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A change or shift from one activity or habit to another, e.g., going home from the playground, change from co-sleeping to sleeping alone.
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My daughter just turned 13 and confides in me she wants to be a boy
If the therapist confirms that this is actually the way to go, they will advise on further steps, which may involve puberty-blockers, and starting transition on the non-surgical aspects (pronouns used, …