“My Drewbie is in a hospital bed because of me! If I hadn't made him be ‘Gaby' so often, this never would have happened!”

“Well Maddy” said Maggie, “Could you tell about the first time you got Drew to dress up for you, and why you asked him to?”

“Well, it was for the Easter Dance. It was a costume affair. I had thought for a long time that Drew would look cute as a girl, so I convinced the other girls that we should all go as Sailor Moon characters, and get Drew and Rhod to be the other characters. They only agreed if we could prove that they would look like ‘real' girls, not boys wearing a dress. So, we made them up and dressed them, and they fooled almost everyone. Drew's sister Jules figured it out, and a few days later my mum did, too. But we convinced them to go through with it anyways.” Maddy was starting to let the memories flow now, and was pretty much just saying what came to mind for her; something that both Maggie and Karen were picking up on, and letting her run with. “She looked so cute and so sexy. I knew that we were going to win the prize. ‘Gaby' actually won best costume that night. Looking the way she did made my tummy do little flips. My Drew is wonderful, but Gaby?.....she takes wonderful to a whole level.” Maddy then started to describe many of the other times she had gotten Drew to be Gaby, and she left out nothing. She wanted her Drew and her Gaby back. She told them how she often tricked Drew into dressing, and how he'd told her he was never going to dress as Gaby again and she was always able to talk him out of it. “She is so much more alive when she's Gaby. It's like the same person but like a hyped up…no, that's not it….it's more like she truly comes to life.”

Maggie and Karen exchanged a look and Karen asked Maddy “So is that the reason why you kept getting Drew to dress as Gaby?”

“Well, sort of….. I'm not sure how to explain it. Gaby is Drew, but Gaby is more than Drew. She's my best friend and she's everything Drew is and she's pretty and fun to be with and I really, really like Gaby. To have Drew and Gaby in the same person is like having the best of both worlds. And I really do love Drew. He's my boyfriend, and I'd do anything for him. But Gaby ……” Maddy was blushing furiously. She hadn't really intended to reveal quite that much. But she would bare her soul to these doctors if they could help Drew. “Umm….Drew isn't going to find out what I told you I he? I think it would hurt his feeling to know that I really, really like Gaby. But then I guess I haven't really been thinking too much about what he wants lately, have I? I've been pretty horrid, really. I know he'd do anything for me, and I used it against him, and now he's had a collapse and it's my fault! I got him to go out for the cheer team, and I'm the one that got him to be Gaby his whole time here. I just hope he'll speak to me again.”

“Maddy – this isn't all your fault.” stated Karen. “Certainly you have contributed to Drew's mental state, but it is not ALL your fault. I won't sugar coat this. Drew is going to need a lot of help and support over the coming months. What's happening to him, some people never recover from. They retreat into their own little world and never come back. If Drew does come back from this, you are going to have to make some choices in your life as it impacts Drew. You are going to have to respect the boundaries he sets when it comes to Gaby. If he says no, then you need to let him be. But you also need to be honest with him. At some point you will need to sit down with him and talk about all of this, if you wish to have a long term relationship with him. Relationships that last are built on a foundation of honesty and friendship, as well as love.

As well, I think you need to explore your own feelings. You need to discover within yourself where your preferences lie. Whether you like boys, or girls, or both in a sexual way. Knowing your own way is equally as important. Perhaps more important. You have to be honest with yourself as much as you need to be honest with Drew. And I think it is also something you need to discuss with your parents as well. They are your family and I'm sure they love you very much. There are no boundaries on who you can love and how they have to look. What matters is how you and that person feel about each other.”

Maggie picked up what Karen was saying at that point and continued. “Yes Maddy, and a relationship that lasts is built on a foundation of trust and equality. It cannot be a one sided relationship – that is not healthy either. A strong and stable relationship takes work, and compromise, and a willingness to put your partner's needs ahead of your own when the situation warrants it. If you think about it, your relationship with Drew has been tilted your way the whole time, hasn't it? As long as Drew has done what you have wanted him to, things have been fine. One of the other girls mentioned the Halloween dance – and that Drew had come to your house as Dracula, a male character; upon which you went off and refused to go unless Drew went as the female character you had picked out for him.”

“But Dr. Maggie, she'd have ruined the whole thing!” exclaimed Maddy. “We'd decided to go as members of the cast of Buffy the Vampire Slayer, and Drew was supposed to be Buffy.”

“Why couldn't Drew have gone as one of the male members of the cast – like Xander or Oz or Rupert?” asked Maggie. “Why was it necessary for you to make him be one of the female characters? And why, when Drew showed up as Dracula, was it necessary to essentially force it on him by making him feel guilty? And who had decided you were all going as Buffy characters? Did you all sit down and agree to it?” Maggie had decided to push Maddy a bit, to try and get her to think about her reasons for everything; and confirm a few things in her own mind.

“And why would it have been ‘ruined' if Drew had gone as Dracula? Would it have been ruined because he made up his own mind as opposed to just deferring to you? Is it because you had told the others that you would have Drew come as Buffy, and didn't want to look bad? Or was it just because he wouldn't be the girl for you?” Maggie knew she was going to spark a reaction from this line of questioning, but was not quite sure what the reaction would be. She and Karen had to try and find out what was motivating Maddy to do this – it would certainly help them with Drew's diagnosis and treatment.

Maddy bristled at Dr. Maggie's questions. “I wanted Gaby with me!” she snapped. “We have a lot more fun when Gaby is there, and that's what the Halloween dance was for – to have fun. And, everyone agreed that the Buffy theme was a good idea”.

“But it was you idea, wasn't it Maddy? And obviously not everyone agreed with it , because Drew came as Dracula. But you still haven't answered my questions. Why would the night have been ruined if Drew was Dracula? And why did you use guilt as a weapon against someone you tell us you love?” Maggie looked over at Karen and saw Karen give her a slight nod. Maggie needed Maddy to confront and admit her to herself what her agenda was when it came to Drew. Otherwise, they would get home and she would slip back into the old familiar patterns and Drew would be right back where he started.

“Yes, it was my idea! Gaby looked fabulous and I knew she would. And it would have been ruined because it wasn't the way I wanted it!” Maddy half shouted at Maggie, rising out of her chair. “And it wasn't me that convinced him to change, it was Mum. I told mum I wasn't going if Drew went as Dracula, and she went and convinced him.”

“So then you manipulated your mother into doing it for you. That's not any better Maddy and you know it. So then, if things aren't the way you want them, then they're wrong. Interesting thought Maddy. Are things the way you want them now? Is Drew being sedated in a hospital what you want? Is possibly destroying him what you want? Because right now, from the outside, that seems to be what you're saying. You have told us yourself how you orchestrated all of this, and Drew is having a mental collapse because of it. How does it feel, Maddy?”

Maddy was stunned by what Dr. Maggie had said. Her mind reeled as she listened to Maggie show her what she had done to Drew. She began to play back their relationship in her mind. It was like a catalogue of control. Drew would do anything she wanted him to – he wanted whatever she wanted; and when he disagreed, she talked him around. He was always doing whatever it took to please her. And she had taken full advantage of that. Tears began to run down her cheeks as she thought of the Con when they were getting harassed and Drew was ready to walk out on her, costume or no. She had been trying to make him into the girl that she could love. And there it was. There – into the GIRL that she could love. Drew was a friend, a companion and a wonderful person; but she would never love him that way. It was always Gaby she kissed and teased and flirted with. But Drew was her best friend, and she had wanted a best friend and someone she could love in that way. She couldn't find that best friend in another girl, and she couldn't get that girl from Drew. So the only thing to do was to combine them. And so she had set about doing just that. The only problem of course is that the object of her affection wasn't in on the plan and was a rather unwilling participant.

“It's true” she thought to herself “I am attracted to girls. I am a lesbian. I want Drew, but I want Drew as a girl.”

“Ohmygod, ohmygod, ohmygod! What will Drew think of me now?!! What will mum and dad think? What will Uncle Dave and Aunt Jenny think? What will all my friends think?” These thoughts and a thousand others flitted through Maddy's consciousness at the speed of light. The emotions warring within her were written all over her face. Maggie and Karen watched in silence as Maddy struggled with the new awareness of who she was, and the new appreciation for the situation that she had put Drew in.

After Maddy started to calm down, Karen took the lead. “It looks like you have made a few discoveries about yourself since you've been here in Grottoes, Maddy. Some good, some not so good. The important thing is in how you deal with them. And in how you help those around you adjust to the new Maddy. By the sound of it you have a very loving family and group of friends; and I think you just need to be honest with them. Tell them how you feel and who you are inside. :

Just then, there was a knock at the door, and Maggie went over to answer it. It was a nurse, letting her know that the Bonds and Mrs. Peters had arrived. Maggie looked at her watch. “Oh my, 6:30 already” she thought. “I'd better go and tell Jos and the others to go home for a while, and that Maddy will be staying here for a while, as her mother is now here”

She turned back to Karen and Maddy. “Excuse me for interrupting, but I need to go and take care of a couple of things. Please continue and I will rejoin you as soon as I can.” With that she left the room, Karen and Maddy engrossed in their conversation once more.

Maggie went out to the waiting room, and signaled Jocelyn to come over. “Jos, we're going to be a while yet. Maddy knows Drew better than anyone and we're trying to get as much input as we can. The Bonds and Mrs. Peters have just arrived from England, so I suspect Maddy will stay with her mum tonight. Please keep it under your hat that they are all here, would you please Jos? I'd like to keep this all as low key as possible for now.” Jocelyn agreed and said they would all head home and that she'd tell everyone that Maggie would arrange for Maddy to be brought home later.

As Maggie headed off to meet the Bonds and Carol Peters, she tried to gather her thoughts, and the direction she wanted to take at the start. She needed to talk to the Bonds about interviewing Drew without them present in the room, she needed to discuss what they had found out today and get Dave and Jenny's thoughts and feeling on the table, and she needed to discuss the results of the physical tests they had run. As well, she needed to sit down with Carol Peters to discuss Maddy with her before she took her to meet Maddy. Maddy, in her own way, was dealing with as much as Drew was. And it was important that Carol understood that and was there for Maddy. But being there for her also meant setting boundaries as well. And she had to understand that letting Maddy manipulate her was not a good thing. She saw a long few days coming with the Bonds and the Peters. She was very glad that Karen had agreed to come and help her with this one.

Maggie went to the ward where Drew was knowing that is where she would find them. As she approached the room, she saw Jenny on one side of the bed and Dave on the other, each holding one of Drew's hands. She could see the concern on their faces, and wished that she could give them some reassurance. But, given the test results and the mental breakdown, she knew they were in for a long and rock road.

Maggie stepped in to the room, and with a finger to her lips motioning them to be quiet, she directed them out of the room to where they could speak. “Hello, I'm Dr. Maggie McArthur. You must be the Bonds, and you must be Carol Peters – Maddy's mother. Right now Drew will likely sleep for another 90 minutes or so and Maddy is in with my colleague, Dr. Karen Page. None of the children know you are coming, so if we could, I'd like us all to have a talk in my office before Drew wakes up and while Maddy is speaking with Karen. Jules, could you sit with Drew for now, and if he wakes up before we get back, please don't let on that your mum and dad are here”

“Okay, Dr. Maggie” replied Jules. “Now that mum and dad are here I know we will get everything worked out, so at least I can be somewhat cheery when he wakes up.”

With that, Maggie asked the other three to follow her, and they headed to her office. Once in her office, Maggie asked them all to take a seat and asked the receptionist to bring in some coffee and tea. “Now I must ask this for the purposes of patient confidentiality. Can we all discuss Drew and Maddy together? They are so intertwined in many ways, that if it is all right with you, I'd like to discuss them jointly.”

Jenny looked at Dave, who nodded, and then at Carol, who also nodded and then she replied “Certainly doctor. We, as much as anyone, know how inseparable the two of them are; and if discussing it jointly will help Drew, then by all means let's do so”

“Well Jenny” said Maggie “this is also to help Maddy, as she has some issues she is dealing with as well. Both concerning her and Drew. Since Drew was brought in first thing this morning, I have spent the day interviewing everyone possible who has a connection to Drew, and Dr. Page is still talking to Maddy as we speak. Karen is a psychiatrist who specializes in gender issues, and I thought it appropriate to get what I consider to be some expert advice in that area.”

“Throughout the course of the day I have also run a lot of physical tests on Drew and there are a number of anomalies that we have to look at as well. As Drew has been sedated to this point, I would like to spend tomorrow morning having him talk to Karen and myself. And here's the rub I'm afraid. I want to ask you to not let him know you are here until after our initial discussions. Now before you get angry, please let me assure you that you will be able to see and hear everything we talk about. I have arranged a room with one way glass and speakers so you can observe without Drew's knowledge. It is my belief, and Dr. Page's, that we will get more ‘unbiased' and open talk from Drew if he doesn't know you are here.”

Jenny and Dave both started to interject, but with Maggie's last statement, stopped and sat back to think about that.

“Well Dave, what do you think?” asked Jenny. “Much as I don't like Drew being alone like this another night, she may have a point. Kids may not say everything they feel if their parents are in the room, and Drew hasn't really told us how he feels about all of this. And as long as we can watch and hear everything that is going on, it should be all right.”

“Maggie, we just want what is best for Drew. If this is what you think is best, we will honour that request.”

“Thank you Jenny. I know it is difficult not to be with him tonight, and not being able to make it all better. But I do think it is important that you and Mr. Bond get to hear what Drew has to say, from his own mouth, how he feels about ‘Gaby' and dressing as a girl.”

“We will discuss the specifics of Drew's physical issues in a few moments. But right now I'd like to discuss Maddy, if I may. Today, Maddy has had a couple of major epiphanies, both of which concern Drew. The first being the realization that their relationship was and is very one sided. That up until now, she has always had her way, pretty much no matter what.”

Carol quickly interjected “What do you mean one-sided?! Maddy is a very generous and caring person, and she would never take advantage like that!”

“Well Carol, she herself gave us many examples of just that behaviour – and the Halloween Dance was a major example. Drew came to your place dressed as Dracula, because he didn't want to go as a girl. And because Maddy had a tantrum about it, you essentially guilted him into dressing and going as Buffy, did you not?”

“Umm…errr…..well, I might have. Maddy told me they had all agreed to it, and then Drew showed up as Dracula. She said she wouldn't go unless Drew changed.”

“So, if Drew came as Dracula, then it would appear that not everyone agreed to it, did they Carol?”

“Well, no, I guess not”

“That is the behaviour I am talking about. From what everyone has told me, Drew will do anything virtually to please others. Which is an issue we will have to begin dealing with, with him. But, I am discussing this with you now, because Maddy has come to the realization that what she has been doing is not healthy for Drew, and certainly not healthy for a long term relationship for the two of them. What I am asking you to do in Maddy's case is to be aware of the behaviour and stop it when you see it. It will certainly help out Maddy in the future, as well as helping out Drew now.”

“So that explains it” said Dave. “I knew he had gone out as a boy, and saw him come back as a girl, but we never discussed it further. He said I didn't want to know. Well then, the interview without us there may be very important then. We may learn a few things we didn't want to know too, but if it will help solve all of this…….”

Jenny was getting angry hearing about how Drew had been manipulated into being Gaby. “How dare Maddy do that to my child!” she thought. “And Carol joined in on it too!”

“Oh God, Dave. We've done it to him too! Germany, Paris, the papers, the team…..we've never come out and supported Drew being Drew! And I bloody started it with the costume race, where ‘Gaby” got her name.” Tears came to Jenny's eyes as she thought about it. They had put their needs and wants ahead of Drew's.

“Jenny, Dave, we can and will talk about that later, and will begin dealing with that with Drew tomorrow as well.”

“Carol, I mentioned that there were a couple of epiphanies for Maddy today. Through the course of our discussion with her today, it has forced her to confront her own feelings and recognize what she is looking for in life. And in a partner. And Drew would be perfect, if he were a girl.”

At that statement, all three of them bolted upright in their chairs and looked at Maggie.

“So you're telling us that my daughter is gay then are you?” questioned Carol.

“I'm not telling you anything Carol – she told us. And I am quite certain she will tell you. I wanted you to be aware, so it does not come as a great shock when she tells you. She is at the stage of development where she absolutely needs the love and support of her family. And how you react to her news will have an indelible impression on her. Dr. Page is with her now talking about things. Would you like to go and talk to her with Dr. Page?” queried Maggie.

“Of course I would. She needs her mum right now. Poor lamb. It's a lot to try and deal with at any time, let alone when your best friend is in hospital.”

Maggie called in a nurse, and asked her to take Carol to Dr. Page on conference room 3. Once Carol had left, Maggie turned back to Jenny and Dave.

“I've been over the notes sent by your doctors in England, which is why I ordered a rather large number of tests. And it appears we will have to do a few more. What we have found so far will require some more investigation. I'm sure that his doctors at home told you he had a pretty much non-existent testosterone level? And that being the case the natural estrogens would begin to shape his body like a girl?”

Yes, they did – I was with Drew when he was told” commented Dave.

“Well, there is more to it than that, I believe. Potentially much more. I ran the same blood work plus a few additional tests, and they pointed in one or two specific directions. Either an Intersex issue; or an Androgen Insensitivity issue. In either case, it will affect Drew's immediate future. Because of that I ordered an abdominal MRI. The MRI shows what appear to be underdeveloped female reproductive structures. Now I believe we need to do further investigation with a much more detailed MRI of the area, looking for evidence of a vaginal canal or surgical scarring.”

“The radiologist doing the MRI told me if she didn't know better, she would have thought they were scanning a female if she was just looking at the bone structure. And Drew's dihydrotestosterone levels were in the normal range, but his serum testosterone levels were very low. I want to run an androgen receptor study to see if Drew is androgen insensitive. If so, then it will be imperative for Karen to talk to him. Gender issues are quite complicated in situations like this. If Drew is completely androgen insensitive, he will develop as a female, and giving him testosterone shots would actually be quite harmful. He will not ‘fill out' like a man, and would never be able to father children, if his genitals worked in that manner anyways. Which they may not. If he is partially androgen insensitive, the physical symptoms can vary quite a bit. I am still waiting on the basic genetic karyotyping at this point, so I am not 100 percent sure of anything yet.”

“I am leaning towards an intersex condition, because of the MRI. If what I suspect is correct then we may not have a boy here at all. In a case like I am describing, t he person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This usually is the result of a female fetus having been exposed to excess male hormones before birth. The labia fuse, and the clitoris enlarges to appear like a penis. Usually this person has a normal uterus and Fallopian tubes. This condition is also called 46, XX with virilization . It used to be called female pseudohermaphroditism. There are several possible causes:”

“ Congenital adrenal hyperplasia  which is the most common cause.”

“Male hormones (such as testosterone) taken or encountered by the mother during pregnancy.”

“Male hormone-producing tumors in the mother. These are most often ovarian tumors . Mothers who have children with 46, XX intersex should be checked unless there is another clear cause. In your case Jenny, I would like you to get your doctors to forward the report here so we can see.”

“Aromatase deficiency. This one may not be noticeable until puberty.  Aromatase is an enzyme that normally converts male hormones to female hormones. Too much aromatase activity can lead to excess estrogen (female hormone); too little to 46, XX intersex. At puberty these XX children, who had been raised as girls, may begin to take on male characteristics.”

“I know this is a lot to take in right now, but before I go and see Drew I wanted to let you know what we have found so far, and what we still have to look for. I am amazed from what everyone has told me about Drew that he has coped this well this long. And become Jr. National Champion and seems well on the way to the Olympics at some point.”

Dave and Jenny were absolutely gobsmacked by what Maggie had told them.

“Ummm…..this is so much to try and absorb, Maggie. Dave and I had never even thought along those lines. We just thought he might be one of those boys who enjoyed dressing up. I think we, well certainly I, understand why you and Dr. Page want to talk to Drew alone first to see what kind of answers he gives. And I now certainly understand the reason for all of his medical reports and the tests you have been running. This puts a whole new complexion on things. And we want to thank you for discussing this part of Drew's condition with us in private.”

“Well Jenny, Dave, this has ballooned into a very complex issue from a ‘simple', and I use that term loosely, teen breakdown. No health crisis is ever simple, but this one is going to take some real sorting. After I get the basic genetics back, Karen and I will sit down with you two and go over what we think is happening, and what we believe to be the best course of treatment. We can decide then how much of it we will share with Drew at this time, and how much we will wait to explain.”

“When I go to see Drew tonight, if you have no objection, I will explain that you two will be coming as soon as you can get clearance from the doctors to travel, Jenny. That way he will know his family is coming and will worry less. Also, I will keep him here for a few days until we know he is on stable ground again. Karen has already told me she has a few days to be here and help.”

Dave and Jenny looked at each other and then Dave replied “ That will be fine Maggie. Jenny and I need to go and get some rest and talk about this ourselves, and how we can deal with whatever happens out of this.”

Just then there was a knock on the door and Karen poked her head in. “Ah, Maggie, how are you and Mr. and Mrs. Bond doing? I have wrapped up with Maddy and Carol for the evening – we'll meet again tomorrow – and I thought everyone could use a break.”

“We're just wrapping up Karen. Please come in and meet the Bonds. And if Maddy and Carol are there, please ask them to come in as well.”

Karen and the Peters' walked in. Maddy ran over to Jenny and Dave and gave them both a hug and was trying to apologize for what happened to Drew. “It's okay Maddy…we know you would never knowingly hurt Drew. Said Jenny. “Now it's a matter of getting Drew better and home”. Dr. Page then introduced herself and she and the Peters' sat down.

“Well I think that you and Dave and Jules, and Carol and Maddy are probably beat and could use a rest. Why don't all of you go and have supper and have a good night's rest and we'll convene here in my office at 9 am tomorrow? I will go and sit with Drew until he wakes up, and will make sure he's looked after until you can see him tomorrow.”

Everyone agreed this was a good idea, so they all headed to Drew's ward. Maggie asked them to hang back when they were nearing the room, in case Drew was already awake. When she got to the room, she saw Drew was still sleeping, and motioned Jules to come out.

“Has he woken at all Jules?”

“Not yet Dr. Maggie, but he started to stir a little bit about a quarter of an hour ago.”

“Ah, good. He should be coming around soon. Why don't you go with your mum and dad. I'll be here with him when he wakes up – he's met me before, so he shouldn't be frightened. You and your parents can get some rest and we'll meet again in the morning.”

Jules looked wistfully at Drew. She didn't want to leave him, but she was hungry and tired, and she hadn't seen mum and dad in 5 weeks. “All right Dr. Maggie. You take good care of him, please?”

“Of course Jules. Now, off you go.”

Kate Hart 06.09.06 © 2006
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