There's some debate within the transgender community about whether one should be 'out.'
In other words, should someone who was born biologically male and then grows up to identify as female go public with that information?
"Usually there are a few of us (adults) who take that on," says Alison Davison, coordinator of the Southern Arizona Gender Alliance. "Many transgender folks prefer to live what we call a 'stealth' existence.
"If they are transsexual, they will go through the stages of transition and often do their best to quietly blend in. There are philosophical and political discussions about the importance of being 'out.'
Personally, I think there is strength in being out and public. I think the rest of society needs to see faces and hear stories of transgender people so they can develop greater understanding and compassion."
What happens when the public face of a transgender person is just 9 years old?
Josie Romero, who lives in the Tucson area, is a transgender girl. She is biologically male and until the age of 6 was known as Joey.
Josie is very comfortable with being transgender and her family allows her to speak to the media about it. To see a clip of Josie on the Tyra Banks show, click here.
Davison says 9 is not too young for someone to know they were born as the wrong biological gender. While the Southern Arizona Gender Alliance primarily caters to adults, Davison anticipates adding more services for youths in the near future.
"Josie is not the only young one in Tucson to know she is trans," Davison says. "She is one who is more public about it than most.
"Despite the challenges trans kids present, I've seen more problems arise when kids are not allowed to be themselves than when they are supported."
While the psychiatric community still lacks treatment guidelines for transgender children, there are already pediatric endocrinologists, including Dr. Norman Spack, working to help children with gender incongruence begin a transition to the opposite sex.
To read more about Josie Romero and her family's decision to support her in being 'out' and public, see Sunday's Arizona Daily Star.
Update: For a link to the story, click here .