanted to be the dad. I wanted to be a positive male role model in someone's life, and that's when I knew that there was a difference between being a lesbian and who I was."
At 13, Julia told her parents she was transgender, and at 15, she started the physical transition to become Jake. "Julia was never there, I don't think," Jake says. "I think I was always Jake, just with a different name [and] different body."
At school, both say they were teased mercilessly. "[School] was a constant place of torment just because I was different. Just because I was more feminine than the other boys," Angelika says.
As Julia, Jake says he started high school with a lot of friends, but that changed when he told them he was transgender. "Everybody would pick on me," he says. "They'd follow me to class and they'd beat me up like four at a time, just punching me and throwing things at me.
target=_blank> Watch Jake and Angelika's emotional confessions.
"The constant name-calling and teasing caused Angelika to have panic attacks and miss school. "I would have 40 to 50 absences a year," she says. Jake says he also missed a lot of school. "I'd start ditching," he says. "They finally called my mom and they were like, 'Hey, your kid isn't coming to school.'"
Eventually, Angelika and Jake say the pain became almost too much to bear. "I started having suicidal thoughts early on because every single day, every single day , it was the same thing over and over and over again," she says. Angelika says she still has scars from when she used to cut herself. "As the blood would come out I would feel like my pain was coming out," she says.
Jake also thought about suicide. "One day I just ran and grabbed a knife and held it to my chest," he says. "I just wanted to die. That was the only way I knew how to solve my problems."
Peggy says she was thrilled when she found out her first child would be a girl. "I had all these ideas of how we would do the girly things together as she got older and I would dress her in the pink ribbons and the pink clothes and the pink bows," she says. "Just being able to talk about the really intimate parts of growing up and being female…that's what I was looking forward to at that time."
Peggy says she and her husband always knew Julia was a tomboy. When Julia told them she was a lesbian, her parents accepted it right away. "Being lesbian was not a big issue," Peggy says. "It was like, healthy kid—that's what we really cared about. But then, when Jake began to discover that he was transgender and not lesbian, that was more of a difficult issue to deal with."
Still, the small, close-knit family remained open-minded. "I accepted the fact of whatever he was going to be. However, I was really sad and scared for what the world had to offer out there," Peggy says. "[Family] is all we have, and we have to make the most of everything."
Angelika wears padding every day to add curves to her hips, but she still has some masculine characteristics. "Yes, I do have an Adam's apple and sometimes you can see it. But for the most part, my chin kind of hides it a little bit."
At age 16, Jake had surgery to remove his breasts. Before that, he would bind them every day. "It's so much easier now to pick out what I want to wear because I don't have to worry about if my chest is showing or not," he says.
Both Jake and Angelika take hormones. Angelika says she has to take testosterone blocker pills four times a day. Jake must inject himself with hormones every two weeks. "It's kind of routine now," he says. Jake now uses men's soap and has learned to shave. "When I was growing up, I really wasn't thinking about it. I used to just pretend to shave with my dad," he says.
Although Jason has been supportive, he says he still struggles with their new relationship as brothers, which he says is more competitive than protective. "Sometimes I wish she could still be a girl. I miss my sister," Jason says. "It's been hard on me, too, because for the past couple years [my parents have] really been focused on her, so it's like, you know, I've been kind of pushed off to the side. I never thought that my dad would be teaching my sister how to shave before me, so it's kind of weird."
Jason's struggle has also affected Jake. "It makes me sad," Jake says. "I usually am the one causing [Jason's pain]."
Although he's "Jake" to the rest of the world, Jason still calls his sibling "Julia." "I guess the name means something special because it was my first word, so it kind of has a bit of a meaning, a value. So it's going to be hard to change that. If I want her to stay in my life, I have to accept whatever she wants to do. I don't want to lose her altogether," Jason says. "She seems happier. She seems normal again…just a different body."
"Many people think the transition is about the surgery, going from male to female," she says. "But the real transition is when you take that first step out into public with that little mini dress that you've been saving up [for] and go off to Target to buy toilet paper. Now that, so to speak, takes balls."
Dr. Bowers says she questioned her gender at a young age. "I've had my first question or feelings at 4 or 5, but felt very ashamed of that and did my best throughout life to hide that inside." At age 19, Dr. Bowers says she ran away from college and tried to transition. "In 1978, there was no Internet. There were barely any newspaper articles," she says. "[There were] very few resources, clinics, doctors that knew about this kind of thing, and so I just tried to put it aside."
In medical school, Dr. Bowers says she decided to specialize in obstetrics and gynecology so that she could be a part of women's lives. "I thought that, that would satisfy the feelings that I had."
As years passed, the feelings only grew stronger. Dr. Bowers says she lived in denial for 40 years until she could no longer look in the mirror. Eleven years into his marriage, Dr. Mark Bowers told his wife he wanted to begin living as a woman. So why did Dr. Bowers get married in the first place? "You play the cards you're dealt," she says. "I thought that I could put it off and do other things, raise a family, get married, and that would be enough for me."
Eleven years after her admission, Dr. Bowers and her wife are still married.
Gender identity and sexual preference aren't necessarily related, Dr. Bowers says. "Generally, if you consider yourself female, you're attracted to males, and vice versa…but not necessarily."
Dr. Bowers says she feels like people are often born in the wrong body. "When I interview patients coming in for surgery, better than 90 percent feel that they had cross-gender feelings from the very earliest of age—less than age 7," she says. "And that really suggests that it's something biological."
In order to have reassignment surgery, Dr. Bowers says patients must complete a series of steps. "You're required to go through psychotherapy to make sure there aren't other mental issues and it also plays a very important supportive role—but it's not a psychiatric illness, I don't believe," she says. "However, that psychiatric diagnosis is necessary in order for a person to get treatment. And then, of course, they have to go on hormones for a year and then live as their desired gender for a year before going on to surgery."
By doing shows about gender identity, Oprah says she hopes people will see how we're all more alike than we are different. "Soon, and I know that it is not going to happen in my lifetime, but I feel like all of us who are living in this lifetime have to do our part to create a greater understanding…where people accept you just for being who you are."