This Is How It Always Is

Even though Poppy is 10 and is self-sufficient, Rosie stays home from work during the three days Poppy is locked in her room. On the third day, James calls and says Rosie has to come in tomorrow. The next day, Rosie goes into the office, and Howie meets her at the door. Howie says that he realizes Rosie has something going on at home, and he doesn’t want to “bust her balls,” but she isn’t keeping up her obligations at the office. Rosie reminds him that she keeps 35 appointment hours weekly and takes emergency and on-call hours the same as everyone else. She has missed one week in four years, and suddenly she is a problem.

Howie asks why Penn can’t deal with whatever is going on at home. “He doesn’t even work,” Howie adds. Rosie again says that she does the same work as everyone else, but Howie reminds her that she refuses to do any work to market the practice, and she won’t go to Thailand. The extra things are what it takes to be a doctor in his practice, Howie says, and if Rosie isn’t up to that, she will have to be a doctor somewhere else.

Rosie calls Mr. Tongo at lunch and tells him that everyone knows about Poppy. He asks how Poppy is taking it, and Rosie tells him it isn’t good. Poppy has shaved her head, and she refuses to leave her room, and, Rosie adds, she has turned back into Claude. “Perfecto,” Mr. Tongo says. Rosie isn’t so sure she understands. He explains that “coming out” is a “queer right [sic] of passage,” but, Rosie says, Poppy isn’t queer. Yes, Mr. Tongo says, she is. The problem is that Penn and Rosie have been so understanding and accepting, they deprived Poppy of her queerness. But she is queer, Mr. Tongo says, and queer is different, that is why they call it queer. 

There is nothing Penn and Rosie can do for Poppy, Mr. Tongo says, except let her suffer. Step one, he says, is coming out, and step two is being rejected by a lot of people, and it is never fun. Step three is the best, Mr. Tongo says, because step three is for “moving on.” For some people, moving on can take their entire life, so Poppy is lucky to have a jump start.

That night when Rosie gets home, Penn is in the bedroom looking at pictures of vaginas on his laptop. He has been doing research on sex reassignment surgery, and the advancements are incredible. Poppy can be given a functional vagina—one that works just like Rosie’s, he says—but Rosie stops him. Poppy is 10n, and has recently turned back into Claude, and she is clearly too young to start talking sex reassignment surgery. Penn knows that Poppy is still too young, but, according to his research, the earlier the surgery is performed, the better.

Rosie used to be grateful that Poppy has gender dysphoria and not cancer, or heart failure, or any number of fatal childhood illnesses, but she knows now that Poppy’s gender dysphoria is more than a medical issue. It is a “cultural issue,” Rosie says, “It’s a social issue and an emotional issue and a family dynamic issue and a community issue.” They might need to intervene medically so Poppy doesn’t grow facial hair, but the world also needs to learn to accept a “guy in a dress.” But, Penn points out, that won’t happen. Then, Rosie says, they all have to learn how to live in a world that doesn’t accept Poppy or Claude. That night, Rosie can’t sleep. She sends a text message to Howie and tells him she will go to Thailand, if Poppy can go with her.