After serving more than twenty years in a maximum security New York state prison for a murder he did not commit, David Ranta walked free on Friday. “To say that I’m sorry for what you have endured will be an understatement and grossly inadequate, but I say it to you anyway,” said State Supreme Court Justice Miriam Cyrulnik. “Sir, you are a free man.”

Ranta did not win an appeal. He was not freed as a result of DNA testing or work by an innocence project. Rather, his exoneration was overseen by the Kings County District Attorney’s Office in Brooklyn—the very same office that vigorously prosecuted him and put him behind bars in 1991.

In 2011 District Attorney Charles Hynes established a special unit within his office to evaluate claims of innocence from people his office had prosecuted. This unit was also tasked with implementing reforms to prevent such mistakes going forward. Hynes’s is the newest of about a half-dozen of these “conviction integrity units,” the largest and most established of which are in Dallas, Manhattan, and Santa Clara, California.

This is an outside-the-box idea. The U.S. criminal justice system is adversarial, set up to pit prosecutors against defense attorneys. For centuries it has been defense attorneys—and organizations where they work, such as innocence projects—that have fought prosecutors to win their clients’ freedom. Now prosecutors are acting on both sides of the system: locking people up, and then, if there has been an error, letting those same people out.

In some ways, this is nothing new. “Even before anyone had the idea of a conviction integrity unit—if you get a bona fide claim of innocence or newly discovered evidence, there’s a whole set of rules that have been around for a long time,” says Nancy Hoppock, executive director of NYU’s Center on the Administration of Criminal Law, which runs the Conviction Integrity Project. “We’d all lose our license if we didn’t bring forward that newly discovered evidence.” A good prosecutor is an ethical prosecutor—committed to doing justice, not just to winning convictions—and as new evidence arises, prosecutors are legally and ethically obligated to vacate convictions of the innocent. Still, Hoppock concedes, “Laziness and inefficiency and messiness” often prevent overworked prosecutors from pursuing innocence claims or investigating new evidence.

When prosecutors do pursue innocence claims, the exonerations happen quietly, without press or fanfare. “Most lawyers and law enforcement professionals have no interest in drawing attention to the tragic errors in their own line of work, even though they may do what they can to correct them,” says University of Michigan Law Professor Samuel Gross. “What’s the value of having a conviction integrity unit? Doing it more systematically. And doing it publicly. If prosecutors themselves start owning up to the issue, they would be more effective at preventing cases and more effective at catching them.”

These units typically have a dual role. On the “front end,” they work with prosecutors and police to prevent wrongful convictions. This could mean offering specialized training in wrongful convictions; working with the police to institute best practices, such as double-blind sequential lineups, which have been shown to reduce eyewitness misidentification; or requiring prosecutors to use a series of checklists throughout the investigation process. As Manhattan District Attorney Cyrus Vance described it in a 2011 speech, these checklists help “anticipate those issues that might lead to wrongful convictions, while strengthening those cases that are brought to trial.”

On the “back end,” the units review claims of innocence from defendants convicted by their office. Credible claims are re-investigated and, if they are compelling, the district attorney attempts to secure exonerations.

The idea of a dedicated conviction integrity unit originates with Dallas District Attorney Craig Watkins, who in 2007 won an upset victory for the post after campaigning as a “different kind of prosecutor.” “I lock them up if they’re guilty,” he told the New York Times after he took office.

Watkins was setting himself apart from what he has called a “convict at all costs” mentality among his predecessors, who oversaw convictions of at least a dozen innocent people and then threw up every possible legal roadblock to prevent the prisoners airing their claims of innocence. “Dallas County fell in line with most prosecuting authorities that viewed claims of actual innocence . . . with skepticism, cynicism, and, sometimes, open disdain,” writes Mike Ware, an attorney with Watkins’s office, in a recent legal journal article about his experiences. “Even now, more than twenty years after the first DNA exoneration . . . prosecutors routinely argue, often successfully, that a convicted defendant, even if innocent, does not have the legal right to conclusively prove his or her innocence.”

Previous Dallas district attorneys treated these exonerations as embarrassments and aberrations, to be downplayed and ignored. Watkins took a different tack, committing to learning from past mistakes, applying these lessons to his practice going forward, and actively seeking out injustices to right. He convinced county officials to provide $450,000 for a new program and hired two lawyers, an investigator, and a paralegal to re-investigate credible claims of innocence. The conviction integrity unit, which has in five years overseen more than twenty exonerations, has made Watkins into something of a celebrity. He’s been profiled in several national newspapers and was even the star of a six-part Discovery Channel series called Dallas DNA.

All of which provides fodder for criticism of both Watkins and conviction integrity units more generally: that they are largely publicity stunts, hobbled by conflicts of interest and motivated by politics.

“One of the things that is most peculiar about the American system of criminal justice is that prosecutors are elected political officials whose position depends not on their performance within a professional organization but on their ability to get people to vote for them in November,” says Gross. “Are we shocked to find out an elected official is acting like a politician?”

As exonerations stack up—there have been more than a thousand since 1989, according to the National Registry of Exonerations, which Gross runs—so does public awareness of systemic flaws that lead to wrongful convictions. So for district attorneys, attempts to publicly “fix the system” are good politics.

Prosecutors know this. A group of them from around the country wrote an 82-page report [PDF] on best practices for setting up these units, and the rationale for doing so: “As more individuals are exonerated for crimes that they did not commit . . . the public—which includes jurors, witnesses, and judges—will begin to lose confidence in prosecutors and view them as responsible,” the report says. “To combat this misperception, prosecutors . . . can take affirmative steps to safeguard and improve the integrity of their cases, thereby shaping the narrative on wrongful convictions.”

In addition to serving as political vehicles, conviction integrity units present possible conflicts of interest. Watkins and Vance are new to their jobs, so they are investigating the mistakes of their predecessors. But what if those predecessors are friends and confidants? And what happens when, inevitably, a prosecutor is called upon to investigate himself?

This is the uncomfortable position that Hynes finds himself in. Hynes was elected as Kings County district attorney in 1989 and made the conviction of David Ranta a centerpiece of his first term. The prosecution’s case against Ranta, for the 1990 murder of a prominent Hasidic rabbi and Holocaust survivor, was riddled with holes, misconduct, and errors. A detective coached witnesses to lie and took prisoners out of jail to eat at restaurants. Hynes personally gave a drastically reduced sentence to an armed robber turned jailhouse snitch who claimed Ranta had committed the murder.

And now that Ranta’s is one of the first exonerations of Hynes’s conviction integrity unit, Hynes seems to be occupying that tense middle ground of doing the right thing while trying to save face. The New York Times reports that John O’Mara, who oversees the Brooklyn conviction integrity unit, “offered no regrets, noting that he was not involved in the original case. And he suggested, without offering evidence, that Mr. Ranta still might have committed the crime.”

In a recent piece for this magazine, I wrote about the North Carolina Innocence Inquiry Commission, an independent state agency that evaluates claims of innocence. The Commission avoids the pitfalls of politics and conflicts of interest by remaining a neutral party with no stake in any of the cases they investigate—except to find the truth. Organizations such as this one, and innocence projects, are essential thorns in the side of a system that’s not working.

But conviction integrity units can at least ensure that the system begins to work better. Despite its flaws, it’s the system we have. “Prosecutors and police are the work horses of the criminal justice system,” says Gross. “They see all of the cases, they are more likely than anybody to run across new evidence that a defendant is innocent, and they probably get more requests for help from wrongfully convicted defendants than everybody else in the country combined.” Thus prosecutors are in a better position than anyone to reopen cases—and to prevent wrongful convictions from happening in the first place.

So “is there a conflict of interest?” Gross asks. “Sure. Will that impact investigations of cases? It may very well. I still think it’s a very good idea.” Ranta must have thought so too, on his first night of freedom in over two decades.

The call came into the Prichard Police Department at 11:20 on Monday morning. It was March 2, 1992. Captain Frank Dees arrived at the modest bungalow a few minutes later to find a woman lying on her bedroom floor, propped up on a pile of clothes, bleeding from the head. Some couches in the living room had been overturned, which seemed suspicious, but the woman’s neighbor said that’s how she did her cleaning, so Dees let it go.

The house was situated on a dead end just off the interstate in this suburb of Mobile, Alabama. To call it a cul-de-sac was probably too grand, but it did have a grassy median around which the houses were arranged in a horseshoe shape, close enough that you could have a conversation from one porch to the next without having to shout. Dees stayed about twenty minutes, until the paramedics arrived. He found out the woman’s name—Valerie Finley—and a few other details: she was 29 years old. She lived here with her husband, Mike, and their two young daughters. Dees reported to the station that it was some sort of home accident—Valerie seemed to have fallen and hit her head—and left.

Three years later Mike’s best friend, Rodney Stanberry, was on trial for shooting Valerie. From the witness stand, the Finleys’ neighbor Tyrone Dortch recalled the morning when Valerie was shot. Around 9:00 am, Dortch said, he had pulled his car into the median to have his mechanic friend take a look at it. He had been under the hood for about two hours when two black men came running out of the Finleys’ house with what looked like a green Army sack.

Dortch watched them. There were some projects nearby, where he would hang out from time to time, and he thought he recognized one of the men from there. Kind of tall, brown-skinned, low haircut. Dortch saw them throw the bag into a faded gray Mercury Caprice parked in the Finleys’ driveway, get into the car, and back out in a hurry. They almost hit his car pulling out.

He would certainly have recognized Stanberry, Dortch told the jury, since Mike had introduced them several times. No, Stanberry wasn’t one of them; Dortch was absolutely positive of that. Of the two men, there was one he had never seen before, and one he had. “And what did you call that person?” asked Ken Nixon, Stanberry’s attorney.

“Oh, I never did really know his name,” Dortch said. “I just knew his face.”

“Have you seen him since then?” Nixon asked.

“Yes, sir.”

“When?”

“In nightclubs,” Dortch answered, “outside court right now.”

Nixon stopped, surprised. “Sir?”

“He’s outside the courtroom now.”

• • •

The man Dortch recognized, Terrell Moore, was never charged with the crime. Instead, Rodney Stanberry was convicted of attempted murder, first-degree robbery, and burglary and sentenced to twenty years in prison. He was 23 years old.

There was one compelling piece of evidence to support Stanberry’s conviction, and that was Valerie Finley, who survived the shooting but not much longer. Her story was sad enough to make you cry and detailed enough to make you believe. She swore to the jury, and felt in her heart until the day she died, that Stanberry broke into her house and stole her husband’s guns, while his childhood friend Rene Whitecloud shot her in the head and left her to die.

But every piece of objective information besides Valerie’s testimony supported Stanberry’s claim that he was an innocent man. He showed the jury route reports from his job as a garbage truck operator—time-stamped and signed by several other people—that accounted for where he was, almost down to the minute, on the morning of the crime. He told a plausible story about what really happened, and the testimony of more than a half-dozen people supported that story.

Stanberry has been behind bars for more than seventeen years. With no DNA to analyze, and an appeals process that values proper procedure over the facts of the case, there is no way for Stanberry to prove his innocence.

Prichard is one of those places outsiders say they don’t like to walk around at night. Poor and predominantly black, the town is known for high rates of crime and a police force that can’t keep up. Snobby folks from Mobile, such as the circuit judge who presided over Stanberry’s trial, make jokes about it. When an African American wearing strong cologne appeared in his courtroom, the judge would sniff the air and say, “Ahhh, evening in Prichard.” Still, it’s hardly the inner city: modest one-family bungalows on small grassy lots predominate, and if there is more peeling paint here than elsewhere, more crooked porches, there’s a sense of community too. The lack of sidewalks or curbs, coupled with a lush overgrowth that the Southern humidity coaxes up every unattended streetlight, makes Prichard’s residential streets feel like country back roads.

Rodney Stanberry’s family moved here when he was a teenager. The Bronx, New York, neighborhood where they had lived until then was overrun with drugs and gangs, and Rodney’s parents feared that if they stayed much longer their son and his younger sister would get themselves into trouble. So when Rodney’s dad retired, he made good on the promise he’d been making for years: to move his family down to his native Alabama.

This was the country: pickup trucks outfitted with gun racks threw dust up the roads, and hunting and fishing were state pastimes. Unlike his sister, who never quite felt at home in the country, Rodney thrived there. He took up hunting and gun collecting and started calling himself a “black redneck.” He left high school one semester shy of graduation—he got suspended for cutting school with a girlfriend and missed finals—but he got a good job driving a garbage truck for the waste management company BFI. He lived at home with his parents, saved money, and studied for his Commercial Driver License exam.

During hunting season, Rodney spent almost every weekend fishing, hunting, and target shooting with Mike Finley, a technician at a local manufacturer. They tracked squirrels, rabbits, and deer with guns or bows and arrows. They went to gun shows together, had almost identical gun collections, and shared equipment. Rodney often brought a girlfriend to the Finleys’ house or out fishing with them. “Mike and Valerie influenced me so much,” Rodney says. “Mike was dedicated to his wife. He was a good father. He was one of those, ‘yes dear,’ types. ‘Yes honey.’ It was cute.” Rodney wanted what his friends had. “I wanted to get married, I wanted to have kids, to have a wife,” he says.

But not yet. In his early twenties, Rodney was still a notorious ladies’ man. His charm and easy way with people—not to mention his confidence, bordering on cockiness—allowed him to get away with juggling multiple girlfriends at once. In Prichard there were Tracy and Deanna, on again and off again. Each traded swipes at the other in public, but they tolerated it just the same. Rodney drove a brown Ford Bronco that had “One Night Stand” (a play on his nickname, Stan), stenciled in white script on the front windshield, with “Bumping and Grinding” in matching letters on the back.

In the year before his family moved to Alabama, when Rodney was seventeen, his then-girlfriend Julia gave birth to their son, David. The teenagers’ relationship remained tumultuous for years after Rodney left New York, but he hatched a long-shot plan, he says.

One afternoon in early 1992, six years after he had left New York, Rodney invited Julia down from the Bronx for a visit. Once she saw all the good jobs and the low cost of living in Mobile, Rodney thought, she might bring David—then five—down to stay. Julia was on a pay phone, and when their childhood friend Rene (pronounced “Rennie”) walked by, he offered to join her. Mardi Gras was coming up the following week, and Rodney promised to take them to parties and parades.

In the days that followed, the plans changed. Rodney found out he had to work and would only have a few hours each afternoon to spend with Rene and Julia. Then Julia found out she couldn’t take time off on such short notice, so she couldn’t come after all. Rene said he’d still come, along with another friend. But who that friend was kept changing.

Everyone told Rodney to cancel. He and Tracy got in a big fight about it. His dad told him, “Leave New York in New York.” But Rene was always a straight-and-narrow type of kid—he was one of Rodney’s few childhood friends who had a straight job, driving a truck for Coca-Cola—so Rodney figured everyone’s fears were overblown. Besides, they had already made the plans and he didn’t want to hurt Rene’s feelings. Since he had to work, Rodney arranged for a local friend, Taco, to introduce Rene to girls and show him around. And since Taco had no car, he, in turn, asked his friend Terrell to join them too. Rene agreed to pay Terrell $150 to drive them around in his Mercury Caprice.

On Tuesday, February 25, Rodney clocked out of work and went to the Red Carpet Inn to welcome Rene, whose bus arrived that day. “I walked into the hotel room and boom,” Rodney says. “There was Angel.”

Angel Melendez—everyone called him Wish—was Julia’s brother, and he shared her fiery temper. Rodney imagined the crowded and raucous Mardi Gras parades and was already regretting that he hadn’t listened to his dad. “If someone steps on his foot, I ain’t going to be able to control him,” Rodney thought. “He can go Jekyll and Hyde in a minute.”

But Rene and Wish had come, and Rodney would try to keep them entertained, in spite of his misgivings. He decided to show them the eight-point buck he had recently shot, waiting in the Finleys’ deep freezer for a trip to the taxidermist. He brought his friends by the Finleys’, and when they met Mike, the conversation quickly turned to guns. Rene and Wish asked Mike to sell them some.

Mike considered it. The Finleys were always tight for cash, and Valerie did often say she wanted the guns out of her house. How much could they pay if he would sell them?

“Put it out of your mind,” Rodney interrupted. “No.”

Later that night, Rodney called Mike. His friends had changed since he last saw them, he said. Hard characters now, into the thug life, they were barely recognizable anymore. Please don’t sell them any guns, Rodney said. Nothing good could come of it.

But Mike didn’t heed Rodney’s advice. Instead he arranged for Rene and Wish to meet a gun dealer. On Thursday after work, Rodney sat frustrated in his Bronco in a Dairy Queen parking lot and watched as Rene paid cash for a Glock nine millimeter, a .25, and a .380.

Excited to use the guns they had bought, Rene and Wish asked Rodney to take them target shooting. So Rodney arranged a Saturday trip to a friend’s property in the country, and when they stopped by Mike’s house to pick up some targets, Mike and Valerie decided to come along. In an effort to keep a low profile, Rodney says, he brought just a single gun, but Mike showed up with more than a dozen, practically his whole collection, including an AK-47 and a TEC-9. Rene and Wish again asked to buy Mike’s guns, but this time he said no. Rodney got into a fight with the pair on the car ride home when he refused to take them to a gun show. They decided to leave on Monday, a day earlier than planned. Rodney was anxious to see them go.

• • •

According to his daily report for that Monday morning, March 2, 1992, Rodney began his route at 2:59 am. He drove a commercial front-loader, one of those giant trucks with a fork to pick up dumpsters. His last stop was at 8:43 am, and then he returned to the BFI headquarters at 9:05 am to have a flat fixed and his brakes adjusted. While he waited, he called Rene and Wish to say goodbye. He had to get to the courthouse by 1:00 pm to apply for his Commercial Driver License, he told them, so he wouldn’t have time to stop by in person. The mechanic logged him out at 9:32 am, and then Rodney drove about an hour up I-65 to the landfill in Chastang. His landfill ticket was stamped at 10:40 am and signed by the administrator there.

After returning the truck to BFI headquarters, Rodney stopped by his parents’ house to pick up his Social Security card. When he arrived there, his sister told him that Taco—the friend he’d asked to show Rene and Wish around—was on the phone. He’d been calling nonstop all morning.

There was no preamble. “Your friends broke in Mike’s house and stole his guns,” Taco said.

Just then, the phone beeped. Mike was on the other line saying he had gotten a call from his sister-in-law that someone had broken into his house. Rodney cut him off. “I already know what happened,” he said.

“But I didn’t,” he says now, his voice heavy with regret and frustration. “I thought it was a robbery. First thing I wanted to do was get my friend’s guns back. I’m thinking, I’m going to have to pay for his door they kicked in.”

Rodney hung up and went to find Rene and Wish at the bus station, where Taco said they would be. “I’m sorry,” Rene kept repeating. He told Rodney the guns were stashed behind Terrell’s girlfriend’s house in nearby Crichton.

Rodney picked up the guns and brought them back to Mike’s house, thinking the incident was more or less settled. But one of the neighbors told him about Valerie. He drove to the hospital, the guns still in the car. When he arrived, Mike warned him: don’t go in there; Valerie’s brother has a gun on him and I told them it was your friends that did it.

Now Rodney was stuck. This wasn’t a simple robbery anymore. It was a potential homicide, and if he gave the guns to the police, he would be a prime suspect.

So Rodney brought the guns to a field and ditched them there, a decision that would eventually prove costly at his trial. But at the time it seemed like his best option. He called Mike to tell him where the guns were, said that’s where Rene and Wish had left them. Rodney bought a tape recorder and started calling Taco, recording their phone conversations in order to capture Taco explaining what had happened, which he eventually did.

And Rodney threw himself into trying to help the police capture Rene and Wish. He took a day off to go to the Prichard Police Department to provide them with names, dates, information, photographs. He called the police in New York State to ask them for help in locating the men. One detective did ultimately find Rene and take a sworn statement from him, which corroborated Rodney’s story. But the Prichard cops told the New York cops to back off. In fact, instead of working with Rodney, the Prichard police started to think he was being a little too helpful.

“To continuously come tell you about this person, that person, you know,” one of the detectives testified at Rodney’s trial, “anyone that comes and keep pouring on information all the time, it has to be a suspect in your mind.”

The police arrived in Valerie’s hospital room shortly after she awoke from a coma. “She was very heavily medicated,” her sister Brenda Gay testified at trial. “When they came over there the nurses was just getting her out of bed and putting her in a chair, but she wasn’t used to even sitting up and she was in a lot of pain and she couldn’t hardly talk.”

But Valerie could point and nod, and she held her sister’s hand as two detectives—a man and a woman—asked her questions.

“Okay, Valerie,” the man said. “Do you remember what happened, on March 2, in your home?”

The conversation was recorded to a cassette tape, and though Valerie couldn’t say much, it is easy to infer from the way the detectives phrased their questions that she was shaking her head no. “You don’t really remember what happened?” the man asked.

“Think about it,” the woman prodded. “Can you tell them anything that happened dear?” she asked, probably referring to Brenda and the other detective.

The man tried again. “You can’t tell us anything about what happened, on March 2 in your house?”

The woman turned to Brenda. “Did she know who hurt her?”

“She told me she didn’t know,” Brenda said.

• • •

Valerie Finley was the youngest of nine kids from a tight-knit family. “We welcomed any and everybody into our family,” says her sister Jo Ann Young. But they never were fond of Valerie’s husband; they thought Mike was a cheapskate, and they hated that he kept all those guns in the house. Jo Ann recalls a fight she once had with Valerie while they were sitting in the car in the driveway. It was a typical sister spat—Jo Ann can’t remember what about—which ended when Mike emerged from the house shooting into the air. “I said, from that point on, I’m finished with him.”

Jo Ann was at the University of South Alabama hospital when Valerie was wheeled into surgery, and from almost the moment she arrived, it became clear she had not hit her head, as the police had said. For one thing, there was a bullet-shaped hole in her skull. Then the neurosurgeon found metal fragments in her brain. That afternoon Mike confirmed that she had been shot during a botched robbery. Mike knew who had done it, he said. Friends of Rodney’s, some guys from New York, had come to clean out his gun cabinet.

Rodney came to the hospital with his girlfriend, but they stayed out in the hall—never came in the room, never said hello or gave their regards to any of Valerie’s family. As Valerie went into surgery, “Mike was running around, running around, running around, trying to get in touch with these people,” Jo Ann says, referring to Wish and Rene. “There were papers that had to be signed because she was so critical. And he couldn’t stand still.”

Days went by, and Valerie’s family’s suspicions grew. On Tuesday, Mike came to the hospital wearing a watch and two rings that had been stolen during the break-in. “And I said, ‘Mike, I thought they stole your watch,’” Jo Ann recalls. “And he said, ‘yeah, but this man called me and told me where to go pick it up.’” It wasn’t just the jewelry, either; he had gotten all his guns back. “Living in Prichard, if somebody’s got that many guns, you know how fast they can sell those guns on the street?” Jo Ann asks. “If somebody steals your wallet, do you honestly believe in anywhere U.S.A. that you would get your wallet back? Your ring, your wallet, and twenty guns?”

It took the police two days to declare the incident an assault, so it wasn’t until Wednesday that an officer finally went to the house to collect evidence. By then, Mike had already mopped, cleaned up, and put the furniture away. “Instead of being with his wife at the hospital,” Jo Ann says, “he was home cleaning up all the evidence that was in the house.” The cop didn’t find any fingerprints. He didn’t ask to see the guns.

The family began to whisper among themselves that Mike had something to do with this. They traded suspicions around Valerie’s hospital bed. Look at him, they said. Look at the way he’s walking around. His story about these guys from New York just doesn’t add up. Where are they? And how was he able to get the guns back so quickly? “I said,Lord, please,” Jo Ann says, thinking back. “I can tell you just like it was yesterday. Lord, please. Let him have nothing to do with this. Even though I didn’t particularly care for him. That was my prayer.”

• • •

It was Rodney’s photographs that detectives brought to Valerie’s hospital room that day when she was first sitting up. Taken about five years earlier, during Rodney’s last visit to the Bronx, there was one of Rodney and Wish, and one of Rodney, Rene, and another friend. Rodney had provided them to the Prichard Police in his efforts to help them.

“Okay,” the detective said during that same tape-recorded conversation when Valerie indicates that she doesn’t know who had shot her. “If I were to show you some pictures is it any way possible you may could tell, shake, nod your head, and tell, say if you know, saw those faces before?” Valerie must have nodded. “You can?”

Responding to the detectives’ questions, Valerie “communicates that yes, she recognizes those people,” says Nancy Steblay, a psychologist at Augsburg College who specializes in eyewitness identification and reviewed Valerie’s testimony at my request. “We don’t know why she recognizes these people. We don’t know if she’s just acknowledging that these people could have been in her house. These are guys she knows.”

The detective pulled the pictures out and asked her another question. “Okay, on these pictures, do you see anybody in here that you know possibly came in your house on March 2? You do?”

It’s not entirely clear how Valerie responded to their questions. She may have squeezed her sister’s hand. She may have nodded or pointed. But the tape ends with a question: “Was it that one?” the detective asked. “Okay, take a good look at it now. Take your time. That one?”

Lineup procedures such as the one used in Valerie’s hospital room are notoriously inaccurate. Three quarters of the wrongful convictions so far overturned through DNA testing involved mistaken eyewitness identifications. Over the years scientists have developed many safeguards to compensate for the ways we know eyewitnesses’ memories consistently fail. The police used none of these safeguards with Valerie.

One safeguard is the use of “fillers”: people who fit the description of the suspect but who are known to be innocent. A witness who picks a filler “is guessing, and can’t be trusted,” Steblay says. Because it’s common for a witness to feel compelled to choosesomeone, even if she isn’t sure, she should also be told that the perpetrator may not be in the lineup. In addition, the officer conducting the lineup should not know which person is the suspect. “It’s not intentional, but it’s so natural for the lineup administrator, if you pick the person they had in mind, to smile, react, to reinforce,” says Gary Wells, a psychologist who pioneered research into eyewitness memory.

That day in Valerie’s hospital room, the police were “essentially saying, ‘tell me if these people are involved. Could these people have been in your house?’ That’s a very suggestive procedure,” Steblay says. By their questions alone, “the police are suggesting that these are the people involved.” What’s more, “She can’t make a wrong pick,” Steblay says. With no fillers, “no matter who she picked from those pictures, that was going to be their suspect.”

The mounting evidence about mistaken eyewitness identification doesn’t trouble Buzz Jordan, the man who prosecuted Rodney, because, he argues, these errors occur when a victim doesn’t know the suspect. “That doesn’t apply in this case,” he told me. “If you get robbed by a stranger, you’re going to have difficulty identifying me. That’s problematic. She knew Rodney Stanberry. So that’s not even a legitimate argument in this type of case.”

But research is full of examples of “unconscious transference,” a phenomenon in which a witness “incorrectly attributes a face’s familiarity to the wrong source because he unconsciously transfers memory of the individual from one context to another,” psychologist Daniel Schacter writes in his book The Seven Sins of Memory. Since she had met both Rene and Wish, “she’s looking at pictures in which she’s seeing three familiar faces, essentially. And now she’s trying to put these faces into the context of that crime,” says Steblay. “The police are basically giving her the faces. ‘Here’s who we think might have been in your house.’ Now she just has to put it together. Who did what?”

Do you remember getting lost in the mall as a child? You were about five. Maybe you wandered off to look at a toy store. You panicked and cried until a kindly older person helped you to find your parents. You don’t remember? That’s because it never happened. But in a seminal 1991 study, experimental psychologist Elizabeth Loftus prompted five of her 24 subjects to remember a scene like this in detail: the bright red letters spelling Kay-Bee, the elderly man’s blue flannel shirt as he guided them back to their parents. Even after they were told that the event had not happened, several study participants continued to “remember” it. Researchers have successfully coached research subjects to remember spilling a bowl of punch on the parents of the bride at a wedding, staying overnight at a hospital for a high fever and a possible ear infection, and other events that did not happen.

In the course of her work, Loftus discovered that false memories usually develop according to a “recipe,” as she calls it.

First, the person must believe the event is plausible. A suggestion by someone she trusts is often all it takes to foster that belief. Next, the person must come to believe she personally experienced the event. “Plying the person with false feedback is a particularly effective way to accomplish this,” Loftus writes in the journal American Psychologist. “With guided imagination, with visualization of the stories of others, and with suggestive feedback and other sorts of manipulations, a rich false memory can develop.”

All of these elements were present in Valerie Finley’s hospital room.

From the moment she recognized Rodney in the photographs, “it sounds like there’s a lot of conversations around her about what’s going on. People in her hospital room constantly,” Steblay says. The family’s suspicions about Mike, Rodney’s unusual behavior at the hospital, and Rodney’s friends from New York were all topics of bedside conversation, speculation, and anger. “I suspect they’re talking about this and they’re having these conversations, and she’s struggling to put together a narrative about what happened.”

Valerie’s eventual court testimony further suggests an attempt to bridge the gaps in her memory. She talks about things she “must have” done or often did. From the length of time she talked to her sister that morning—crucial information to pinpoint the time of the event—to exactly what she saw when she looked out the window, “it seems like she’s filling in a lot of pieces by what should’ve happened, usually happened,” Steblay explains. “She said she saw the telephone pole. Really? You looked out the window and thought, ‘there’s the telephone pole’? I think what she’s talking about is, what do youusually see when you look out the window?”

In other words, “What we think we know, what we believe with all our hearts,” as Loftus writes in her book Eyewitness Testimony, “is not necessarily the truth.”

• • •

It was October 1992, and Ryan Russell was in the Galaxy nightclub in Prichard, looking for Terrell Moore. Russell, who passed away just a few months ago, was a private investigator working for Rodney’s defense lawyer, Ken Nixon. Russell was a man of dubious ethics—even friends and colleagues remember him with choice words—but he was damn good at his job.

This part of town made Russell nervous, but he had heard Terrell would be there, and when he spotted him in a gray shirt, black tie, and baseball cap, he made his way over. Terrell told Russell he had lied to the police. He told officers that Rene and Wish had borrowed his car, that he had had no idea what they had done with it. He was on probation and didn’t want any trouble. But now, he told Russell, “I am willing to come forward and come clean.” They walked out and sat in Russell’s car and talked.

“They paid me $150 to show them around town first,” Terrell said, speaking of Rene and Wish. “I showed them around town and then that Monday that’s when they really came out to me and told me, ‘we paid you $150 really so we can make a hit and you can be our getaway.’ They told me that if I didn’t cooperate they was going to do me in and my family.”

Rene stayed behind in the hotel room with Taco, while Terrell drove Wish to the Finleys’ house in his blue-and-silver Mercury Caprice. Valerie answered the door. Wearing a mask, Wish pushed in with the nine-millimeter pistol that Mike had arranged for him to buy, and held it to Valerie’s head, demanding she tell him where Mike kept his guns. “Then she started pleading for her life,” Terrell said. “She said she had kids, she said that she was married, this and that. I walked up to her personally,” Terrell said. “I said, ‘Miss, we’re not going to hurt you,’ I said, ‘just tell him where the guns are at so we can leave.’”

The guns were in a steel cabinet, and as soon as Valerie gave the men the keys, Terrell started stuffing rifles and pistols into a pillowcase he had taken from the children’s room. “As I was walking out the back door,” he said, “I heard a shot go off. I ran inside and I found Mrs. Finley lying on the floor and I asked him why did he shoot her. She already gave him the guns. And he said that he was afraid that she might recognize his accent from Saturday when they went to the gun range.”

When they got back to the hotel, Wish reported to Rene that he had “dusted the bitch.” They asked Taco to hide the guns for them and said they would be in touch later to arrange to have them sent up to New York.

“You swear before God Almighty right now that you are telling the truth and the whole truth so help you God?” Russell asked.

“Yes, I do.”

“Are you willing to testify to what you have just told me right now on this tape?”

“Yes, I am.”

• • •

But that’s not how it happened. By the time he was subpoenaed to testify at Rodney’s grand jury trial, Terrell had gotten a lawyer. He took his lawyer’s advice and invoked his Fifth Amendment right not to incriminate himself. So Buzz Jordan, the assistant district attorney who was prosecuting the case, offered Terrell a peculiar deal: if Terrell would tell his story to Jordan, Jordan would grant Terrell immunity from prosecution for anything he said that day, in his lawyer’s office. But Jordan would not extend the immunity any farther than that.

Terrell agreed, and in the presence of his lawyer, he confessed again, told Jordan the same story he had told Russell six months earlier. Jordan dismissed all of it as “a pack of lies.” He couldn’t corroborate any of it, he said. He didn’t even know whether therewere any guys from New York. He suggests perhaps Mike Finley paid Terrell to confess. Jordan proceeded undeterred with his prosecution of Rodney.

At trial, Jordan argued that because Terrell planned to plead the Fifth again and therefore could not be cross-examined, the confession amounted to hearsay and should not be admitted.

“The whole theory of the hearsay is that the other side doesn’t have an opportunity to cross-examine the person about the statement,” Nixon says now. “And it seems ludicrous that they claimed they didn’t have the opportunity to cross-examine him when they were the only ones questioning him” during the meeting where Terrell was granted immunity.

This clearly bothered Judge Ferrill McRae, despite his reputation for coziness with prosecutors such as Jordan. “You know, I have a problem with this whole procedure,” McRae said when Nixon challenged the immunity agreement in court. “We’ve got a case called Brady, and if there was anything in the world out there to clear this man, under the Brady case there’s a duty on the district attorney…to make sure that information is brought forward.”

McRae was referring to a landmark 1963 Supreme Court case, which established that the district attorney’s office is obligated to turn over any evidence that might help prove a defendant’s innocence—even if it means losing a case. Brady reaffirmed one of the most fundamental principles of the American criminal justice system: a prosecutor’s responsibility is not to win convictions but to do justice.

Jordan could have extended the immunity agreement to cover Terrell’s trial testimony, but he chose not to. So Terrell wouldn’t take the stand, and all Nixon had was the confession. He fought hard to have it admitted.

In most states and under federal law, it probably would have been. As long as there is evidence to corroborate it, a “statement against penal interest”—a statement so clearly harmful to a person’s welfare that the only reason he would make it is if he believed it were true—is typically “a black-letter hearsay exception,” says Talitha Powers Bailey, a law professor at the University of Alabama who is not involved in Rodney’s case. And there was corroborating evidence: testimony at trial by Taco and by Tyrone Dortch, who saw two men burst out of the Finley’s house on March 2. The man he recognized, whom he later saw outside the courtroom? Terrell Moore.

But Alabama law leaves the admissibility of even this kind of exceptional, corroborated hearsay up to the discretion of the judge, and Judge McRae ruled despite his reservations that if Terrell was not available to be cross-examined—and he wasn’t, since he pled the Fifth—then the confession could not be admitted.

To this day, Jordan is untroubled by his role in convicting Rodney of a crime that another man confessed to. “The entire Terrell Moore thing was a fabrication,” Jordan says. “If you knew Valerie Finley—everybody keeps forgetting about her. She was the key to the case. She was the eyewitness.”

• • •

When it came time to testify at Rodney’s trial, Valerie was confined to a wheelchair, partially paralyzed, and living with her mother. She and Mike had divorced and were in the midst of a bitter custody dispute, which she would eventually lose. After the shooting, she had been diagnosed with breast cancer, and doctors told her that as a result of her injuries she was too weak to undergo chemotherapy. So when she sat on the witness stand and told her story, Valerie was dying. She was 31.

Here is what she said: the girls had stayed at her mother’s place the night before, so she had the house to herself. She was chatting on the phone with her sister Brenda. They often had long leisurely phone calls in the mornings after Mike left for work. When the doorbell rang, she put the phone down and went to her daughters’ room to look out the window. From there, she saw Rodney’s Bronco in the driveway. She made her way to the front door to let him in. En route, she noticed Rene—she never did know his name, she just called him “Ponytail”—on her back stoop.

When she opened the door, Rene came around to the front and pushed in after Rodney. Rene pulled a gun out of his shirt. He called her “bitch” and told her to sit down behind the sofa, against the wall. They started searching the house for the keys to the gun vault. Rodney found them and took a pillowcase from her daughter’s bed to stuff the guns into. The robbers argued about whether there was room in the truck for the microwave or other appliances. “The next thing after that I remember,” she said, “I was in [University of Southern Alabama] Hospital.”

“Just so we’re absolutely clear on this,” Jordan asked, “did anybody else come into your house on that Monday besides Stan and Ponytail?”

“I didn’t see anyone else.”

“They were the only two people?”

“Yes, sir. . . .”

“And you’re absolutely sure that Stanberry and Ponytail were the two individuals that came in your house and that assaulted you?”

“Positive.”

Jordan never explained how Rodney could have returned his truck to BFI, picked up his Bronco, driven to Prichard to shoot Valerie, then returned the Bronco, picked up his truck again, and resumed his route without anyone noticing. Instead he asked insinuating questions, such as “Mr. Stanberry, it’s true, isn’t it, that you work alone?” and “Nobody rides with you?”

During the trial, Jordan implied that Mike had orchestrated the shooting. He continually mentioned Mike’s life insurance policy, which would have paid out $35,000 in the case of Valerie’s death. Nixon asked her about it too. “You think that your husband hired somebody to kill you?” he said.

“Yes sir.”

Valerie Finley was, by all accounts, a truthful person, a gracious person, a kind woman who loved her family. She meant no one any malice. She believed every word she said.

“Valerie,” Jordan asked. “Before this happened, were you able to walk?”

“Yes.”

“Were you able to use your left arm?”

“Yes, sir.”

“And since this happened, can you use your left arm?”

“No, sir.”

“Can you walk?”

Valerie didn’t answer. The court reporter noted, simply, Witness sobs.

• • •

Rodney has twice been denied parole. All of his state appeals have been denied. His federal appeals have been denied. He appealed to the Supreme Court, but it declined to review his case. His last shot came in 2001, when he was granted a Rule 32 hearing, a last-ditch procedure that Alabama inmates can use when their other legal options have run out. Most states have a similar post-conviction remedy for convicts who have exhausted their appeals.

At the hearing, Rodney and his new lawyer Dennis Knizely argued primarily that Judge McRae erred in preventing the jury from hearing Terrell Moore’s confession. Presiding over the hearing was the very same judge—Ferrill McRae.

This is how Rule 32 hearings are typically done, so a new judge doesn’t have to learn the details of the case from scratch. But the practical effect, says lawyer Randy Susskind of the Equal Justice Initiative in Montgomery, Alabama, is that “sometimes it does feel like you’re litigating in front of somebody who has an interest in protecting the conviction.”

One of the documents Rodney brought up at the hearing was the signed statement that Rene made to a detective in New York in August of 1992, just months after Valerie was shot.

“Sometime in late February 1992, I went down to Alabama w/ Wish for the Mardi Gras,” Rene said. “While I was down there I bought a Glock 7 semi-auto,” Rene said, likely referring to the Glock 17, a popular handgun.

In the statement, Rene describes partying in the hotel room he shared with Wish and leaving his gun on a nearby desk before going to sleep. “When I woke up in the morning,” he continues, “(about 8:00 am–8:30 am) Taco was also in the room but Wish was gone. Also missing was my Glock 7. About 9:00 am–9:30 am, Wish appeared in the room w/ a friend of Taco’s . . . showing us two (2) large sacks full of several weapons (guns). . . . When I asked Wish where he got the guns he motioned a cutting gesture w/ his hand over his neck which we all understand as a signal for death.”

Ken Nixon, Rodney’s original lawyer and now a witness, evaluated the statement. “It verifies,” Nixon told the judge. “It is consistent with Mr. Stanberry’s version of what happened and the other witnesses who said Mr. Stanberry was not there.”

Jordan also took the stand, where he dismissed Rene’s statement. Even if it had been admitted at trial—hell, even if Nixon had brought Rene down from New York to Mobile to testify—it wouldn’t have changed the outcome. “I would have had a field day if Mr. Nixon would have put ‘Ponytail’ on the stand,” Jordan told the judge. “That would have just given me one more nail to put into this case. . . . With Mr. ‘Ponytail’ here, with Valerie being able to identify him, put him on the stand . . . . It would have just corroborated everything that Mrs. Finley said in my opinion.”

The judge agreed. Much of his ten-page order denying Rodney a new trial was lifted directly from Jordan’s version of events, including his assertion that “the appearance and presence of [Rene] at this trial would have backfired on the defense.”

Aside from Mike Finley, Taco Jones, Tyrone Dortch, and five of Rodney’s coworkers who testified at Rodney’s trial, there was one additional person who would not have corroborated everything that Valerie said: Terrell Moore. Hoping that Terrell would finally “come clean,” as he had promised Ryan Russell he would, Knizely called him to the stand at the hearing. Terrell seemed prepared to testify.

But Knizely had no sooner asked Terrell his name than Martha Tierney, the assistant district attorney, jumped in. “Judge, I hate to interrupt Mr. Knizely, because I have the world of respect for him,” she began, “but if Mr. Moore is going to testify about the things we anticipate he will testify about, and I’m concerned this is a state forum, and that he would take this stand unrepresented and with no grant of immunity to make statements that could have life consequences for him. I just wish that the Court be apprised of that and our concern about that, sir.”

Knizely was incredulous. “Judge, from our understanding, the State’s [position is that] the man—he has no credibility. And are they are telling us now they are going to prosecute him if he confesses to it?”

It was a good question. If the district attorney’s office truly believed, as it had maintained all along, that Rodney was guilty and Terrell was (for some inscrutable reason) lying about his involvement, then why threaten to prosecute him? To prosecute him, the state would have to believe he was guilty. It would have been almost impossible for both Terrell and Rodney to be guilty, since one story contradicted the other. And yet Tierney was simultaneously defending the verdict against Rodney and threatening to prosecute Terrell. It seemed she was trying to scare Terrell off the stand in order to preserve Rodney’s conviction. The Mobile District Attorney’s office did not respond to multiple requests for comment, submitted via email, by phone, and in person.

Tierney pressed on. “If he comes in here and says ‘it’s me pals,’ then it’s goodbye sunlight for the rest of his living life, and he’s young,” she said.

Finally, after some additional back-and-forth, Knizely was allowed to proceed. “Mr. Moore,” he began, “you recall whenever a lady named Mrs. Finley was shot? Do you remember back in those days when you were called as a witness in this case?”

Tierney interrupted again. “Judge, may I object sir, for one minute? Could you just, Your Honor, if I may respectfully ask that at least you instruct him that he does have the right under the Fifth Amendment not to make any statements.”

“I thought I just did that,” McRae said, “but I’ll do it again. Under the Fifth Amendment of the Constitution,” he told Terrell again, “you do not have to answer any question which could even possibly incriminate you. Do you understand that?”

“Yes, sir, I understand it.”

“Okay, proceed,” McRae said. But Tierney interrupted again.

“And that the State would use anything he says today, Your Honor, against him.”

“The State can and may,” the Judge said.

“Yes, Your Honor, I understand,” Terrell said, “and I plead the Fifth Amendment.”

• • •

In a small apartment on the outskirts of Durham, North Carolina lives an assistant professor of political science at North Carolina Central University, a historically black college. Her apartment is sparse and painted in shades of white, with almost no decorations on the walls and only the most basic of furniture. But books are everywhere, in small piles: on tables, stacked against the walls. The Federalist Papers, Martin Luther King’s Why We Can’t Wait, The Rise of Southern Republicans, Sue Grafton paperbacks. She also writes books. One of them is called Travesty of Justice: The Politics of Crack Cocaine and the Dilemma of the Congressional Black Caucus.

She is shy and private, and aside from her students, whom she mentors with a patient devotion, she largely keeps to herself. But Artemesia Stanberry feels driven into the wider world by what she sees as her family’s own travesty of justice: her cousin Rodney’s conviction.

Growing up, Artemesia wasn’t close with Rodney’s family. She saw them from time to time when they were visiting from New York. So it was unusual when, in her twenties, she got a call from Rodney’s father, her uncle Earsell. She was living in Washington, D.C., pursuing her PhD in Political Science at Howard University and working as a staffer on Capitol Hill. She had only heard the briefest details about Rodney’s legal trouble but figured, “If the jury convicted him, he must be guilty.”

But Earsell told her more about the case and asked her to take a look at some papers. When she sat down to read the trial transcript, she tells me, “I just cried, because I knew right away that individual has been wrongly convicted,” she says. “I was convinced almost immediately.”

She began reaching out to the NAACP and members of Congress she’d met in the course of her work. She wrote Rodney a letter and committed to helping to clear his name. She runs a Web site, freerodneystanberry.com, devoted to her cousin’s cause. She sends long emails to everyone she can think of (Innocence Projects, the Mobile County District Attorney’s Office, county commissioners, journalists and editorial boards), and has gotten zero traction. “You think, hang in there, we’re going to get this done,” she says. “Year after year after year, it doesn’t get done.”

Yet Rodney’s case might be playing out very differently if he lived near Artemesia. Not because he’d be closer to her geographically, but because she happens to live in the only state in the country with the formal means to look at post-conviction claims of innocence.

In 2006 North Carolina established the Innocence Inquiry Commission, which sidesteps the usual legal channels to look at the actual facts of whether someone might have been wrongfully convicted. North Carolina’s is the first, and, to date, only, program of its kind. Many other states have such commissions in name, but they are largely “advisory” in nature; their roles tend to be limited to issuing reports that no one reads and that have no influence on policy. Individual district attorneys have occasionally been aggressive in seeking to overturn false convictions, but the Commission, unlike a district attorney up for reelection, is a neutral player concerned only with the truth. It has to date exonerated four wrongfully convicted men.

It’s easy to see why the justice system has trouble accommodating the protests of the wrongfully convicted. “The post-conviction process in general is not really designed for innocence claims,” Christine Mumma, one of the Commission’s architects, says. “The system is set up, really, for guilty people.”

The truth is the jury’s job. The jury is the fact-finder, the arbiter of innocence or guilt. “Jury verdicts are considered to be almost unassailable, in factual matters,” University of Alabama law Professor Bailey says. Even a Rule 32 hearing is designed only to weigh whether the defendant got a fair trial according to the law. If Rodney had succeeded in that hearing, he would not have been exonerated; he would have gotten a new trial, with a new jury.

Sometimes, of course, juries are wrong. But there is almost no legal mechanism to appeal a conviction on this basis, to say to an appeals court, the jury was wrong. I didn’t do it. That’s because appeals courts only rule on the law: their sole job is to ensure due process. They decide whether a particular piece of evidence was properly admitted or whether a defendant suffered from ineffective assistance of counsel. Theresults of due process—whether an innocent person is incarcerated or a guilty person goes free—are largely immaterial, so long as they were arrived at in accordance with federal and state statute, the state constitution, and the U.S. Constitution.

This holds true even in capital cases. “This Court has never held that the Constitution forbids the execution of a convicted defendant who has had a full and fair trial but is . . . ‘actually’ innocent,” Supreme Court Justice Antonin Scalia wrote in response to a petition by Troy Davis, a Georgia man convicted of killing a police officer and later executed. “Quite to the contrary.”

Victims’ advocates are—understandably, from victims’ points of view—concerned with closure, and the many and varied procedural bars that prevent innocent people from airing the true facts of their cases were put in place to prevent convicted people from dragging those cases on and on. Laws such as the Antiterrorism and Effective Death Penalty Act, passed in 1996 in the wake of the Oklahoma City bombings, establish arbitrary statutes of limitations on when convicted people can file claims for relief, with the aim of hastening executions. “We can’t give new trials to everyone who establishes, after conviction, that they might be innocent,” Texas Judge Sharon Keller told Frontlinein 2000, explaining why she denied relief to a man who turned out to be innocent. “We would have no finality in the criminal justice system, and finality is important.”

Mumma began thinking about these issues more than a decade ago as a clerk for North Carolina Supreme Court Justice Beverly Lake. While at the court, Mumma watched appeal after appeal denied on procedural or legal grounds when the facts seemed to indicate that the appellant had been wrongly convicted. It was frustrating to realize that, legally, her hands were tied.

So Mumma and Lake worked with the North Carolina legislature to craft the Innocence Inquiry Commission. When the Commission receives a seemingly credible claim of innocence, its investigators do an exhaustive inquiry. If the claim holds up, the investigators report what they have uncovered to an eight-member panel. The panel includes, among others, sheriffs and victims’ advocates—not typically inclined to give a convicted person the benefit of the doubt. In order for his case to qualify for review, the appellant must waive his right to attorney-client privilege and to other types of trial protections. He must waive his right to Fifth Amendment protections. If the panel finds anything incriminating, it can be used against him. If the panel agrees that there is “sufficient evidence of actual innocence to merit judicial review,” the case goes before a three-judge bench.

“Proving anything to one judge is hard enough,” Mumma says. “The burden is very very high.”

Being a state agency gives the Commission teeth: it can issue subpoenas, access police files, search evidence rooms, and order DNA testing, all without asking a judge. Without these powers, the Commission could not have secured its most recent exoneration.

Willie Grimes, who is black, spent more than 24 years in prison for the 1987 rape of a white, elderly North Carolina woman who never positively identified him. (It’s “hard to see any difference” among the men she observed in a lineup, she told a judge during a proceeding that the jury never heard. “They all look the same.”) Grimes appealed, but all of the biologic evidence from the case was missing. The rape kit, hairs collected from the victim’s bed, and scraps from fruit that the attacker ate on his way out of the victim’s house were nowhere to be found. The Denver Post ran a story about Grimes in 2007, and the reporter was told by the court clerk’s office, “It’s a mystery to me why we don’t have it.” Grimes asked the local innocence project to take his case, and they, too, were told the evidence had been lost or destroyed.

But when the Commission asked the local police department for access to their case files, they found a fingerprint card with prints lifted from one of the banana peels that the attacker had discarded. The prints matched another man: one of the police department’s key suspects at the time of the attack, a man who fit the victim’s description. A man with a long history of rapes and other violence against women.

The Commission previously used its powers to uncover a “DNA hit” in the case of two men who had each served a decade for a murder they did not commit. In that case, in addition to the DNA results—which implicated other murderers—the subpoena uncovered a confession from another person that corroborated the DNA results. But because the two men had already been convicted, the prosecutor never turned the results over to them. “Here were these two significant pieces of evidence that the state was aware of, but there was no duty to turn them over post-conviction,” the Commission’s executive director, Kendra Montgomery-Blinn, told me. “We were not aware of [the results] when we started our investigation and our jaws hit the floor when we uncovered the hit.”

Including Grimes’s case, “there were seven cases where we have found evidence where other agencies have looked and could not find them,” Montgomery-Blinn says. If a nonprofit agency, such as an innocence project, is told by a police department or court’s clerk that evidence is nowhere to be found, “they can’t say, ‘look again.’ Or, ‘I want to come in when you look and look with you.’ We have the power of the state to say that.”

The Commission’s first exoneree was Greg Taylor, who served seventeen years in prison for a murder he didn’t commit. “If I was in any other state, I would still be in prison for the rest of my life,” Taylor told me.

The Commission operates on a shoestring, with an annual budget of less than $400,000. But its staff has spent hundreds of thousands of hours sifting through more than a thousand claims of innocence to arrive at these four exonerations. Some critics ask whether it is worth all the trouble. To which Montgomery-Blinn answers, “Why don’t you go ask Greg Taylor if it was worth it?”

• • •

When Artemesia heard about Willie Grimes, she was “surprisingly happy and sad.” She was, she told me, “glad for the exoneration, sad that it took more than two decades for it to occur, and, obviously, thinking about Rodney.” Rodney’s mother died last September, and Artemesia had just returned home from her funeral when Grimes was cleared.

Last anyone heard, Terrell Moore lives in California. I tried to reach him, but he seems intent on not being located. Even his mother says she doesn’t know where he is.

Wish, Angel Melendez, is dead. He was killed on his own block by a fellow drug dealer before Rodney’s case even went to trial. “From what I heard, he was walking around fluffing his feathers like a rooster,” says Jorge Resto, a childhood friend of Wish and Rodney’s. Wish “tried to play like he was a big man in the Bronx, and one of the other drug dealers shot him.” At the time of Valerie’s shooting, Resto was a New York state trooper in upstate Orange County (he is now retired). It was he who connected Rodney with the detective who took Rene’s statement. By then Resto had left the neighborhood, but he says he heard later that Wish “was walking around bragging because of the shooting down South. He came up here and thought he was invincible. Thought nobody would mess with him because he got to shoot somebody and get away with it.”

Rene Whitecloud is serving a life sentence for murder—a killing that occurred, Rodney points out with frustration, after Rene returned home from Mobile. If only the police had apprehended him. . . . Rene was eager to help with this story, and called me often, repeating again and again, “It wasn’t me and it wasn’t Rodney.” Who was it, then? I asked him once. Was it Wish? The usually voluble Rene was silent for a moment. “I don’t want to talk bad about my boy,” he finally said. Despite the fact that Valerie identified Rene as the shooter, he was never tried in Alabama.

“I was satisfied that he was being handled by New York for some type of serious offense up there,” Jordan told me. “That was a discretionary decision. I suspect that New York prisons are a little worse than Alabama prisons.”

Mike Finley remarried. He and his wife live on a corner lot in Mobile in a one-story house with green shutters. I went there one day and introduced myself, said I was writing about Rodney’s case and Valerie’s shooting all those years ago. “But he didn’t do the shooting,” Mike said. That’s what I wanted to talk about, I told him. Mike had just returned home from work and asked me to wait while he showered.

I lingered at his house. The sky was richly blue, dotted with a handful of cotton ball clouds. Mike’s backyard was scattered with kids’ toys. It was a warm Alabama fall, and mosquitoes lit on my arm, hovering over the front stoop and the lush green lawn. A bamboo wind chime clinked pleasantly.

It was Valerie’s sister Jo Ann who helped me find Mike. She hadn’t talked to him in twenty years; the animosity was so bad, she said, that, after spending time with the children, Valerie’s family would drop them off on the corner and let them walk home rather than pull up outside Mike’s house. But she wanted me to see this man for myself. And here he was emerging from the house, smelling like soap in a black T-shirt and jeans. He looked younger than his fifty-odd years, his hair and close-cut beard still a deep brown that matched his eyes. Drops of water still glistened on his head, and he held a cold Corona in his hand.

“What I went through, I really wouldn’t wish on anyone,” he told me. He waved at the driver of a passing car. “What my kids went through, too. Financially, emotionally. To relive it?” He shook his head. “I’m not trying to do that right now.” His demeanor was gentle but his meaning was clear. I told him I was going to see Rodney in prison the next day, asked if he wanted me to relay a message. He looked surprised. “I thought he would have gotten out by now,” he said.

I showed him a picture that Rodney’s family had given me, a 25-year-old shot of Rodney and Mike posing triumphantly with a deer they had just killed. “I remember that day well,” Mike said. “I still have the antlers in the house.” He looked off into the distance. “I really don’t want to relive that,” he repeated, and then he climbed into his Jeep and drove away.

From the time she could talk, Maggie* has told her parents that she is a boy. She doesn’t say, “I want to be a boy.” She doesn’t say, “I feel like a boy.” She says, “I am a boy.” She tells her classmates, too. Lately—she’s in elementary school now—they’ve been having debates about it. “Maggie’s a boy,” one kid said recently, in a not-unfriendly, matter-of-fact sort of way.

“No, you idiot,” countered another. “She’s a girl. She’s wearing pink shoes.”

On a recent Tuesday morning, psychologist Kenneth Zucker tells this story at a weekly group supervision meeting, where he reviews cases with his dozen graduate students and postdocs. “As if, ‘duh’—it’s so obvious,” he says, and the room chuckles along with him.

Head of the child and adolescent gender-identity clinic at Toronto’s Centre for Addiction and Mental Health, Zucker is one of North America’s most widely published experts in the field of transgender and gender-variant children. Since it was established in the mid-1970s, his clinic has assessed more than 600 kids with gender-variant behavior and gender dysphoria—the distress that results from feeling that one’s body does not match one’s sense of self. He has treated more than 100 of those children.

Given how early dysphoria can emerge in kids like Maggie and how deeply it cuts to the core of who they are, a growing number of therapists, doctors, and parents are advocating an early gender transition: If Maggie says she’s a boy, then it’s our duty to believe him and treat him as such. Given the very real risks to transgender people who remain in the closet—at one prominent clinic for transgender adolescents and young adults, 20 percent of patients have engaged in cutting or other self-mutilation, and almost 10 percent have attempted suicide—those in this camp say that to deny that Maggie is a boy is to set the child up for a lifetime of repression and pain.

Zucker, on the other hand, believes that girls who say they are boys are not expressing their true identity. Rather, they are confused. Their mismatched gender identity is likely the result of a childhood experience or trauma, or a manifestation of some underlying psychiatric or family problem. The situation will only be made worse, he argues, if parents and teachers encourage it. Zucker’s aim, if a family comes in with a kid like Maggie, is to make her more comfortable in her own body: to make her understand that she is a girl.

“We don’t know why Maggie mislabeled herself as a boy when she was younger,” Zucker says. “Was it because she was in some home day-care thing where she was around a lot of boys?”

One of Zucker’s doctoral students has been working with Maggie in play therapy. The student, Julia Vinik, pulls out a drawing that she and Maggie made together. Four stick figures represent a girl who likes to play sports, a girl who likes to play with dolls, a boy who likes to play sports, and a boy who likes to play with dolls. Vinik had asked Maggie which one she was. “She first went to circle the boy,” Vinik recounts at the supervision meeting. “And then stopped herself and said, ‘Wait a minute. Can you make another one here called tomboy?’

“I asked her, ‘What’s a tomboy?’

“‘It’s a girl who likes to do boy things.’

“I said, ‘Do you think there’s one already here like that?’”

Maggie pointed to the girl who likes sports. “She said, ‘Oh yeah, that’s a tomboy,’” Vinik tells her colleagues.  “And she decided this one over here”—Vinik points to the boy who likes dolls—“would be called a tomgirl.” Everyone chuckles. Vinik recounts how Maggie then pointed again to the tomboy. “‘OK,’ she said, ‘This is me.’”

“That was very encouraging,” Vinik says. “She didn’t see herself as a boy anymore.”

This kind of therapy is precisely what worries Zucker’s critics. “That looks like psychodynamic free play, but it’s really coercive,” says Herb Schreier, a San Francisco Bay Area psychiatrist who has worked with children as young as kindergarteners to help facilitate gender transition. Schreier is part of a consortium of some 30 Bay Area psychiatrists, psychologists, and therapists who work with gender-variant children and their families. He’s one in a large and growing chorus of voices that accuse Zucker of relying on regressive gender stereotypes and practicing a thinly veiled version of 1950s-style reparative therapy

, which was used to “cure” homosexuality.

“The therapy session starts with an incredible assumption: that these kids have a problem. ‘We’re trying to figure out what problem you’re dealing with that gives you this particular way of being.’ It’s not a neutral therapy if it starts with that premise,” Schreier says. “Any therapy that starts with that assumption is bound to be problematic. In essence, he’s asking parents to deny who the kids say they are.”

Schreier characterizes Zucker’s approach as, “I think we should change them, and this would be for their betterment.” To Schreier and his colleagues, this sounds ominously paternalistic. “We would strongly raise the point: Isn’t there a downside to be had by denying a child’s identity?”

Zucker’s peers have written detailed, impassioned critiques of his work and his theories in professional journals—to which he writes detailed rebuttals—and his lectures and panels at professional meetings are often peppered with hostile questions and comments. A quick Google search turns up scathing, profanity-laced takedowns of Zucker and his clinic, including one calling Toronto the “global epicenter for oppression of sex and gender minorities.”

“The reason there is such dislike of and distrust for Dr. Zucker in the community is because he holds a position of immense power,” says Madeline Deutsch, a Bay Area emergency-room physician specializing in transgender health care. Since he publishes so widely, and edits an influential journal in the field, Zucker’s opinions matter. His opinions, she says, “fail to incorporate the very real empiric findings and experiences of other experts in the field, experienced clinicians, and activists … and instead remain focused on attempting to prove his own theories.”

Zucker does have a tone-deaf tendency to operate from the lofty perch of academia rather than engaging with communities on the ground. Despite a palpable empathy for his patients when he’s with them, in conversation with his colleagues he slots patients into scientific categories and describes their lives in psych-speak. Zucker doesn’t use the language or terminology that members of the trans community use to talk about themselves; instead, he refers to “homosexual persisters” and “homosexual desisters,” by which he means boys who grow up to be trans women and boys who grow up to be men. In meetings with his staff, he insists on referring to his patients—even those who have already begun to transition—by the pronouns of their birth sex. In an e-mail to me, he referred to a young patient by using that patient’s preferred gender pronouns in scare quotes: “… help us understand ‘his’ insistence/belief that ‘he’ ‘is’ a boy.”

The criticism of Zucker only became fiercer in 2008 when the American Psychiatric Association, which publishes the Diagnostic and Statistical Manual, or DSM—psychiatrists’ bible of mental disorders—announced that for the manual’s upcoming fifth edition, Zucker would chair the committee to revise the section on Sexual and Gender Identity Disorders. The National Gay and Lesbian Task Force issued a statement calling the appointment “extremely disappointing and disturbing.” In The Nation, Peter Rothberg called Zucker “retrograde” and encouraged readers to sign a petition opposing him. More than 9,000 people did. Circulated by the transgender community, the petition asked for Zucker’s resignation or removal, declaring that “in order to have any credibility in the field of gender identity, the DSM must not include discounted theories or junk science.”

The DSM is the primary tool by which psychiatrists and other mental-health professionals standardize, diagnose—and, crucially, bill insurance companies for—the mental-health problems their patients suffer. As the authoritative psychiatric guide for the National Institute of Mental Health, pharmaceutical companies, and other national and international organizations, the book’s practical and cultural significance is hard to overstate.

It’s also a historically loaded book for the LGBT community. Until 1973, homosexuality was listed as a mental disorder, and it was under the guise of treating it as an illness that many psychiatrists offered reparative therapy. (The diagnosis also meant that gay psychiatrists, psychologists, and psychoanalysts were forced to remain closeted in order to practice.) It wasn’t until a huge push by the gay community—and with fierce resistance by many association members—that the diagnosis was removed.

Transgender advocates and activists say that in a generation we will see the diagnosis of gender identity disorder as equally ridiculous. “Being differently gendered is not a psychiatric problem,” says Lisa Mottet, director of the Transgender Civil Rights Project at the National Gay and Lesbian Task Force. “It’s a human variation.” Or, as the University of California, San Francisco, child psychologist Diane Ehrensaft writes in a recent journal article, “As with left-handed children, who are also a small minority of the population, I believe these children who experience this discord [between their bodies and their sense of self] are not abnormal, they simply vary from the norm.” Ehrensaft and Zucker have sparred publicly on this issue. Gender identity disorder in children, or GIDC, is “a diagnosis and implied treatment that pathologizes perfectly healthy children who are simply expressing their authentic gender identity,” Ehrensaft writes. “The job of the clinician is not to ward off a transgender outcome, but to facilitate the child’s authentic gender journey.”

At the heart of the debate between Zucker and his critics lie fundamental questions: Are transgender people “born this way,” as people who support early gender transition argue? Or is gender a set of learned behaviors, a mix of “biological factors, psychosocial factors, social cognition,” and other mechanisms, as Zucker argues?

For Zucker, these questions are partly matters of scientific and intellectual curiosity. But for gender-variant kids, the stakes are much higher: If being transgender is part of one’s hard wiring, then to try to change kids like Maggie would be impossible at best, psychologically destructive at worst. Therapy that aims to change gay people’s sexual orientation is condemned as harmful and unethical by a slew of major professional organizations, including the American Psychiatric Association. Gay people subjected to conversion therapy as children have higher rates than their counterparts of depression, anxiety, and self-harm, including suicide.

Critics say that Zucker’s approach will have the same effect on trans kids: It will teach them from an early age that a fundamental part of their identity is wrong. What’s more, if these kids aren’t truly changed—if they simply learn to hide their identity until they are old enough to make autonomous decisions—then aside from the psychological harm caused by this hiding are issues of physical comfort and safety: Those who transition later in life have a harder time being perceived as the gender they identify with and require many more surgeries.

The argument about the origin of our gender identity has been simmering for decades, particularly among feminist theorists. On one side is the view called “social constructionism”: the idea that everything we know about what it means to be a man and a woman is something we learn, through subtle cues and explicit lessons, from our parents, TV, the world around us. The flip side is “essentialism,” a word radical feminists have used derisively, snubbing their noses at the idea that there might be something hardwired into women’s brains to make them more inclined to like lipstick and less inclined to fix a leaky faucet.

It’s not just the drag queens, social constructionists argue; we’re all in drag, performing our gender as surely as RuPaul does. Gender is “a kind of persistent impersonation that passes as the real,” writes social constructionist Judith Butler in her seminal 1990 work, Gender Trouble. Or, as Simone de Beauvoir famously said, “One is not born a woman, but, rather, becomes a woman.”

To embrace social constructionism means that there is no “born this way,” no born any way, except with a body around which the world begins spinning meaning and symbolism even before we are born. (See: blue nurseries, “it’s a girl” balloons, and, the latest, “gender reveal parties.”) So to hear the politically progressive, trans-positive community embrace essentialism, and then to hear Zucker, the man they accuse of being retrograde, embrace social constructionism is enough to make one’s head spin. Until you remember the gay gene.

When, in the early 1990s, geneticists discovered a relationship between homosexuality and certain genetic markers, many members of the gay community embraced these findings, using them as the basis of a new push for acceptance. If we were born this way, the argument went, then you can’t hold it against us; we can’t help it. Indeed, the work of these geneticists was read from the floors of many a senate chamber, and the “gay gene” was part of what turned the tide of public opinion in favor of compassion and nondiscrimination.

But this emphasis on biological determinism is discomfiting. First of all, even if gay folks weren’t born this way—even if they “learn” to be gay or develop the identity over time as a result of complex social processes—why would that make it any easier to change their identities? Second, there’s something apologetic about the whole premise that the world should accept gay people because they can’t help being gay. The unspoken part two of that argument is that if they could change, they surely would—or should.

It’s now widely accepted that no amount of therapy can change a person’s sexual orientation, and Zucker says he would not try to do so. But gender identity and sexual orientation are not the same thing. Sexual orientation is a matter of whom you are sexually attracted to. Gender identity is more elemental: It’s who you feel in your bones that you are. Zucker’s critics say that most transgender children know precisely who they are. “These kids come out very early and say, ‘Mommy, I’m in the wrong body,’” Schreier says.

Sure, Zucker says, but that doesn’t make it a fait accompli. Children’s gender identity is plastic and malleable, he says, shaped and formed by the world around them, by the feedback they receive, by the emotional resonance of the things they do, by their personal relationships, even by the clothes they wear. If this is true, then it should be possible for these kids to change.

Zucker is quick to point out that his clinic has referred more than 60 kids for the medical interventions required to begin their transitions; a paper he wrote on the subject was, in fact, the first such study published in North America. By age 11 or 12, he concedes, trans kids are typically “locked in” to their gender identity, and for them, “I very much support that pathway, because I think that is going to help them have a better quality of life.” But it’s different, he says, for younger kids. “If a child can grow up and feel comfortable in his or her own skin that matches their birth sex,” Zucker argues, “then you avoid the complexity of fairly serious surgical treatments. Penectomy and castration are not the same thing as having mild and minor cosmetic surgery. Lifelong hormonal therapy. It’s serious.”

It’s not just the medical interventions, he says. “One could argue, like many things, that there’s a strong value component to it. Holding everything else constant, at least at this point in time it’s relatively easier to grow up with a gender identity that matches your birth sex.”

That may be true. But for how much longer? Society is changing. The alphabet soup of LGB—lesbian, gay, bisexual—has, bit by bit, broadened, first to include “T” for transgender, and, more recently, to become the unwieldy LGBTQQIAA, which includes people who identify as queer, questioning, intersex,

asexual, and ally. “Transgender,” usually used broadly to encompass a range of gender-variant people (including transsexuals, the word traditionally used to describe people who make a full medical change to the “opposite” sex), is bursting at the seams as 21st-century gender identities proliferate. There are people who identify as genderqueer, bi-gender, agender, Two Spirit. There are trans people who choose surgery but no hormones, hormones but no surgery, or no medical interventions at all.

To the extent that Zucker builds upon this gender diversity by encouraging kids to widen their sense of what their gender can be—by helping kids feel comfortable as “tomboys” or “tomgirls,” or other gender inventions in between—he furthers the worthy cause of making the two traditional boxes bigger or helping to break them down, rather than stuffing kids inside them. At the same time, Zucker knows that the more society moves in this direction, the more his work becomes obsolete. “One could argue that with the emergence of gender-transition subculture, Western culture in some ways now has a third gender category,” Zucker says.

“Gender-transition subculture” is Zucker’s mildly dismissive go-to term for the approach of people like Schreier and Ehrensaft who advocate allowing gender transition for very young children in certain cases. “One could argue” is also a favorite formulation—it’s an easy way to distance himself from potentially controversial statements. He’s not necessarily arguing this, it seems to imply—just that one could. “It could be that in the next 10, 15 years, there will be more and more acceptance of extremely gender-variant kids, and the reaction will be, ‘Oh, he’s just a transgender.’ And we’ll see. If there is this greater acceptance, the argument that [not being transgender] is an easier pathway may be harder to make.”

Alex exemplifies the growing acceptance of gender diversity. Born with a girl’s body six years ago, Alex is “just a cool little kid, really,” says his mom, Andie. At school, he is a boy: boy clothes, boy hair, boy pronouns. “And at home, we respectfully—somewhat faking it, because I’m not 100 percent there—we treat Alex as a boy.”

Andie knew from the time Alex was a toddler that something was different. “I noticed that Alex gravitated towards playing with the boys,” Andie recalls. “She* preferred to do the boy things.” At three, Alex refused to put on a girl’s bathing suit. She refused to wear dresses, then she refused to wear skirts, and then “it got down to, if there was a little pleat that you wouldn’t even notice on the shoulder,” Alex would refuse to put it on. Still, Andie was herself a tomboy as a kid, so she mostly let Alex dress how she wanted and didn’t think much of it.

About halfway through Alex’s kindergarten year, Andie’s usually easygoing, happy kid seemed anxious and irritable. She discovered that Alex was polling kids at school: “Do you think I’m a boy or a girl?”

“And I go,” Andie says, “‘Why are you doing that? You’re obviously a tomboy.’

“‘Well, I want to be a boy.’

“I’m like, ‘Well, you’re not a boy.’ I had no idea, really, about issues like that.”

She went to talk to Alex’s teacher, who had noticed a similar change in Alex’s behavior. “It’s almost like she doesn’t know who to play with or what to do,” the teacher said. “Have you heard of gender dysphoria?”

Andie took a few weeks to think it over, do some research, and talk to her family. Then she called the principal. “Listen,” she said. “Alex thinks she’s a boy. So we need to somehow make Alex comfortable at school.” The principal said, “OK. I’ll make some calls.”

It was that easy. But it won’t necessarily stay easy.

In five or six years, as boys his age find their voices deepening and their upper lips darkening, Alex will begin to develop breasts and hips. He will get his period. Unless, that is, he begins the long journey of medical interventions that will allow him to stay a boy.

First there are hormone blockers, medications that are used to suppress puberty in one’s birth sex. These are fully reversible—an adolescent who stops taking them will begin puberty in their birth sex—and are meant to buy the child some time to mature enough before he or she makes irreversible choices.

For adolescents who continue their transition, hormone blockers also help to prevent later surgeries; a boy like Alex who never grows breasts in the first place need not have them removed. By around age 16, Alex could start on cross-sex hormones, which would deepen his voice, cause hair to grow on his face and his chest, and prompt the other hormonal changes of a typical teenage boy. Genital surgery—a much less common choice in transgender men since the surgical techniques are less advanced than they are for transgender women—can happen as early as age 18.

Andie admits that she would prefer Alex not go down this path. Not because she has a problem with him being transgender but because she hates giving her kids medication. “I don’t care what drug it is,” she says. “I don’t like the thought of kids putting drugs in their body. But I also want a kid that’s alive,” rather than at high risk for suicide. “My other little guy has epilepsy. So he has to take high levels of meds to keep his body safe. I’m going to try to look at this the same way. If that’s what Alex needs to feel secure, that’s what Alex will have.”

Andie brought Alex to Zucker’s clinic after Alex had already made his gender transition at school. She Googled Zucker only once her family had gotten to know him and was shocked by the criticism she read; she says he has been supportive of her approach and has never encouraged her to treat Alex like a girl.

“One starts, more or less, with where a family is at,” Zucker says. “I offered for us to see Alex in individual therapy to get a further and more in-depth understanding of Alex’s internal, subjective world. I think that both Andie and I are watching to see if Alex will develop any alternative ways of how Alex currently experiences ‘his’ gender.” Zucker stops short of saying that fostering these alternative ways is his aim. “It would have to be their aim,” he says of Alex’s family. “It’s not my job to impose it.”

With encouragement from Zucker, Andie reminds Alex that he could grow up to be anything—a girl, a boy, or anything in between—and tries to encourage him in any case to love his body. “My goal is for Alex,” she says, “to feel good about herself, and to have the tools she needs to be able to say, ‘Hey, this is who I am.’ I have no right to tell somebody that they’re something that they’re not.”

Alex plays on a local boys’ hockey team; his dad volunteered to coach so Alex would feel more comfortable playing. He goes snowboarding and dirt biking with his mom. In advance of Thanksgiving, Andie called her own mom—who is slowly coming around—to lay out the ground rules for their family dinner: “‘Refer to Alex as he, or I’m not OK with it.’” Andie’s family complied.

Andie doesn’t want Alex to talk to reporters, so I didn’t get to meet him. But as Andie was gathering him to leave after his therapy session, I couldn’t help but see his little snowboarder jacket and his mop of dark hair out of the corner of my eye. Zucker was bending down, hands on his knees, to look at the newly loose tooth Alex was excited to show off. “Now what,” Zucker said, with grandfatherly excitement, “do we have here?”

The industrial sign marking the bathroom in Zucker’s clinic is all-inclusive, with a hybrid male-female symbol indicating a myriad of gender possibilities. Zucker’s office door is papered with colorful marker drawings of smiling cartoon figures, trees, flowers, and houses. “Thank you!” several of them read, in rainbow letters. “I enjoyed being with you!” reads one. “Thanks for helping me,” reads another.

While countless individual therapists work with transgender kids on an individual basis, there are only about a dozen clinics for transgender kids and adolescents at major medical centers in the Western world. Most clinics take a “watchful waiting” approach. They advise against an early gender transition, instead counseling parents to find “a sensible middle-of-the-road approach,” as one clinic describes it—neither encouraging nor actively discouraging. A few, like Herb Schreier’s Bay Area group, will—in extreme cases—help children make an early gender transition. But none attempt to actively prevent transsexuality as Zucker does.

With short silver hair and beard, mismatched belt and shoes, and a perpetual pen stain on his shirt pocket, Zucker looks, and has the demeanor of, the workaholic grandfather that he is. The first thing you notice, talking to him, is his voice: Its deep basso timbre rumbles in a blend of Canadian and Midwestern accents. He has a dry sense of humor and a penchant for deadpan teasing that at times catches even friends off guard. “One of the things I told everybody that they really needed to think about today,” Zucker said at the opening of his Tuesday-morning clinic-supervision meeting, “was what to wear.” He never even broke a smile, but he was (mostly) joking that everyone should try to impress the visiting journalist. “I wore my best shirt and got here early and then”—he pointed to that day’s pen stain—“put my blue pen in upside down.”

Zucker grew up in suburban Skokie, Illinois, the older of two kids (his sister Barbara, he points out with an ironic smile, is nicknamed Barbie). His “intellectual, left–winger” Jewish parents were victims of McCarthy-era witch hunting—his dad lost several jobs, Zucker says, because he refused to “rat on his Commie friends.” In Zucker’s telling, they ultimately decided that “for the sake of their children, they needed to become conformist,” and they moved to the suburbs to “disappear from the scene—trapped in middle-class consumer subculture for the good of the cause.”

Born in 1950, Zucker came of age at the dawn of a different kind of scene. During our time together, Zucker happened to mention, in passing, a cow that stuck its head into his VW van at Woodstock and a summer he spent in Cambridge, Massachusetts, driving “the People’s Bus,” but when I pressed for more details, he would say only, “We’ll leave it at that.” What he will say is that he emerged from those times with a distaste for dogmatism and a sense that “maybe hiding in science is safer than fighting political, dogmatic battles.”

He regards his detractors as dogmatists. “I would say one thing that does bug me about some of the debates in this area is people’s supreme confidence that gender is a complete social construction, or that gender is completely biologically determined, or that this can all be explained by specific psychodynamic mechanisms.” Zucker calls himself a “gender agnostic.” He thinks that gender emerges as a mix of these elements, but he feels that the mechanisms are still far from clear.

His fascination with gender identities began while Zucker was a psychology graduate student and he read a book by UCLA psychiatrist Richard Green, whose pioneering work in the emerging field of sexology laid the groundwork for Zucker’s practice today. Green’s 1974 book Sexual Identity Conflict in Children and Adults was the first longitudinal, scientific description of a cohort of “feminine boys” and included transcripts of Green’s sessions with these boys and their families. Zucker was intrigued. “Identity is such a core part of what it means to be human,” he says, “and gender identity is such a core aspect of the self that it’s inherently interesting.”

When Green began his “Feminine Boy Project,” the research study on which his book (and The Sissy Boy Syndrome, a subsequent book) is based, his aim was to describe the “natural history” of transsexuals. He thought that by studying these boys early in life, he could watch their cross-gender identities unfold, like caterpillars in chrysalises. That’s not what happened. Green’s most striking finding was that only one of his 44 “sissy boys” turned out to be transsexual. Most of them—75 percent—grew up to be gay men. Subsequent studies led to similar findings: Gender-bending kids who grow up to be transsexual adults are the exception, not the rule.

This may be changing. Given increasing visibility and acceptance (think Chaz Bono, Transamerica, RuPaul), more and more people who challenge traditional gender stereotypes (from butch women to “sissy boys” to those whose gender identity is more fluid) feel empowered to take on the mantle of genderqueer or transgender—and, in some cases, to seek medical attention. Recent studies indicate that the number of people seeking treatment at gender clinics in the United Kingdom and Canada has risen sharply in the last five years.

Does this mean that Green’s numbers are an under-estimate—that with greater parental and societal acceptance more of his “sissy boys” would have grown up to be transgender? New data might help to answer this question. During the time I was in Toronto, Zucker talked a lot about a scholarly paper currently under review by a group of well-respected Dutch clinicians and researchers. In their group, kids like Alex who underwent an early gender transition were more likely than other gender-variant kids to be “persisters”—that is, to continue to identify as the opposite sex into adolescence and early adulthood.

Because the Dutch data seem to support Zucker’s theory—that the way parents respond to a child’s early gender dysphoria has an impact on whether it persists—the paper feels, to him, like something of a vindication. Herb Schreier sees the same data and reaches the opposite conclusion: The kids who transition early, he says, are the ones who identified themselves vocally and from an early age—the ones who were clearly going to persist anyway.

In the vast majority of these kids, however, gender dysphoria resolves on its own. In light of that, I asked Zucker, how do you know your interventions are working? He was honest: “I don’t think we know.”

As a child, Karl Bryant, now a sociologist at the State University of New York, New Paltz, “desperately wanted to be a girl, and I expressed it often,” he recalls. But this was the early 1960s—there was no early gender transition subculture—and Bryant was growing up in a small farming town about an hour from Los Angeles. So he became one of the earliest subjects of Richard Green’s Feminine Boy Project. He was enrolled in the “treatment” arm and had sessions with Green every other week.

Bryant liked Green and remembers trying hard to please him. “I knew at a certain point what the expectation was,” he recalls. Bryant wrote his Ph.D. dissertation on the politics of gender identity disorder, and he recounts the story in the introduction. “I remember occasionally trying to muster the kinds of masculine behaviors that I knew I was supposed to naturally express,” he writes. “Ultimately I learned to hide as best I could my feminine behaviors and identifications.”

Bryant grew up to be a happy, successful gay man, and he refuses to speculate how, or whether, things would have been different if his parents had allowed him to follow his fervent childhood wish to be a girl. But his “happy outcome,” he says, is despite, not because of, Green’s interventions. The study, he says, gave him the lasting impression that “the people closest to me, and that I trusted the most, disapproved of me in some profound way.” He says it’s hard to overstate the harm that such knowledge can inflict: “The study and the therapy that I received made me feel that I was wrong, that something about me at my core was bad, and instilled in me a sense of shame that stayed with me for a long time afterward.”

Zucker acknowledges “more similarities than differences” between his treatment and Green’s. “The UCLA group, Richard’s group, certainly had a big impact on me,” Zucker says. That said, developmental and cognitive psychology are much more sophisticated now than they were then, and Zucker says that the theoretical underpinnings of his work rely on much of this new research. For example, he bases his approach in part on the concept of “gender identity self-labeling.” Zucker explains: “You somehow, by the age of two or three, have recognized that gender is a social category. The world consists of males and females: mommies, daddies, men, women, boys.” Children figure out how to label themselves as a boy or a girl (how they do this is the big question, and one that has not been satisfactorily answered) and then “search out information in their environment: If I’m a girl, how is a girl supposed to behave? You look to the social environment.”

Take something as seemingly arbitrary as color preferences. In general, girls like pink and boys like blue. This is not just anecdotal, Zucker says; studies have confirmed “sex-dimorphic⁸8.Sex-dimorphic: (adj) used to describe a trait or characteristic that varies along gender lines—height, for instance, or the presence of facial hair. color preferences.” This isn’t because girls are “born” to like pink, Zucker says, but rather because they say to themselves, “‘I’m a girl. OK, so what do girls do?’ You have your own self-label and then you actively try to behave in a way that matches the label.” Zucker’s aim, then, is to broaden the kids’ sense of what someone of their birth sex can be. “Let’s say a little boy with a strong desire to be a girl, in part, has come to this because temperamentally he has a lot of trouble with rough-and-tumble play,” Zucker says. “And so recognizing that some kids might think in binary terms—‘I’m not like that, therefore, the only alternative is to be a girl.’ But if one can help kids realize there are different ways one can be a boy, maybe that lessens the wish to be a girl. Because one realizes, ‘Oh, I don’t have to be running around on a soccer field as the only way one can be a boy. I can do something else.’”

Zucker also relies on more traditional behavior–modification therapy, in which you reinforce or reward certain behaviors and ignore or discourage others. He encourages “limit setting,” like allowing your boy to wear a dress at home but not out of the house, for example, or only for a certain number of hours a day. But he stresses that each child’s treatment plan is individualized: For a kid like Alex, encouraging him to be flexible in the way he thinks about gender is as far as he’ll push. For a kid like Olivia, he felt comfortable going further. This is largely because Olivia’s parents felt comfortable going further.

Olivia is nine now. But from the time she was two, “She wouldn’t wear things if there were a pleat or a bow or a sparkle,” her mom, Erin, says. Olivia wouldn’t drink from a pink cup or eat off a pink plate. She refused to go to school on her birthday, because the teacher gave girls a princess crown to wear on that day. “And if there was a special day where I would tell her that a dress was required, there would quickly be juice dumped down the front of it.” Erin laughs recalling it. “Smart kid.”

Erin also noticed that Olivia couldn’t tolerate social situations. She got teased a lot at school, and at home, if Erin’s friends came over with their kids, Olivia would either go up to her room and shut the door or sit and rock in the corner—“almost like she was autistic,” Erin says.

By the time Olivia was four or five, they would argue about her gender constantly. “I would clarify—not understanding what the heck,” Erin recalls. “I would say, ‘Olivia, you’re a girl. You’re a bit of a tomboy. You’re a girl that likes boys’ things.’ Then it started into the whole dialogue of, ‘When am I going to become one?’ That’s when I realized that she needed help.”

Erin was referred to Zucker by a therapist she was seeing, but having read some of the criticisms of him online, she was wary. “My values are that you take people for who they are, and people can be whoever they want to be in life,” Erin says. “So if my daughter chooses to be a boy or chooses to be gay or whatever, so be it, and I’ll love them and support them and do whatever I can to make them happy in their world.”

But then Zucker asked her a question that stuck with her: “If your daughter said to you that she wanted to stay up until two in the morning, would you let her?” No, Erin told him. “Well,” Zucker continued, “she’s telling you that she’s a boy and is going to change into one. And she’s young enough that we think in this clinic that she’s confused, and you can clarify that for her. What do you think about that?”

Erin thought, “OK, let’s try this.”

The first thing Zucker encouraged them to do was to go shopping for clothes. “You’ll have to try to make her clothes gender-neutral,” Erin recalls Zucker saying to her. “We’re not telling you she’ll ever wear a dress. But you need to try to get her to grow her hair, get it so she’s not looking so much like a boy.” He also told her to be clear with Olivia why they were coming to the center for ongoing therapy sessions and why they were going shopping. Erin was nervous about it, because she knew it would upset her daughter, but she recalls, “I said, ‘You’re not going to be able to wear boys’ clothes anymore. So we’re going to go to the store, and you’re going to wear girls’ clothes because you’re a girl.’”

Zucker is mindful that clothes and hair length—not to mention toys and games, indeed, just about every outward sign of gender that he targets—are superficial. “Yet, if you look at normative studies of gender development, kids often use cues pertaining to hairstyle and clothing style to not only mark their own gender but to mark the gender of other kids,” Zucker says. “So those cues, or markers, are surface representations of a child’s underlying gender identity. And I think, in young childhood, there can be a feedback effect.”

If a young boy feels he is a girl, Zucker argues, then playing with Barbies is not as simple or as neutral as playing with blocks or puzzles. Part of the thrill of the Barbies for that boy is that they make him feel like a girl. Because he feels like a girl, he will continue to want to play with Barbies. And so on. “There is a back-and-forth between gender identity and surface behavior,” Zucker argues. “I’ve been trying little questions out lately, like: ‘If you like to eat leaves off tall trees, would that make you a giraffe?’ Some little kids fit that kind of thinking. Kids conflate identity with appearance.”

This was certainly true for Olivia. Finding gender–neutral girls’ clothes was a challenge, but she and her mom finally agreed on some collared shirts and cargo pants cut in a girl’s style. “What happened over time was, she stopped getting bullied at school because she stopped looking like a boy,” Erin says. “It would get her confidence going.”

On days that Olivia came home from school and complained that “so-and-so called me a boy,” Erin would steel herself and reply, “Well, you kinda look like one today, Liv. Your choice. I don’t know what you’re expecting.” Ultimately, Olivia “got to a point where she would get upset when people would get confused, calling her a boy. Even though originally that was what she wanted.”

The final recommendation her parents followed was to help Olivia make more female friends. She’d always had more boy friends than girl friends, but her parents enrolled her in girls’ soccer and hockey and were amazed at the difference it made. “The girls are like her,” Erin says. “They’re still more girly than her, but they’re rough, and when they go to a tournament, they’re just tearing around playing Hunger Games. They relate to her.”

Social interactions still don’t come easily for Olivia, but Erin feels the changes they made have helped give Olivia the confidence she needs to move through the world more peacefully. “I think that if I hadn’t gotten the help, I would have allowed her to continue to dress the way she was, and life would have been really tough,” says Erin. “I think she would have been very withdrawn and disturbed and had difficulty making friends, and been bullied.” Erin knows the future is still uncertain: “Who knows what she’s going to decide? Is she going to be gay? Is she going to be transgender? I don’t know. But I do know that she’s going to be a confident person and be her own person and feel like she can make her own choices, and recognize how to fit in and how society works. I think this place has saved her.”

There’s a chance, of course, that Olivia might feel otherwise later in life. “If your parents have brought you to Dr. Zucker to figure out your gender, and they are already perhaps less than supportive or [at] least nervous and confused, and then you sit in a play space with an authoritative doctor suggesting you play with a truck, what do you think the child would do?” asks emergency-room physician Madeline Deutsch, who is transgender. “I suspect that we will see a large number of Dr. Zucker’s former patients in their thirties, forties, or fifties seeking gender reassignment, only to regret having not been able to do so decades earlier.”

Traditional epidemiologic studies have assumed the prevalence of transgender people to be rare: somewhere in the neighborhood of 1 in 10,000. But recent studies show the numbers are much higher than previously thought (or are higher now than they used to be): 1 in 200, or even, in one recent sample of middle schoolers, 1 in 100. This means that only a tiny sliver of what may be a relatively large population of transgender people are showing up at clinics to make a medical transition. It speaks to the fact that in between living fully in one’s birth gender or undergoing all of the cross-gender interventions that Western medicine has to offer is a whole range of options that Zucker’s approach doesn’t account for.

“The proliferation of gender categories that represent people’s desires and experiences and identifications, those are fairly new,” Bryant says. So “to look at kids today who are gender-nonconforming and try to make some prediction about what they’re going to be when they grow up is really fraught. The things that they are going to be when they grow up don’t exist right now.”

Because of this proliferation, critics like Bryant say, Zucker is basing his work on an outdated conception of gender, suggesting parents radically change the way their children live—not let them play with the toys they choose, or wear the clothes that make them most comfortable, or play with the friends they most connect with—on the basis of a dubious guess that some tiny percentage of them will one day want to have sex-reassignment surgery. Or, worse, on the basis of societal prejudice: because the world will not accept them for who they are. This seems as unsettling as Zucker’s parents moving to the suburbs and conforming for the good of the cause. It’s fair to ask: Whose cause, exactly?

Although the DSM is strictly a diagnostic manual—it does not make treatment recommendations—implicit in the very existence of a diagnosis is the suggestion that it warrants treatment. This is largely the concern that transgender activists and mental-health professionals had when they heard that Zucker would be chairing the DSM’s Sexual and Gender Identity Disorders work group.

Zucker’s approach “has this default assumption that not identifying with the sex you were assigned at birth is in some way psychopathology,” says Karl Bryant. “It treats the gender of the child [as] a problem that merits some kind of correction.”

But transgender advocates concede that the new diagnostic criteria represent an improvement over the old. In the previous DSM, for instance, the bar seemed lower for diagnosing boys than girls: To meet the criteria, boys need only have a “preference for” wearing girls’ clothes, whereas girls had to “insist on” wearing boys’ clothes. In the new DSM, the language is more analogous. The new DSM, which will be published in May, also recognizes the limitations of the gender binary, noting that a child could express either “a strong desire to be of the other gender” or “some alternative gender different from one’s assigned gender.”

Still, whether the diagnosis should be in the DSM at all remains a contentious issue. Because hormone–replacement and sex-reassignment therapy cost tens of thousands of dollars, transgender people are in a bind: They need a diagnosis to get health-insurance coverage for their transition-related medical care. Zucker and his colleagues tried to address some of the community’s concerns by renaming the diagnosis “gender dysphoria.” This means that it’s not the identity that is a disorder but rather the distress that may result from that identity. A gender-variant kid—a boy who likes to wear dresses, for instance—wouldn’t automatically meet the criteria, unless the behavior caused him “clinically significant distress or impairment.” In other words, unless he were suffering.

The name change alone was a big deal, says psychiatrist Dan Karasic of the University of California, San Francisco, because it implies that “the distress of gender dysphoria is the pathology as opposed to gender identity.”

Zucker likes to say that the DSM is “agnostic” with regard to the origins of one’s suffering, but the question of where the distress originates is not a small one. Many kids in Zucker’s clinic come in with psychiatric and psychosocial issues. A quarter of them have been involved with child protective services and a quarter have attempted suicide. Zucker concedes that “experiences of ostracism, social rejection in the peer group, et cetera, does account for some” of the distress. But, he says, “I personally think that it’s too simplistic to say that it’s the peer ostracism or the stigma that explains it all. We see a lot of adolescents whose families are pretty supportive,” he continues. “They’re not being rejected. Their friends are chill. But they’re still very unhappy and very distressed and miserable. So even with external acceptance, the incongruence between somatic sex and felt gender is still very painful.”

For the most part, following his interpretation of the standards of care, Zucker will not recommend puberty suppressors or cross-gender hormone therapy for anyone whose psychiatric issues aren’t addressed first. His critics say this misses the point: Transitioning is addressing their psychiatric issues. By offering hormone therapy and other medical interventions, “you treat not only the medical hormonal deficiency and help them attain the body that they wish, but you are very likely to erase a whole bunch of psychopathology that’s all secondary,” says Norman Spack, an endocrinologist who runs the Gender Management Service at Boston Children’s Hospital. Spack says he has seen major depression, anxiety—even mild Asperger’s—resolve after kids are able to transition.

While I was in Toronto, a teenage patient of one of the other psychologists in the clinic came in for a follow-up visit. This person had the body of a female but covered his breasts in layers of binders and was so afraid to be read as a female that he wouldn’t leave the house, even for school—he attended high school online and ventured out only for his appointments and, once a week, to the in-person component of his curriculum. He told his psychologist, one of Zucker’s colleagues, that if she wouldn’t refer him for hormone therapy, he would kill himself. The colleague stopped by Zucker’s office to ask him what to do.

The standards of care say someone is ready for hormone therapy when he has lived successfully as his preferred gender for a period of time. Did this person qualify, if he never left the house? Is his extreme distress the result of his gender dysphoria? Or is the depression clouding the psychologists’ ability to get an accurate read on his gender identity? All these questions were theoretical, though. In the next room was a real patient who was suffering, and Zucker did what he thought was best: He referred him to the endocrinologist to begin hormone therapy.

*The names of Zucker’s patients and their family members have been changed to protect their privacy.

When Rob Wildeboer, a criminal-and-legal-affairs reporter for public radio WBEZ in Chicago, read a report from a local watchdog group about conditions in Illinois state prisons, he was taken aback: “The stuff that they were saying—if true—was just horrendous.” The report, and his own follow-up reporting, revealed vermin infestations so severe that a cockroach had to be surgically removed from a man’s ear. Hundreds of bored and restless inmates—some serving time for nothing more than driving on a revoked license—crowded dormitory-style into dank, flooded basements. Six hundred men sharing seven toilets. So Wildeboer did what any good journalist would do: He asked to see for himself. “I expected we’d get in, to be honest,” he says.

Instead, he found himself at the center of a yearlong standoff, during which the governor of Illinois, Pat Quinn, publicly issued blanket denials to journalists seeking access to the state’s prisons, and then refused to sit down with Wildeboer—or any other reporter—to discuss this policy or its rationale. It wasn’t until WBEZ, with the help of two pro bono attorneys, threatened a federal lawsuit that the governor backed down, and even then only partway. Tours would be allowed, he said, but no tape recorders or video cameras. “It’s a step in the right direction,” says Wildeboer.

Prisons are an abundant source of scoops and stories for enterprising reporters. Life “behind the walls” is rich with drama and moral complexity, and departments of corrections are as badly in need of journalistic sunshine as any other government agency. But to cover them is difficult. They are, of course, closed institutions, meant to lock some people in and keep others out. Reporters often “don’t know how to get access, or they’re refused access and they throw up their hands,” says Michele Deitch, a University of Texas law professor who specializes in prison oversight. Even those who can get in must navigate a complicated relationship with correctional administrators whose goals and needs are often at odds with their own.

The skyrocketing US incarceration rate is by now a familiar story. Thanks to “tough on crime” politics and the War on Drugs, almost one in every 100 Americans is in prison or jail, a rate that leaves even China and Russia in the dust. And lockup does not come cheap. The average state spends almost a billion dollars a year running its prisons. The growth of prison spending in state budgets outpaced every other expenditure except Medicaid, according to a 2009 study by the Pew Center on the States.

Compared to other areas that siphon significant public resources, such as healthcare, prisons get vanishingly little media attention. Ted Gest, a longtime crime beat reporter and president of Criminal Justice Journalists (a nonprofit dedicated to improving coverage of crime and law enforcement), guesses there are a half-dozen reporters across the country covering corrections, some of whom have other duties as well. “It’s never been perceived as that newsworthy,” he says. “Most prisons, unless there’s a riot going on, [are] just not considered that sexy.”

Still, it is hard to overstate the importance of covering prisons. For starters: 95 percent of prisoners—more than 600,000

people each year—eventually go home. What happened while they were inside—whether they received job training, adequate healthcare, or learned positive life skills, or whether they were embittered, recruited into a gang, or made connections in the criminal underworld—has profound consequences for the society they return to. And the ripples extend far beyond the prisoners themselves: Almost two million children have a parent in prison—to say nothing of inmates’ parents, spouses, and siblings. Half a million correctional officers work behind the walls.

Given this, “we want to make sure there’s accountability for the results of all this imprisonment,” says Jenifer Warren, a writer and editor in Sacramento who for more than a decade covered corrections for the Los Angeles Times. “If you’re going to use incarceration as a tool and response to crime, you want to make sure your money is being used wisely, and you’re getting a return on your investment. It’s billions and billions of dollars that could be spent on other things.”

To ensure accountability, the reporters who do take an interest in prisons need access. But policies vary widely from state to state. Some states are models of openness. In Rhode Island, for instance, journalists are not only allowed access, but are “encouraged . . . to visit correctional facilities and to report on programs and activities” as a matter of policy. And even the sorts of negative stories that have made prison administrators in other states wary of the press are there considered “a cost of doing business” in Rhode Island, according to Department of Corrections director A. T. Wall. “Most of what we do is behind walls and fences,” Wall says. “If we don’t make ourselves available to the media, don’t let people see a lot of what we do, we’re going to perpetuate a stereotype that we’re running dungeons.”

A

t the other end of the scale, according to freelance journalist Jessica Pupovac, who did a state-by-state survey as part of a journalism-school master’s thesis, are states like Arizona, Alabama, Georgia, Louisiana, and Michigan. Each allows occasional press access—Alabama’s Corrections Commissioner cited two recent occasions when the press was allowed to accompany the state’s Prison Oversight Committee on a tour—but in these five states’ written policies, openness, and transparency are “the exception to the rule,” says Pupovac.

Most states fall somewhere in the middle, allowing certain types of access but not others. California, for instance, does allow tours, but does not grant requests for interviews with specific inmates. Governor Jerry Brown recently vetoed a bill that would have allowed greater media access to prison—the ninth time a California governor has done so in the last 20 years.

Making the situation more complicated is the fact that the rules covering media visits are typically a patchwork of legislation, regulations written by administrators, and case-by-case decisions made by the wardens of individual facilities. Few states have official channels through which reporters can appeal if their requests are denied.

In the case of WBEZ, “we went through all the proper channels,” says Cate Cahan, the editor who worked with Wildeboer. “We want to do things properly.” WBEZ submitted to the press office a request to tour two facilities, and was dismissed via email. When the journalists appealed to the governor’s office, they were again dismissed, in one line. Stonewalled, Wildeboer did what reporting he could from the outside—interviewing inmates who had already been released—and the refusals themselves became fodder for his work. “It becomes a government story; it becomes a transparency story,” says Cahan.

After Wildeboer’s seven-minute story about lack of access aired in August, reporters began to pepper the governor and the Department of Corrections with questions. “Security comes first, and it isn’t a country club,” Quinn told reporters. There are, of course, legitimate reasons that prison administrators might be wary of the media. It takes staff time to guard the journalist, for one. And “it would be so easy for a journalist on a first-time tour of a facility to freak out about something,” says Michele Deitch. For instance, during the day, inmates are rarely confined to their cells; unwitting journalists may panic when they see dozens of inmates moving around freely between programs and dayrooms and meals. “Journalists need to be pretty damn educated before they go in,” Deitch says.

Leaving aside safety considerations, the people who run prisons are in a delicate situation with regard to the press. “In corrections, the bad news is bad news, and the good news can be bad news,” says Rhode Island’s A. T. Wall. For example, Wall says, he likes to showcase educational and other programs offered to inmates at his prisons “because they’re consistent with our mission to foster a successful transition back into the community.” However, “when we do attract media attention, there can sometimes be a backlash of people who are offended that taxpayer dollars are being spent that way.”

In ex

treme cases, public outcry can jeopardize the program. “The public could get very up-in-arms—They should be breaking rocks!” says Deitch. The coverage “could end up being really counterproductive if it’s not reported on in a smart way.”

Press policies are often crafted with extreme sensitivity to victims, an effort to avoid reporting that might be perceived as “glorifying prisoners” or giving individual inmates “celebrity” status. “I try to put myself in the shoes of a victim,” says Kim Thomas, the Department of Corrections commissioner for Alabama. “If I was sitting in my living room and the person who destroyed my family and my life all of a sudden appears on TV—I don’t want to be the commissioner who does that.”

On those grounds, Thomas declines every single press request to interview inmates. Rhode Island’s A. T. Wall has taken a different tack. “Sensitivity to victims, as my lawyers have reminded me,” he says, “is not a constitutional right.”

Meanwhile, journalists’ access to prisons is not a constitutional right per se, either. The courts have repeatedly held that journalists do not have any rights of access greater than that of the general public. Of course, they have no fewer rights of access, either. WBEZ’s threatened lawsuit homed in on that right to equal access. State prison officials “permitted school groups, church groups, the John Howard [watchdog group] all to have access to the prisons,” says Jeffrey Colman, one of the lawyers representing the station (John Howard’s reports prompted Wildeboer’s initial efforts). “I believe that’s the reason why the Department of Corrections caved in: because they knew that to give access to John Howard and not the media raised a significant equal protection claim under the Fourteenth Amendment.”

Reporters who find themselves barred from their local prisons, and who don’t have pro bono lawyers, still have options. “Prisons are functions of state governments, and state governments keep all sorts of records,” says Jenifer Warren. If you can’t get in, she says, follow the paper trail: state budgets, lawsuits, disciplinary proceedings, labor contracts, parole hearing transcripts, lobbying records, and state personnel board files—all are good sources of information. If you can’t interview current inmates, you can interview former inmates; talk to people who just got out, people on probation and parole, and their friends and family.

It’s worth the effort. Despite the human and financial reach of prisons, says Deitch, “What goes on in there is a complete mystery. It’s a leap of faith for the public. The role the press can play is to keep that light shining on what’s going on in prison facilities. They make sure that we get the prisons that we want and we deserve.”

By just about every standard, Dr. Nick Gorton is like any regular, well-adjusted guy. A 42-year-old veteran emergency-room doctor in the San Francisco Bay Area, he is happily married to his partner of 16 years. He is a self-professed science geek who enjoys hanging out with his Chihuahua-Jack Russell mix and spending too much time online.

But according to the American Psychiatric Association, Gorton has a major mental illness: gender identity disorder. Gorton was raised female, though as early as nursery school he knew he did not feel like a girl. Or, in the phrasing of Diagnosis 302.85 in the fourth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM), he had “a strong persistent cross-gender identification” and “persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.”

Transgender activists have long called for this diagnosis to be revised or removed altogether from the DSM, arguing that being transgender is not a disease but a human variation—more like being left-handed than schizophrenic. The manual listed homosexuality as a form of“sexual deviation” until 1974, and some advocates say that in a generation most people will see the diagnosis of gender identity disorder as equally absurd. Now, a new diagnosis has just been approved by the American Psychiatric Association, but challenges remain for transgender people in need of help.

Many trans people do describe being intensely unhappy before they came out—feeling betrayed by their bodies and unable to live as their true selves. This disconnect between one’s body and sense of self, known as gender dysphoria, can be crippling. “I literally spent the first three decades of my life, pretty much every day, unhappy,” Gorton says. He recalls seeing homeless men on the streets of New York City and wishing he could trade places with them just to have their bodies. In his early 30s, he decided to undergo a course of treatments that included a mastectomy, male hormones, and talk therapy. Now that he’s transitioned to living fully as a man, he says, his “tremendous amount of mental-health issues” are “virtually gone.”

Yet according to the current DSM, he still has a mental-health problem. The manual is the scientific bible by which psychiatrists and other mental-health professionals standardize, identify, and, importantly, bill insurance companies for their patients’ afflictions. Because the gender identity disorder diagnosis includes “a lot of stuff that basically just describes trans people,” explains Dr. Dan Karasic, a psychiatrist at the Bay Area-based Transgender Life Care Program, there is no way to be transgender, according to the DSM, without being mentally ill.

That can have devastating consequences. “We lose our homes, we lose our families, we lose our jobs,” says Kelley Winters, a transgender activist and the founder of GID Reform Advocates. Family law is littered with cases of transgender parents whose parental rights were threatened or terminated because their ex-spouses or former partners argued that their mental state put their children at risk. Until the Federal Aviation Administration changed its policy last August, transgender people aspiring to be pilots were required to undergo expensive psychological testing—which they often had to pay for themselves—before they could get a license.

The diagnosis has also been used to block legal equality for transgender people. At a hearing before the Maryland state Senate last February, Peter Sprigg of the conservative Family Research Council cited the “behavior” trans people “engage in in order to fulfill their sexual desires” and pointed to the DSM to support his argument against a bill that would protect trans people from housing and employment discrimination. “We should show compassion for these individuals, but that should manifest itself in mental-health treatments to help them become comfortable with their biological sex, not in legislation which denies the reality of their condition.”

Yet, advocates for updating the manual have also been in a bind: Medical interventions like hormone treatments and sex reassignment surgery can cost tens of thousands of dollars, and without a specific medical diagnosis, no health insurance policy will cover them. (Not that many do cover them even with a diagnosis.)

Major revisions to the DSM occur about once every 15 years, and the APA is set to release a new edition in May. In the new version, gender identity disorder will be renamed “gender dysphoria.” The new description specifies that this diagnosis only applies if a patient’s condition causes active suffering or debilitation, such as the inability to hold a job.

Some advocates are encouraged by the move to narrow the definition. “Once people have gotten whatever the requisite treatment is and they’re not in that state of immediate distress, then they no longer have a mental illness,” Karasic says. Yet the change includes a loophole that allows clinicians to make the diagnosis after patients no longer have symptoms in order to get their treatment covered by insurers.

“The reason we proposed this is that this would allow them to still have access to medical treatment” and coverage, says Dr. Kenneth Zucker, chair of the committee that drafted the new revision. Zucker is a controversial figure: The head of a clinical program in Toronto, his approach to treating transgender children has included discouraging behavior like cross-dressing and trying to steer kids toward living life in their birth gender. His appointment by the APA generated alarm among trans activists, but in the end their concerns were not realized; the new diagnosis, most acknowledge, is an improvement over the existing one.

With the argument over diagnosis settled at least for the next few years, advocates on all sides say it’s time to focus on showing the rest of society the normalcy of transgender people’s lives. “Things that are in the DSM are not disorders of character,” says Gorton. “They’re disorders of chemistry.”

I’m having lunch with Dana Cowin. Foodies everywhere would kill to be able to say that. As editor-in-chief of Food & Wine magazine, Cowin ’82 is one of the country’s most influential gourmands. Over the past seventeen years she has made Food & Wine the top food magazine in the United States, steadily growing its circulation and expanding its influence. It hasn’t been easy.

When Cowin took the reins at Food & Wine in 1995, the nation’s current obsession with food and chefs was in its infancy. The Food Network had launched only two years before. Iron Chef, Top Chef, and other reality cooking shows wouldn’t appear for another decade or more. And Food & Wine, founded in 1978, was “the third book in a two-book category dominated by Bon Appetit andGourmet,” says Ed Kelly, CEO of American Express Publishing, which publishes Food & Wine. “Now, within that group, one is gone, and the other is a struggling also-ran. The tables have flipped upside down under Dana’s leadership.” As a result of Food & Wine‘s success, Cowin earlier this year received one of the food industry’s most coveted honors when she was inducted into the James Beard Foundation’s Who’s Who of Food & Beverage in America, taking her place alongside Mario Batali, Martha Stewart, Madhur Jaffrey, and Tim and Nina Zagat.

Through it all, Cowin has maintained a sort of star-struck naiveté. It’s as if she’s a schoolgirl dropped into a room full of movie stars; she can’t get over how lucky she is. When two of New York’s top sommeliers walked in during our lunch at ABC Kitchen (which is just north of Manhattan’s Union Square), she burst out, “Ooooh!” and waved enthusiastically. “Robert Bohr!” she said. “Love him!” Cowin doesn’t write about food very often, she says, “because it’s really hard. The people who are good at it, I worship at their feet. And there are not many of them.”

With that in mind, here goes: Lunch begins with kale salad. It comes out alongside three slices of crusty bread in a rough-hewn wood bowl and a plate of fiddlehead ferns, compliments of the chef. The kale is lemony and tart, with a spicy kick, and the fiddleheads, available only a few weeks each year, taste like garlic and earth. “This place is alarmingly good,” Cowin says.

Part of the high-end decorating store ABC Carpet & Home, the restaurant’s décor is a mash-up of rustic and modern, as if someone had crossed a barn with an abandoned warehouse furnished by Mies van der Rohe. The feel of the place reflects its farm-to-table New American menu, and this synergy of design with food and drink is what makes Food & Wine tick. Because, despite its name, Food & Wine is not just about food and wine.

“The idea is to talk about life, but with food at the center,” Cowin says. “There’s this life that we talk about that we call the ‘always hungry’ life. They’re always hungry,” she says of her readers. “They always want more information. They’re adventurous. They’ll try new things; they’ll travel for food. The central idea is that somebody would have food and wine at the center of their life, and everything else would revolve around that.”

It would be easy to sell magazines by running five-minute microwave recipes or splashing pictures of Anthony Bourdain or other celebrity chefs on the cover. Cowin has chosen a different approach. Food & Wine contains plenty of recipes, of course, but Cowin has been masterly at giving readers instructions for food they can prepare while goading them to take their passion for food to the next level. She likes to see Food & Wine as the place where everyone from a small-town mom with an adventurous cooking streak to a Michelin-starred chef can turn to find out what’s new—to be surprised.

“We hope it’s not intimidating,” she says. “I really don’t believe that everything should be a thirty-minute meal. And I don’t believe that everything should be supermarket ingredients. One thing that has led to the magazine’s success is a balance between the aspirational and the practical. In every issue, we’re really, really conscious of delivering both.”

With a median household income of $160,000, many readers of Food & Wine can afford to be aspirational in ways the rest of us cannot. For us, the magazine is a masochistically delicious cascade of beautiful meals you’ll never eat at restaurants you can’t afford in destinations you can only dream of visiting: Tangier, Uruguay, Alsace, and Lyon. And yet, alongside every dish is a recipe, ranging from simple (mozzarella with summer squash and olive puree) to elaborate (baked seafood dumplings with saffron sauce and Swiss chard). Can’t afford a trip to Napa Valley’s hot new restaurant Oenotri to try their Pizza with Garlic Cream and Nettles? Make it yourself.

Food & Wine features such articles as “the Costco Challenge,” in which a celebrity chef is set loose in the warehouse store, and “Wine Lover’s Guide to Party Planning,” which suggests “the best buys in wine, food and style” at Target, Trader Joe’s, and Whole Foods. “I’m really interested in what people actually do,” Cowin says. “They actually go to Costco and Target.” The flip side of that is inspiration. “I want to inspire people to do things that they maybe wouldn’t have thought of doing.”

As soon as our lunch arrives, Cowin spoons bites of her chicken salad onto my plate. When I protest, she insists that “in the food world, you share. If you don’t share, you’re weird.” The salad is tossed in a light vinaigrette, slightly sweet with a hint of heat. In the salad are whole tiny carrots, battered and fried. Those carrots—crisp on the outside, sweet and soft on the inside—are one of the highlights of the meal.

In return, I tell her to help herself to bites of my tuna burger and fries—“I’m going to,” she says. “I wouldn’t actually give that a second thought”—and she does, reaching over throughout our conversation to dip the golden fries dusted with fresh rosemary into the aioli on my plate. We talk about how delicious the food is, but we don’t dwell on it. Dissecting in too much detail why a meal is special or satisfying, Cowin says, can ruin it.

“The key to being a good food writer is actually being a good fiction writer,” she says. “If you can write fiction—draw a scene, make characters, come up with metaphors, tell a story that goes from beginning to middle to end—that’s your best qualification. Every dish is a narrative. Every meal is a narrative. Every restaurant is a narrative. Every dinner party is a narrative. Without the narrative, it’s just a bunch of ingredients put together.”

Later that afternoon Cowin walks into a spotless, beautifully appointed kitchen ten stories above Times Square, where Justin Chapple is de-veining shrimp. Chapple, a lanky blonde with striking blue eyes, is one of the magazine’s three full-time cooks, and the Food & Wine test kitchen has three of everything: Sub-Zero refrigerators, sinks, industrial ranges and ovens, butcher-block counter space. Chapple has just finished preparing a plate of tacos with fingerling potatoes, kale, and chorizo. “Have you had fun testing these recipes?” Cowin asks him.

Oh, my god,” Chapple says. “So much fun. Everything is so different.”

Each year Cowin edits several Food & Winebooks, including cookbooks and a wine-and-cocktail guide. Chapple is testing recipes for a new annual cookbook that Cowin is calling the Discovery Series. This new book will showcase ten cooks, each of whom will contribute ten recipes, with art shot by ten different photographers. Discovering new talent, Cowin says, is one of the most fun and most important parts of her job. The magazine does this all year, but once a year a special issue showcases ten Best New Chefs, a designation that can make careers and rescue faltering restaurants.

“One of her favorite days of the year is when she gets to call our Best New Chefs and tell them that they’ve been selected,” says Cowin’s deputy editor, Christine Quinlan. “Without fail, there’s always somebody who thinks they’ve been punked, someone who’s in tears, someone who’s cursing in public.”

Best New Chefs like David Chang or Thomas Keller are unknown when they are selected, but then “go on to do just incredible things,” Cowin says. “I’m trying to think of a way to say this without sounding conceited, but we don’t make a lot of mistakes when we pick talent. People come to rely on the magazine for finding new talent, and the new talent is so proud of having been found that they help promote the magazine.”

As the Best New Chefs demonstrates, Cowin has transformed Food & Wine from a magazine into a brand. Each summer the chefs are fêted at the Food & Wine Classic, an extravagant, star-studded weekend in Aspen, Colorado. It  is one of seventeen events that the magazine puts on each year—opportunities, Cowin says, to maintain a personal connection with readers and “bring the magazine to life in three dimensions.” The Food & Wine brand now includes the print magazine, events, an active social media presence (including Cowin’s own lively Twitter feed), books, iPad and other tablet versions of the magazine, and a content-packed, aesthetically engaging, and revenue-producing website. “The breadth of the brand,” Cowin says, has helped solidify Food & Wine’s place.

Make no mistake: the magazine is still the brand’s core. Food & Wine is always evolving, Cowin says. Interest in wine among the general public, for example, has increased dramatically over the last decade. In the past, readers serious about wine, she says, “had a geeky magazine which had point scores. But we are the magazine for the wine enthusiast who just wants to understand it better.”

Food & Wine has in the past several years devoted a lot more space to mixed drinks, which have become an important trend in the food world. Until then, those who love the kooky names and great stories about cocktails but don’t necessarily want to dissect every ingredient “didn’t have a general interest magazine that was really for them,” Cowin says. “If you love cocktails and food, then we become the magazine for you. All of these side groups have a home at Food & Wine. We see it all as part of a lifestyle.”

Cowin is one of those editors whose antennae are always up. “This ingredient I’ve seen at five other places!” Cowin told deputy editor Quinlan recently over a meal. “Maybe there’s a story here!” Quinlan adds: “The wheels are always turning.”

“Dana is, in a world where that’s becoming rarer and rarer, one of the most principled people I know,” says Andrew Zimmern, host of the Travel Channel show Bizarre Foods and a food celebrity in his own right. Zimmern said that where other magazines beg him to appear in their pages—“I’m not humble-bragging,” he says. “I have a TV show. So I’m a recognizable face and name; it helps sell magazines”—it took Cowin three years to hit on a way to work with Zimmern that felt true to Food & Wine’s brand identity. “If you’re trying to create an image for a magazine and what a magazine stands for, you need to have a really keen understanding of what the magazine is about,” Zimmern says, “and it’s really hard to stick to your guns.”

Cowin’s introduction to the magazine world came when her former Brown English professor, the late Roger Henkle, landed her an entry-level job at Vogue, where one of her tasks was to edit the magazine’s monthly wine column. The text, she concedes with a laugh, was unreadable “before I got it, and after I got it. I was not Mrs. Added Value.”

But the magazine introduced her to the “food lifestyle” idea, she says: “the place where food, design, entertaining, wine all intersected.” The decorators and fashion designers that the magazine profiled all lived what Cowin describes as “pretty lives,” and she was drawn to their beautiful houses and the elegant way they set a dinner table. To this day, Cowin says, “I love houses. I love design. I love the way people live. I love objects. I love artisans.” And she loves entertaining. She and her husband, Reuters producer Barclay Palmer, and their two kids, Sylvie, 11, and William, 9, spend weekends in upstate New York, and they often invite friends to come along.

With short brown hair, a petite frame, and a preference for dress blazers in bright colors or bold prints, Cowin certainly doesn’t look like someone who eats for a living. Born and raised on New York’s Upper West Side—from the roof of her current apartment building she can see the one where she grew up—Cowin says she comes from “a total non-food household. My mother literally does not cook. I don’t think she has ever cooked me a complete meal. She subsists on English muffins, chocolate bars, and going out. That’s not even an insult to her. It’s just a fact.” When, during and after college, Cowin discovered that she liked entertaining, she taught herself some simple dishes in order to have friends over. “And,” she adds, “maybe find a boyfriend.”

But, Cowin says, “I don’t pick up a pot or a pan during the week.” If she isn’t eating out for work—and, she says, she tries not to do so more than two nights a week so she can be home to put her kids to bed—dinner is usually something easy and fast, like yogurt. “But on a weekend, a Saturday, I will just spend all day standing at the stove, or chopping at the counter, or shopping or marketing.” Her idea of a happy Saturday, she says, is going to a flea market and a farmers market. “I love shopping for food. Love it. If I do not go to a farmers market, I actually feel incomplete.”

In the early days at Food & Wine, Cowin says, the work was simpler. There was no Pinterest or Tumblr or iPad edition. She edited a magazine. And yet, “I worked every single weekend, and I worked every night until 9 or 10 o’clock. When I think about that, it’s comical. What could I have been doing?” She chuckles as she recalls it. “Part of it was, I was trying to reimagine something. But part of it”—she pauses, laughs some more—“I mean, I needed to get a life.”

Now she grapples with a very different problem. In Aspen this summer, Cowin sat down for a two-and-a-half-minute interview with the website genConnect. How do you balance your career and kids? the host asked. How do you make time for yourself? “I have no time for myself,” Cowin says. But “every minute that I’m doing my job, I love. And every minute I’m with my kids—” she pauses, considers. “Well, 99 percent of the time I love being with my kids. But that’s my time, actually. I don’t need the separate extra time. I’m not sure what that separate extra time would be. Because my days are filled with fun.”

Although she’s a tough critic with a strong point of view, Cowin often describes herself as “pathologically positive.” Coworkers describe her as relentlessly upbeat and supportive. “Dana is incredibly loyal to her staff, and does everything she can to try to take care of them,” says Quinlan. The magazine had never had a deputy editor before, she says, but Cowin, impressed by Quinlan, invented the position in order to promote her. “You don’t have to ask for all of these things,” says Quinlan. “When you work hard, it’s recognized and rewarded.”

Cowin first earned the pathologically positive descriptor in 2008, after she was diagnosed with breast cancer. She wrote about her experience in an essay in O, The Oprah Magazine. “After her diagnosis,” the introduction read, “Dana Cowin saw three choices: (1) feel sorry for herself, (2) hole up alone, or (3) celebrate the things that matter most.”

The essay, called “Is This Any Time for a Party?” described the series of “cancer parties” Cowin threw during the year that she has come to describe as “my year of breast cancer.” One party had an if-life-gives-you-lemons-make-lemon-meringue-pie theme. “My friends would bring both savory and sweet pies,” Cowin wrote: “Quiche, apple, chocolate pecan, and of course lemon meringue. And my mother would host. No way did I want to cook or clean up for a big group of people. I’d been feeling relatively well, but not that well.”

Another party, timed to coincide with her double mastectomy, was a ladies-only Soul Sisters party, with a 1970s-style dress code, platters of soul food, and bottles of Strong Arms Shiraz. At another, Cowin made a toast that Food & Winepublisher Christina Grdovic says has stayed with her ever since. “I just want to tell everybody,” Cowin said, raising her glass, “stop saying you can’t find the time. To learn photography, or learn a new language, or go to the gym, or spend time with your kids. I definitely didn’t think I had time to go to chemo every day for sixty days. But you know what? I found the time.”

“It’s weird to say,” Cowin concedes now, “but I had a very good year.” She reconnected with old friends, who cooked for her and accompanied her to chemotherapy. “Drip buddies,” she called them. “My husband likes to remind me it was indeed stressful. And I was sick. But my immediate emotional reaction was sort of positive. And then you get all this positive reinforcement for having reacted positively to cancer. Then you feel really great about yourself!” Cowin knows how lucky she is: “I wouldn’t want to fight the demon that is the sadness about illness, because that’s really, really, really hard.” But, for the most part, she says, “it just didn’t come.” Cowin has been cancer-free for more than four years now. After five, she will be considered, as she puts it, “done with that cancer.”

Grdovic says that Cowin’s reaction to her diagnosis is reflective of her approach to life in general: “If you can take something as horrible as cancer on with a positive attitude, imagine how great it is to take on things like food and wine and parties and entertaining, that are really fun to begin with.”

At our ABC Kitchen lunch, we decide to share the salted caramel ice cream sundae for dessert. The subtle flavor of the ice cream, served in a sea of chocolate sauce, is set off by the crunchy, salty sweetness of the candied peanuts and caramel popcorn sprinkled on top. With the toppings so reminiscent of peanuts and cracker jack, I am surprised to discover that each mouthful tastes nostalgically, whimsically, exuberantly like the circus.

Ultimately, it’s that moment of surprise—the discovery of some amazing piece of furniture at a flea market, an idea shared over a meal that might change the world, the summer’s first perfect ripe tomato—that makes Cowin say that she has the world’s best job. “I personally think that every day, if you’ve had an adventure in taste, your day is better for it,” she says. “I hope we’ve helped people expand their happy world.”

Where the Knives Meet Between the Rows by Leigh Marble ’97 (Laughing Stock Records, 2012)

Leigh Marble was angry. It was a dark, relentless anger. In 2007, his girlfriend, Elena Wiesenthal ’98, was diagnosed with breast cancer, and suddenly hanging over the couple’s lives was “a feeling of constant impending doom,” as he describes it. Out of that fear and rage Marble created his third full-length album, Where the Knives Meet Between the Rows.

“Writing is my last option when I’m at the end of my rope,” Marble says. “So when I had nowhere else to go with these feelings—when I had exhausted the easy ways out—of drinking or taking antidepressants in order not to feel these things—I wrote what I was feeling, often quite bluntly, and turned them into these songs.”

While the Portland, Oregon-based Marble fought his demons in the studio, Wiesenthal underwent treatment, and in 2008 her cancer entered remission. The couple decided to start afresh: after many years together they married—“as a way to put it behind us,” Wiesenthal says. Their daughter, Vivian, was born last April. “It was a new phase of our life,” Wiesenthal says. “[We thought] maybe life won’t be as dark once our child comes into the world.” Given the darkness of Knives, she says, “It was important for Leigh to finish the record before I gave birth.”

The album’s opening track, “Walk,” begins with twenty seconds of a single melancholy note of feedback and the heartbeat-like thump of a tom-tom. “I’m gonna walk until the anger’s gone,” Marble sings. “Gonna walk into the setting sun.  “Gonna step into the anger ball and let it burn ’til it’s all done.”

The song is aggressive, Marble concedes. “It starts off in your face and doesn’t leave much of a silver lining.” But it was important, he says, that “Walk” be the opening track. “Here we are, in medias res. Boom. You’re in my shoes.” The tune also functions as an overture, laying out themes that run throughout the record.

In Knives, brooding vocals and a fuller instrumentation replace the dark-edged, experimental Americana sensibilities of Marble’s earlier records. That early work owed a debt to Wilco and Tom Waits. (“Steel-cut oats and billy goats, wrapped in a crunchy fuzz blanket” is how Marble describes his second album, Red Tornado). His plaintive baritone on Knives is more reminiscent of Magnetic Fields frontman Stephin Merritt.

On this new CD, even songs with lilting and sweet melodies have a dark edge. “I know you want to leave me,” he sings on the lullaby “Goodnight.” “Well, I want to leave me, too.” A song that sounds like a paean to a sparkling sunset turns out to be sinister. “The line of cars in the late afternoon glitters from here to the horizon,” Marble sings in the subdued waltz “Cars.” “It’s the sickest thing.… Making clouds of waste, skies of waste, mountains and valleys and oceans of waste.”

For all its edginess, the album does offer some reprieves. “Holden” is a send-up of Portland’s hipster poseurs, and “Pony” is a rollicking, laugh-out-loud rock anthem about an awkward sexual encounter. Despite its deep sadness, the dirge “Nail”—which Wiesenthal says she can’t listen to without crying—looks forward: “And there at the end of your rope,” Marble sings in haunting two-part harmony, “you’ll test the aerodynamics of hope.”

When Marble finished Knives, Wiesenthal was seven months pregnant. He planned a West Coast tour, sent copies of the record to the press, and booked a launch party.

And then Wiesenthal’s cancer returned.

She is undergoing another round of chemotherapy and radiation; her doctors tell her she’s lucky that in both instances she caught the disease early. Marble postponed his tour to stay home with his family. So far, the fragile optimism he struggled to achieve has been shaken but not destroyed. On his website, he is slowly letting his fans in on what he’s going through.

“You don’t want to feel like you’re exploiting it,” he says. “But at the same time, it just felt like a conspicuous absence without talking about what was really going on.” He’s working on new songs about this next phase of his journey, which he plans to take into the studio next winter.

“That’s part of the process for him,” says Wiesenthal. “Not just making music, but having people hear it. Having art affect people’s lives in some way, even for just a moment of a song.”

Her brown hair pulled back in a ponytail, a twentysomething woman at Mitt Romney’s October 10 town hall meeting in Hopkinton, New Hampshire, asked the presidential candidate, “Will you commit to putting 6 million people on lifesaving medication by 2013 in an effort to end the worldwide AIDS epidemic?” She was referring to incumbent president Barack Obama’s World AIDS Day 2011 pledge to increase to 6 million the total number of people treated for HIV under the President’s Emergency Plan for AIDS Relief (PEPFAR).

Rather than answer the young woman’s question, Romney changed the subject. “Here’s what I’m going to do to balance the budget,” he said.

Soon another question was lobbed at Romney, this time by a young man in the far corner of the town hall. “I would like to know if a Romney administration would be committed to continuing the tradition laid forth by the [George W.] Bush administration in terms of [how to] fund PEPFAR and the Global Fund [to Fight AIDS, Tuberculosis and Malaria],” he asked. And then another, from a young woman elsewhere in the room: “This is a follow-up on the questions about HIV/AIDS funding,” she began, before Romney finally snapped, “I’ve got nothing more for you on that.”

Meet the bird-doggers, a tenacious group of HIV activists who pursue political candidates at local and national campaign events as relentlessly as a pointer on the scent of a quail, hurling questions about HIV policy and funding at contenders from all parties. As the 2012 elections approach, bird-doggers are just one part of a widespread political mobilization led by the HIV/AIDS community. Races with important implications for HIV-positive people range from those for city councils and state legislatures all the way up to the contest for the White House. With that in mind, advocates, activists and policy wonks are designing voter registration drives, scaling up lobbying efforts and planning direct actions.

“The stakes are very high,” says Ronald Johnson, vice president of policy and advocacy for AIDS United. With trillions of dollars in cuts to the HIV safety net being used as a pawn in the fallout from last year’s debt ceiling debacle and with the full impact of the Affordable Care Act still unknown, Johnson says, “this is not an election to be on the sidelines.” Indeed, with 28 million positive people going untreated for HIV worldwide—750,000 of them in the United States—the outcome of the 2012 race will have lasting and potentially dire repercussions.

Advocates wistfully recall a time when funding for AIDS was a bipartisan issue. In 1990, the Ryan White CARE Act passed the Senate almost unanimously, 95 to 4, and one of its most vocal proponents was Senator Orrin Hatch, a conservative Republican from Utah. PEPFAR itself—the single largest financial commitment in history by any country to combat a disease—was established in 2003 by then-President George W. Bush, with congressional support from both major parties.

No longer. Now the two parties’ stances on issues affecting people with HIV are diametrically opposed. Take the Affordable Care Act (ACA, or “Obamacare”), a “game changer in making progress against the domestic epidemic and absolutely critical,” says Chris Collins of amfAR, The Foundation for AIDS Research. Democrats, led by the Obama administration, passed this legislation two years ago. Republicans, on the other hand, opposed the bill en masse in the House and Senate (not a single Republican in either chamber voted for it), and at press time, they had voted for the 33rd time to repeal it. Romney has pledged that repealing the ACA would be one of his first priorities as president.

More broadly, the two parties’ differing financial philosophies have deep implications for the HIV community. As a result of the debt ceiling fiasco in summer 2011, when Congress could not agree on a limit to the debt the country could amass, and the subsequent failure of the “super committee” (the bipartisan Joint Select Committee on Deficit Reduction), Congress must now find an estimated $1.2 trillion in savings in the federal budget. To do so, Democrats favor a blend of tax hikes and spending cuts. Republicans insist on achieving all of the savings via cuts: no tax increases. Since Republicans are also loath to cut defense spending, “that means it would only be discretionary dollars cut—basically only social service programs,” says Christine Campbell of Housing Works. These include Medicaid, Ryan White and other critical programs that directly fund HIV services. “[Republicans are] going to work at balancing the federal budget on the backs of poor people.”

So the choice is clear, right? If you care about people living with HIV or are yourself HIV positive, you should vote for President Obama and the Democrats, right? Advocates will say so behind closed doors. But don’t count on hearing it publicly.

That’s because almost all AIDS service and advocacy organizations register as 501(c)(3) nonprofits, forbidden by law to endorse candidates. There are discussions in the community about founding a new 501(c)(4), or political action committee, to do more straightforward political fundraising and support in the future. For now, organizations must focus on registering voters—something the national movement is gearing up to do on a large scale—and publicizing the issues that matter.

“If health care reform is [fully implemented] in 2014, you’ll have access to Medicaid, you’ll be able to get medications at no cost for HIV and for heart disease, diabetes, mental health. But if health reform is repealed, good luck with all that,” says John Peller, vice president of policy for the AIDS Foundation of Chicago. “[Informing people of this] is education we can do without running into trouble around the election laws.”

On a warm evening during Gay Pride week in Boston, the local ACT UP chapter gathered in a South End bar amid rainbow balloons and drag performers. Katrina Ciraldo, a 26-year-old Boston University medical student, unpacked a box of fliers that read, “A TAX CAN END THE AIDS CRISIS” over the iconic image of the charging Wall Street bull.

The flier promoted the “Robin Hood tax”—a tax on financial transactions to raise money for -social issues such as HIV/AIDS—and referred to recent scientific findings that have left the HIV community full of optimism. “R.I.P. HIV,” shouted the pages of this magazine. Secretary of State Hillary Clinton said the world’s first “AIDS-free generation is ambitious but possible.” President Obama spoke publicly of the “end of AIDS.” That’s because recent evidence shows treatment can be prevention: Since antiretroviral treatment for people with HIV may reduce sexual transmission risk by up to 96 percent, universal access to meds could be the practical equivalent to ending AIDS. Research toward a cure has also progressed.

Whether and how this access will be funded, then, is a crucial question—and a larger one, some activists say, than simply who wins in November. “If we’re going to educate voters, and get voters out, then we need to do the other part too,” says Health GAP’s Jennifer Flynn. “Which is, show that we’ve actually got numbers. I don’t think elected officials know [how many Americans are actually living with HIV/AIDS]. We have to show them that.”

During campaigns, candidates are often more sensitive to public pressure and more open to new ideas. What’s more, those inclined to take a particular position may still need public pressure for political cover. Many activists cite the advice Franklin Roosevelt is supposed to have given labor leaders urging him to create the National Labor Relations Board: “I agree with you,” he told them. “Now make me do it.”

That’s why as we go to press, activists are organizing a major march and rally in Washington, DC, during the XIX International AIDS Conference (AIDS 2012). With the eyes of the world focused on DC and HIV for that week, the conference “is the perfect advocacy opportunity,” says Flynn of Health GAP, one of the march’s organizers. The We Can End AIDS Mobilization hopes to bring tens of thousands of activists to the capital to call for everything from ending the criminalization of sex workers, drug users and people with HIV; to stopping attacks on LGBTQ people; to providing money for AIDS housing—and to finding a cure for HIV, a move that would truly end the epidemic.

At that Boston ACT UP meeting, a dozen people ranging in age and experience from college students to gray-haired veteran activists were planning a teach-in about the tax. “[The teach-in will] illustrate how we are planning to build power over the months until the election to make [the Robin Hood tax] a campaign issue for Elizabeth Warren and Scott Brown,” Ciraldo said, referring to the candidates for Massachusetts’s hotly contested Senate seat. “If we bird-dog them, maybe we can get the financial transaction tax in the news on a statewide level.”

But not everyone is comfortable with this confrontational approach. More cautious advocates fear that publicly announcing the ways Democrats have fallen short in their efforts to end AIDS will only give ammunition to the right and alienate potential voters. “This is not the time for a blame game or a lot of negative advertising,” says Kali Lindsey of the National Minority AIDS Council. “There are ways to hold individuals accountable without going on attack mode.”

Further, some fear that being too vocal and too critical will cause the AIDS community to lose access to the Obama administration—or any administration, for that matter.

“We might piss them off and not be their quote-unquote ‘friends’ anymore and therefore lose our quote-unquote ‘seat at the table,’” as Housing Works’ Christine Campbell characterizes it, with no small amount of frustration.

But regardless, history has shown that getting to the table is not an effective end goal. Those who sat at the table with the Obama administration last year to encourage broader access to care were surprised when little more than a month after his December 2011 pledge to expand treatment via PEPFAR, the president recommended an estimated $550 million cut from that program. Both the organization’s officials and the Obama administration claim that the goal of getting 2 million more people into care via PEPFAR can and will be done anyway, but questions remain about what will not be done for people with HIV as a result of the cut.

The real issue is not so much whether to be polite or loud, but rather how to recognize some extraordinary steps the Obama administration has made for people living with HIV—such as providing emergency funding for the AIDS Drug Assistance Program (ADAP) in 2011 and 2012—while pushing for more. To people who say: “We need to get Obama re-elected, [so] we can’t really yell at him,” Campbell responds,  “We need to push him a little farther. [Otherwise] he’s going to stay in the middle. We have to be in the streets, being loud, being visible. Being vocal.”

At 20, Norman Spack learned the power of hormones. By adjusting the prolactin and thyroid levels of tadpoles, Spack found he could prompt metamorphosis; he watched from a bench in his research lab as they grew legs and their gills were absorbed and replaced with lungs.

Forty years later, a patient named Mark walked into Spack’s adolescent medicine clinic in Chestnut Hill and told Spack he wanted to change. He was male, he told Spack, but his body was a woman’s.

Back then, in the 1980s, many doctors might have seen Mark’s predicament as a mental-health problem: someone with a desire that challenged the status quo of society and gender must need a psychiatrist, not an endocrinologist. But Spack approached the personable young man in much the same way he had approached his research on newts: Mark had a practical problem, and Spack had the tools to address it. “I had given plenty of testosterone to hypo-gonadal males,” he recalls. “It just seemed to me you’d give the same amount you’d give a guy.” And that’s what he did.

Now nearing 70, and at the edge of retirement, Spack has gone on to change how transgender kids are treated. When he founded the Gender Management Service, or GeMS, at Boston Children’s Hospital in 2008, it was the only pediatric clinic of its kind in the US. Adapting protocols developed by doctors in the Netherlands — the “Dutch masters,” he calls them — Spack was one of the first doctors in the United States, certainly the first based at a major urban academic children’s hospital, to try to tackle this problem, treating kids as young as nine with hormone blockers to delay puberty.

Today, clinics for transgender kids in British Columbia, San Francisco, Los Angeles, Chicago, Denver, Minneapolis, New York, Hartford, Providence, and Washington, DC, have either been created or expanded. And in almost all of these places is a doctor that Spack has trained, mentored, or guided.

“As centers like Norm Spack’s are starting up in a number of places, a lot more pediatricians and a lot more child psychiatrists will be educated about this issue and will be able to refer children,” says Laura Erickson-Schroth, a psychiatry resident at NYU and a former student of Spack’s who is helping to set up a clinic like GeMS in New York. This is both a result of Spack’s work and a sign of the times. As a result, “as a society, we’re sort of beginning to accept that gender and sexuality are not straightforward and simple.”

Spack, for one, understands transsexualism as a straightforward medical issue. “This is two conditions that pediatric endocrinologists treat all the time,” Spack says. “One is precocious puberty. The other is delayed puberty. So for the transgendered, it’s the precocity of the puberty they never wanted, and a delay of the puberty they affirm.

“Gender dysphoria is a condition that can be treated rather easily,” he says. “You don’t need to be a rocket scientist to take care of a transgender patient.”

For decades endocrinologists have been treating transgender adults with cross-gender hormones: testosterone if you’re female-to-male, and estrogen if you’re male-to-female. This is nothing new. But for kids like Spack’s patient Justine (names have been changed to protect the identities of the children and their families), who, from the moment she could speak, “told us she either wanted to be a girl or she was a girl,” as her dad describes it — kids who can articulate their gender identity, without a shred of doubt, from the time they are toddlers — waiting until after puberty means years of psychological agony; girls develop thick muscles and deep voices, and boys grow breasts and hips and get their period. The risk for self-harm during this time is enormous; among Spack’s patients, one in five has engaged in cutting or other self-mutilation, and almost 10 percent have attempted suicide. Waiting to intervene until after puberty also means playing catch-up physically, with more medical interventions and more extensive surgeries required to “pass” in the right gender as teenagers and young adults.

Unlike the cross-gender hormones that kids may start later as teenagers, the effects of the puberty suppressors are entirely reversible: adolescents who stop taking them will immediately begin to experience puberty in their birth sex. The idea is to buy them some time. Time to grow up, time to develop what Spack calls “clarity and certainty” without the stress of their unwanted puberty bearing down with increasing intensity every passing day.

For the first nine years of his life, Aileen Smith’s son hated his name. It’s a girl’s name, and not only couldn’t he bring himself to say it aloud, he couldn’t even be friends with girls who shared it. When he first went to see Spack, the boy — who later named himself Kyle — had a flat chest and lanky body. But he was only nine. That would soon change.

Spack told them that Kyle would get his period within a year and a half. He’d also start developing. He would likely be a C cup.

You can almost hear Kyle’s breath catch in his throat as his mom recalls this visit. “Geez,” he whispers. He sinks deeper into the ottoman where his legs are folded underneath him.

Now 15, Kyle is a sensitive young punk kid with a floppy brown Mohawk, a blue lip piercing, and a set of rainbow rings around his neck. He is happy and easygoing, well-liked at the lefty private high school where he’s just finished his freshman year, and close with his family. When he first met Spack, though, he had for years felt so uncomfortable in his own skin, that he developed paralyzing anxiety; he refused go to school, lest he’d have to talk to someone, or worse, introduce himself.

Kyle only recalls his first appointment in bits and pieces. Many memories of his life before age nine are this way. He can’t — or won’t — remember them. But he does remember looking at Spack as “some kind of god” when he told him that there was another way. And he does remember when Spack told him that without intervention he was going to be, physically, a well-developed young woman within the year.

“Shit flew off the hook,” Kyle says.

Doctors and other providers working with transgender patients typically “have some sort of personal connection, whether through their politics, or they were in the LGBT community already,” says Spack’s former student Erickson-Schroth. Spack, on the other hand, “came to this by accident. He just saw there was something wrong in the world, and he did something.”

Spack grew up in a conservative Jewish community in Coolidge Corner, where his father ran a Hebrew school and was devoted to their local synagogue. Although as a kid Spack looked up to his dad’s best friend, their family physician, he never seriously considered medicine as a career until his senior year of college.

It was an accident, really, dumb luck that led him to a senior biology thesis that would set the course for the rest of his career. A student before him had been working with newts and other amphibians, and an ecology professor invited Spack to continue the research the other student had started. And so Spack sat on that research lab bench, watching the tails of these aquatic animals shrink and their legs grow for their new life on land.

The parallel isn’t lost on him: he chuckles now to think of himself as a college student, using many of the same hormones he uses now, to much the same effect.

Spack went on to medical school, and then post-graduate training in adolescent medicine and endocrinology. And among a certain subset of the endocrine patients he saw in his adolescent medicine clinic, he discovered something unsettling: “Sometimes there was a kind of conspiracy between the doctors who cared for them years before, and the parents,” says Spack. A conspiracy “to not tell what had happened to them.”

As many as one in 100 babies are born with genitals, chromosomes, hormonal systems — or some combination of these — that don’t fit the standard parameters for male or female. Today, treating kids with what are now known as “disorders of sexual differentiation,” or DSD, is one of GeMS’s specialties, and Spack routinely helps families decide whether to raise their child as male or female and weighs in on whether and when surgery is required. In making this decision, they consider “diagnosis, genital appearance, surgical options, need for lifelong replacement therapy, potential for fertility, views of the family, and, sometimes, circumstances relating to cultural practices,” Spack and his colleagues wrote in a landmark 2006 consensus statement in the journal Pediatrics on the management of intersex disorders.

But these guidelines were developed partly in response to increasingly vocal activists like Intersex Society of North America founder Cheryl Chase, who as an infant had her clitoris surgically shortened. Before people like Chase began to speak up in the early ’90s, parents of these kids — even babies who were unambiguously sexed except for a particularly small penis or a large clitoris — were often pressured into sex reassignment and early genital surgery to make their infants appear more “normal.” In some cases, the condition was treated as an emergency, and parents were not even consulted until after the surgery was over.

By the time Spack began his adolescent medicine practice, it was not uncommon for him to meet teenagers who had never been told that these surgeries had been performed on them as infants.

“In the days before the computer, you could seal medical records,” Spack recalls. “You could literally control that information.” But one of the reasons Spack was drawn to working with adolescents in the first place was that he liked to have independent relationships with his patients — developing trust with teenagers gave him a “direct line” to them that bypassed their parents — and he felt strongly that these kids needed to know what had happened to them.

“This was in an era when chromosomes were so important,” says Spack. “If somebody’s chromosomes didn’t match the way they were raised, many parents didn’t want the kids to know.” For instance, he saw young women who “never knew that they were born with a male set of chromosomes. There were a number of circumstances where I would tell them and make them understand how meaningless their chromosomes were.” The parents feared that the information would “do something to their gender identity,” but Spack consistently found that it didn’t.

While he worked with young intersex patients during the day, at night he volunteered one evening a month on a medical outreach van with the organization Bridge Over Troubled Waters. Here he encountered members of the LGBTQ community professionally for the first time. The “Bridge kids” were hustling for sex, some of them in drag bars, dressed as women.

Spack wasn’t sure whether they were gay, transsexual, or just runaways doing what they needed to do to get by.

“I was naïve,” he says now. “I thought that all the kids I saw in the streets were runaways. And I had been told about the rules about runaways, like that they could be housed for three days without calling the parents. But one of the street workers said, ‘They call them runaways. These kids are throwaways. Our goals aren’t to get the kid home. Home is not a safe place.’ ”

His 10 years working with Bridge kids left a lifelong impression on Spack, who is acutely aware of the “kind of ideal world” that GeMS selects for when it screens its patients. “Both parents have to agree, and you have therapists who have weighed in, good people you trust.”

This, he knows, is sadly uncommon. Even transgender children with one supportive parent, he says, are “one parent away from being a Bridge kid.”

For Kyle Smith at age nine, the first two of GeMS clinic’s three requirements to begin puberty blockers were easy: extensive psychological testing confirmed that he had a “strong and persistent” desire to be a boy, and ongoing mental-health counseling was also covered: he’d been going to therapists for years. But the third requirement — support of both parents?

“Fathers often do come around a little later,” Aileen says of her husband. “Medical things are so hard. He was supportive, but he was saying, ‘Let’s see. This could be a phase. How do we know?’ ”

For Kyle at that first appointment in Spack’s office, the stakes couldn’t have been higher. “He walked up to his dad, and looked at him as if he was like a teenager, but he was only a little boy,” Aileen recalls. “He must have been thinking, ‘I didn’t come this far to be told that I have to leave and not get help.’ He said, ‘Dad, I need help. You need to help me. You need to tell Dr. Spack. I need medical help.’ He literally said those words: ‘I need medical help.’ ” Aileen looks at Kyle now, who is fiddling with a rubber rainbow bracelet. “And Dad started crying.”

“I really don’t remember that,” Kyle says. “I wish I did. I can’t picture that at all. I’ve never seen my dad cry.”

Aileen nodded. “Dad started crying and he looked at Dr. Spack, and he said, ‘I understand. You need to help my son.’ And that was the beginning.”

Happy with the treatment he received from Spack, Mark referred his friends, and his friends referred their friends, and soon Spack had a busy practice of transgender teenagers and adults. Doing this work, he was often struck by “how difficult it was, particularly for male-to-females who were undergoing transition in their 30s and 40s,” he recalls. For those who had completed puberty in their birth sex 20 and 30 years before, hormones and surgery could only do so much. So when, in the early 2000s, he heard about a new Dutch protocol which could prevent the onset of puberty in young trans people, he was intrigued.

He was a pediatrician, after all, and together with the administration at Boston Children’s Hospital — where he was transitioning to a full-time position — Spack decided to transfer all of his adult patients to other providers in order to focus solely on kids. He personally trained many of these doctors who went on to care for his adult patients. One of them was Alex Gonzalez, medical director of Fenway Community Health Center.

The Fenway has 800 patients in its transgender health program and is considered one of the nation’s premiere medical centers specializing in care of the LGBTQ community. Indeed, you might think they had a strong transgender health program from the start. But “of all the many different people we’ve had to come help us build our program here,” says Gonzalez, “Dr. Spack stands out as one of the most instrumental.” Spack’s “Transgender Health 101″ presentation some six years ago, and his ongoing support, has helped to quadruple the program’s size. “Probably the most attention-getting aspect of Dr. Spack’s approach is that it really isn’t sensationalistic at all,” says Gonzalez.

At the time, Spack had colleagues who wanted to start a program like GeMS, but they faced unsupportive department chairs reluctant to intervene medically “in a pediatric population deemed to have a primary psychiatric problem,” as Spack describes it. “They said, ‘You guys have got to be nuts, doing this in a pediatric hospital.’ ” But the administration at Children’s was on board from the start. Joseph Majzoub, Chief of Endocrinology at Children’s, who years earlier had helped arrange a special rider on Spack’s malpractice insurance to allow him to see transgender adults, encouraged Spack to pursue puberty suppressants, the newest approach to treating transgender kids.

“The guiding principle should be what’s best for the patients,” Majzoub says. “Norm has been very crystal clear in his thinking about this and his commitment. He made it easy. I don’t know what the biases might have been elsewhere, but when one takes one’s cues from what the patients need, you’re usually right.”

Kyle Smith had crushing parental separation anxiety and, until he was 10 years old, not a single friend in the world. How could he? He couldn’t even say his own name. He had not gone to school for more than a week since first grade. His family and the school had tried everything, from a rewards system to the principal carrying him physically into the building, but it was never long before he had a massive anxiety attack and had to go home.

“Dr. Spack and his team told us that his anxiety, his school, everything would be fine, when he lived fully as a boy,” recalls his mom, Aileen. “And of course they were right. Everything.” They had to move from a small college town in central Maine to another city in that state in order to do that — they later won a large settlement from their original school district when the school superintendent refused to cooperate — but once he walked into the first day of sixth grade at his new school with his new name, his male pronouns, his boy haircut, and boy clothes, he introduced himself to his new friends and never looked back.

As kids like Kyle become increasingly more accepted, and as access to care becomes easier, critics on both the left and the right of Spack’s pragmatic, supportive approach fear that Spack and those like him are making it too easy for kids to transition.

“If you put a kid on blockers, in a way the clinician is giving either an implicit or explicit message that we don’t really see that there are alternatives than to go down a sex-reassignment pathway. And we don’t really see it as possible that there could be other outcomes that may be equally as good — maybe even better for some kids,” says Dr. Kenneth Zucker, head of the child and adolescent gender identity clinic at Toronto’s Centre for Addiction and Mental Health.

Accused by some of practicing “reparative therapy”— he encourages parents to stop their young gender-variant kids from experimenting with opposite-gender names, toys, and clothes — Zucker is something of a bête noir in many trans communities. But he feels strongly that “if a child can grow up and feel comfortable in his or her own skin that matches their birth sex, then you avoid the complexity of fairly serious surgical treatments. Penectomy and castration is not the same thing as having mild and minor cosmetic surgery. Lifelong hormonal therapy: it’s serious.”

On the left are critics who dislike the binary model that GeMS inevitably plays into. “Sometimes when I speak in a binary model, people are critical of that,” says Spack. “They want more fluidity about gender.” As an endocrinologist, Spack can only treat those trans kids who want to be either boys or girls: there can be no gray about it. His hormones and pubertal suppressors would be of no use to other kids — and the intervention is too serious for him to consider using with kids who might later change their minds. Still, he’s not advocating that kids need to live in a binary if that’s not right for them. “I would [defend] the right to be genderqueer just as much as I would defend the transgender person’s right to be in the gender they affirm,” he says. “So when people come up to me, I say, ‘You know, you of all people should be sensitive to the fact that in my accepting you, you have to accept them.’ ”

Whether transsexualism is a medical or psychiatric issue — or an issue at all — is more than a rhetorical question. According to the American Psychiatric Association, Gender Identity Disorder (or GID, diagnostic code 302.6–302.85) is a mental disorder: it has been classified as such in the Diagnostic and Statistical Manual, or DSM — the bible of psychiatric illness — for 30 years now. A new volume, DSM-V, is currently being researched and written, prompting vociferous debate about whether trans people warrant a psychiatric diagnosis — and, if so, what to call it. (In the new edition, due out in May 2013, GID will likely be renamed “gender dysphoria.” Over the protests of many trans activists, Zucker is chairing this committee.)

Hormones and surgery cost tens of thousands of dollars, and whether these are covered by insurance hinges, in part, on whether kids have a formal medical diagnosis. Spack sees families all the time whose insurance companies refuse to cover pubertal suppression because their gender dysphoria is classified as a psychiatric illness. But it seems clear to him that whatever mental distress these kids are suffering is the result of their medical problem. With treatment, he says, “You treat not only the medical hormonal deficiency, and help them attain the body that they wish, but you are very likely to erase a whole bunch of psychopathology that’s all secondary.”

He has seen this over and over again in patients like Kyle: once they are able to live comfortably in their affirmed gender, their anxiety and depression — even bipolar disorder — disappear. Spack says that even mild autism in trans kids (studies show that 10 times as many gender-variant kids than kids in the general population have autism-spectrum disorders) may be alleviated with treatment for gender dysphoria: “Perhaps the social awkwardness and lack of peer relationships common among GID-Asperger’s patients is a result of a lifetime of feeling isolated and rejected,” he wrote in a recent article in the Journal of Homosexuality; “and maybe the unusual behavior patterns are simply a coping method for dealing with the anxiety and depression created from living in an ‘alien body,’ as one patient described it.”

For Kyle’s part, now that he has less to prove with regards to his masculinity — he has been on testosterone for more than a year and lives fully as a boy — he has chosen to express his boy-ness in a less “binary” way. “I’m not exactly the most masculine of masculine,” Kyle says. He feels freer to express what he calls his “feminine side,” sewing, knitting, and shedding the emphatically masculine clothes he used to wear in favor of more gender-neutral or feminine attire, like wrists full of beaded bracelets. He has become deeply involved in the Trans Youth Equality Foundation, a national organization that provides support and education for families and communities of trans kids. He recently came out as gay. And he has stopped being “stealth” at school and started telling friends about his experience.

As for GeMS, since its founding, it has grown into a multidisciplinary clinic, with a team that includes a psychiatrist, a psychologist, a urologist, a gynecologic surgeon, a specialist in genomics, and a social worker. They have developed a careful algorithm: families do a preliminary intake with an administrator first, then a more thorough intake with a social worker, followed by exhaustive testing by a psychologist, before they ever set foot in Spack’s office. That’s how it’s designed to work, anyway, and it’s largely set up to save Spack time and trouble; patients who are too young, or are not totally sure they want to transition, are referred for further therapy or counseling. But as often as not, Spack thinks of kids like Kyle, and is so eager to end their suffering that he just picks up the phone himself.

Victor Samuels, father of Spack’s patient Justine, e-mailed Spack when his daughter was 11. The reply came the next day, Samuels recalls.

” ‘I have a six-month waiting list,’ ” Spack told him, ” ‘but I’ll see if I can get you in earlier.’ Ten o’clock that night I get a phone call at home. It’s Dr. Spack. He says, ‘I have a cancellation tomorrow at 10. Would you and your wife like to come in to see me?’ ”

Justine is now 13, and “sometimes I actually have to remind her,” says Justine’s mom. “If you look at so many other transgender individuals who have had to figure out how to take back certain things: how to become more feminine, how to become more masculine. And she’s been able to stop time. And stop this puberty. We’re sometimes like: ‘You don’t know how lucky you are.’ ”

On the day I met her parents, Justine was at cheerleading tryouts. “At my chagrin,” her mom said, laughing. “But she’s there.”

In 2009, Spack co-authored the Endocrine Society’s first-ever clinical guidelines on treatment of transsexuals, and this year Pediatrics published an article in which Spack describes GeMS and his clinical approach; this article — the first time treatment of trans kids has been described for a general medical audience — was a real coup, since primary care pediatricians are often the first person a parent turns to for help with a gender-nonconforming kid.

Alongside Spack’s pragmatism and his protectiveness of his patients — his insistence that taking care of them is just like taking care of any other patients — is an enduring sense of wonder at stories like Kyle’s, at the kinds of transformations that something as simple as hormone re-regulation can help facilitate. This is a source of great comfort and satisfaction for Spack as he looks toward his retirement.

It feels good, he says, “watching kids move confidently through life. Feeling that they’re not crippled. But that’s also a dual thing. That’s both a hormone and a receptor, you know?” he asks, ever the endocrinologist. “The kid is the hormone who’s had changes that enable them to be accepted, but they’re also entering a world that’s more accepting.”

“There are two things you are not allowed to do,” her mother said.

Deborah Heiligman ’80 was sitting in her dorm room, talking on the phone with her parents in Pennsylvania. She had just told them she was planning to concentrate in religious studies.

“You are not allowed to be a rabbi,” her mother continued. “And you are not allowed to marry a rabbi.” So Heiligman did what any self-respecting Brown student in this situation would do: she decided to be a rabbi.

Truthfully, she didn’t really want to be a rabbi. She wanted to be a writer. But she did find herself increasingly preoccupied with religion, a preoccupation that would become most apparent three decades later with the 2009 publication of the biography Charles and Emma: The Darwins’ Leap of Faith, the book that cemented Heiligman’s place as one of her generation’s best authors of books for young people. Charles and Emma is one of those books whose subject matter is so suited to its author that there’s really no one else who could have written it. Heiligman draws from the Darwins’ letters and papers to tell, in novelistic style, the true story of the long and happy relationship between the scientist who seemed to take God out of evolution and his deeply religious wife.

In August, Heiligman returned to the subject of religion in her first novel for young adults. Intentions is a coming-of-age story narrated by sixteen-year old Rachel Greenberg; the book chronicles Rachel’s crisis of faith and of self, sparked by an unnerving experience at her family’s synagogue. Although Judaism is front and center in Intentions—the book draws its title from the rabbi’s instructions to pray with kavanah, or intention—the particular details of the religion itself are secondary. At the heart of the book are questions that all teenagers grapple with. Intentions, says Judy Blundell, a close friend of Heiligman and a National Book Award–winning young adult author, is about  “a basic part of adolescence, which is, finding out that something you totally believed in is a lot more complicated than you ever thought.”

Heiligman’s lifelong preoccupation with religion began at Brown with just such an experience. After reading Peyote Hunt: The Sacred Journey of the Huichol Indians for a religious studies course, she found herself obsessed with the book, and as she dug deeper into the Huichol and their religious rituals and beliefs, she says a light bulb went off: You, little Jewish girl from Allentown, Pennsylvania? Your religion is not the only religion. You’re not the chosen people. As unnerving as it was, the realization, she says, was a relief: There is no one right way.

She began to ask more questions. “Why is it that we think there is one right way?” she asked herself. “And what does that do to us as a people? And do to religions? And what has that done to the world?” Twenty-eight books later, Heiligman is still circling these questions. Her books, written for kids as young as two and as old as eighteen, have been her way of searching for their answers.

Heiligman’s first job after graduating from Brown was at the Jewish magazine Moment. There she met Jonathan Weiner, the writer who had held her job before her. The two fell in love and married. Weiner then went on to write such acclaimed science books as the Pulitzer Prize winner The Beak of the Finch, his 1994 account of scientists who study evolution on the Galapagos Islands.

Heiligman often tells audiences of students that, when she and Weiner met, “I looked at the world kind of through the lens of somebody thinking about religion. And he looked at the world through the lens of somebody thinking about science. Does this sound at all familiar to you?”

It would be easy to say that Charles and Emma was inspired by Heiligman and Weiner’s own marriage of science and religion, but Heiligman says the explanation is bit more subtle. It was only after Charles and Emma had been published to critical acclaim, nominated for a National Book Award, and awarded the Young Adult Library Services Association’s Printz Honor for Excellence in Young Adult Literature that Heiligman says she realized what the book was really about. “In this case it hit me hard, my one liner for Charles and Emma,” she told the audience at the Printz Awards ceremony: “It really matters who you marry.” (By “marry,” she was quick to point out, “I mean choose to spend your life with, whether it’s recognized by the government or not.”)

She went on: “Who you marry influences everything—especially how and if you grow into the person you were meant to be. If Charles had not married Emma and settled in the country surrounded by a houseful of boisterous children running in and out of his study; if he had not suffered, with Emma, deaths of three of those children; if he had not had in Emma a challenging AND devoted partner, what would he have become? Marrying Emma was the most important decision he made. It shaped the man, the scientist, and the writer he became. His marriage to Emma changed history.”

Heiligman went on to tell the Printz audience about a yarn she used to spin in her head as a kid when she lay awake nights, unable to sleep. It was an ongoing saga, a love story, in which the main character—a stand-in for Heiligman herself—was a poet. “And the boy is—you can guess this, right?” She paused. “No, not a science writer. A prince!” She threw up her hands as the audience laughed. “As cheesy as it sounds, the story was a reflection of the big questions that teenagers ask themselves and I was asking myself over and over again: Who am I? What do I believe? How much do I have to compromise? Do I have to compromise at all? What is the meaning of life? What is the meaning of my life? What is my place in the world?”

These are precisely the questions that drive Rachel Greenberg, the teenage girl who narrates Intentions. Set in a small Pennsylvania city resembling the Allentown where Heiligman grew up, Intentions opens with Rachel’s parents fighting, which they have been doing often. “I am so out of here!” Rachel announces as she takes off early for her weekly religious studies class.

But when she arrives, she witnesses her rabbi, on the bima, doing something very un-rabbi-like. As she comes to terms with what she saw, Rachel must navigate two competing love interests, each intriguing in his own way: Jake, a sweet, smart, but somewhat nerdy, boy-next-door type, and Adam, the rabbi’s son, who is edgy, brooding, and mercurial. Alexis, meanwhile, who until recently was Rachel’s best friend, has lately has been acting mean and distant. Deeply shaken by what she saw in the synagogue that day, Rachel doesn’t always approach this difficult situation maturely—despite her best intentions.

A typical teenager, Rachel experiments with smoking pot, takes tentative steps toward losing her virginity, and sends text messages constantly. She loves her parents and craves their approval but is also learning that some problems you must fix yourself—and some you simply cannot fix. Heiligman has an uncanny ability to get inside Rachel’s head, to capture exactly what a sixteen-year-old might think or do in a given situation. “Before,” Rachel says, early in the book, “I thought that most people were basically good, and I was sure that holy people were, well, holy. I just had the crap beat out of that stupid idea.”

Michelle Frey ’94, the executive editor at Knopf Books for Young Readers, edited Intentions. “Going from the black-and-white of childhood to the grey of adulthood is something Deborah looks at in a very authentic way,” she says. “I couldn’t believe a middle-aged woman had written this book.”

Heiligman’s own family was an unusual blend. In some ways she was an only child, born to her mother and father when they were forty and fifty, respectively. In a weird way, she says, she was also a youngest child and an oldest child. Her mother had two children from a previous marriage, and her half-sister and half-brother, who were fifteen and thirteen years older, had moved out by the time Heiligman entered grade school. Heiligman was only four when her sister, who lived nearby, married and five when she began having children.  “I had these three little girls who I would baby-sit for and hang around with,” she says; Heiligman became their older sister. Much like Rachel in Intentions, the young Heiligman was also very close to her grandparents, and the family was involved in their local Reform synagogue.

Judaism, Heiligman says, “meant family to me, it meant friends, it meant community, it meant ritual that I enjoyed, songs that I enjoyed, food that I—mostly—enjoyed. Rachel is growing up in the kind of happy religious atmosphere that I grew up in. That is a direct lift from my childhood.”

Yet Heiligman says that she was aware even as a kid—and her experience at Brown crystallized this sense—that her family’s way of doing things was just one way in a universe of choices. “That was actually such a happy feeling, rather than the opposite, for me,” Heiligman says. “That we are all part of humanity—we can be different but in it together.”

This, she hopes, is the take-home message of many of her books—and a reason that writing for young people is particularly powerful. She cites Celebrate Ramadan and Eid al-Fitr, one of the ten books in her Holidays Around the World series, as an example. Illustrated with vibrant National Geographic photographs, the series, aimed at ages six and up, also includes books about Diwali, Independence Day, Thanksgiving, Halloween, Christmas, Easter, Passover, Rosh Hashana, and Yom Kippur. “So if you are a little kid, and you’re growing up in Iowa, and you pick up my book about Ramadan, and you don’t know a single Muslim in your community,” Heiligman says, “you see: ‘That’s a kid who looks a lot like me, and that kid is playing soccer, just like I play soccer. But he’s Muslim?’ Then that’s going to stick with you in a way that it might not when you’re an adult.”

More so than most other adults she knows, Heiligman is deeply in touch with her childhood. From the peanut butter-and-baloney sandwich that prompts the main character in her 1998 Mike Swan, Sink or Swim to conquer his fears to the “mean best friend” whom Rachel must confront in Intentions, Heiligman draws from childhood memories to shape her characters and the situations they face.

“Whenever I write a book,” she says, “I write it for me at the age that I would have wanted to read that book. When I write my little rhyming picture books about dogs, I write for the five- or six-year-old in me. When I was a young adult, up through college, that’s when I wanted to read the books that addressed the big questions: science, life, death, meaning.”

Heiligman never planned to write for children. When she and Weiner met, she was at Moment in Boston and Weiner worked at The Sciences in New York City. She wanted badly to move to New York to be with Weiner, so when a contact in the human resources department at Scholastic told her there was an opening at the fourth-grade magazine, Heiligman told herself, “I’ll just do this until I can find a real job writing.” But when she sat down to complete the trial assignment after her interview, she was shocked at how natural it felt to write for fourth graders—and how fun. “It was like I fell off a log,” she says. “It was that easy for me to write on a fourth grade level. I had more fun than I had any right to have applying for a job.”

Just as Charles Darwin’s marriage to Emma changed the course of both his life and his career, the defining thread in Heiligman’s and Weiner’s lives and work is the decades-long love story that is their marriage and their family. They are extraordinarily close to their sons, who are now in their twenties; the four of them vacation together and collaborate on various projects. The family still has Sunday night dinner together along with other family and friends. (The couple’s younger son, Benjamin, says that even when he was studying abroad his parents still invited his friends over to dinner.) Thirty years on, Heiligman and Weiner are still each other’s first reader and most supportive critic. They dote on each other, play practical jokes on each other, and talk late into the night about the Big Questions.

Heiligman stands only five feet four inches tall, but her presence is large. She is known to whoop and scream in public. (“This is Deborah,” her son Benjamin once introduced her while the family was playing a game of one-liners. “She screams. Casually.”) Heiligman laughs at herself freely and loudly. She talks to strangers, listens intently, and asks probing questions. “In conversation, you really can’t get away with fuzzy thinking with her,” says her friend Judy Blundell. “She’s so curious about everything. I’ll say something, and she’ll say, ‘Why do you say that?’ and then you have to circle back and look at your own information and motivations.”

These days, Heiligman says, religion both attracts and repels her. “I waver between being an agnostic and an atheist. And yet, I wish I didn’t. I wish I believed.” Her desire to believe is undercut by the horrors religious people can perpetrate in the name of religion.

Heiligman began writing Intentions in the late 1990s, when the Clinton-Lewinsky sex scandal was emerging. Her kids were about ten and thirteen. Suddenly, she discovered, “I had to explain to my children how grown-ups do bad things.” She worked on the book for a while, then put it away. “Every time I started working on it again, there would be another scandal like this in the news,” she says. In 2002, a New Jersey rabbi was convicted of killing his wife. Then the Catholic sex abuse scandal broke. It seemed so appropriate that the emerging novel was “about that moment when kids go, ‘Whoa. Grown-ups are, like, messed up.’”

One day this winter, on a visit to Hunter College Elementary School, Heiligman was fielding questions from students. “How do you face writer’s block?” one boy asked.

“I don’t think that I actually have writer’s block,” she began. In fact, she told him, she has the opposite. “I’m writing two books right now. Which kind of means I’m writing zero books. And I’m finishing another book,” she said. The one she is finishing, The Boy Who Loved Math, due out next year, is a whimsical picture book about the eccentric and brilliant mathematician Paul Erdös. Also published next year will be Snow Dog, Go Dog, the third in her series of rhyming picture books about a mischievous dog named Tinka.

One of the books Heiligman is writing now is another young adult novel tentatively entitled Spirits. Set in Rhode Island, Spirits was inspired by an experience Heiligman had shortly after her mother passed away. Her father, along with a caretaker named Mary, was still living in the house where Heiligman grew up. One day, Mary’s grandson—like Heiligman at the time, he was in his thirties—emerged from the basement and asked, “What’s that woman doing downstairs?” What woman? his grandmother wanted to know. “There’s a white woman in a white dress,” he replied. But when they went downstairs, there was nobody there. Spirits, Heiligman says, is a love story that crosses the boundaries of time and space, life and death.

Heiligman is also working on another nonfiction book for teenage readers, this one about the relationship between Vincent van Gogh and his brother, Theo. “Just as I believe Charles Darwin wouldn’t have been Charles Darwin without Emma,” Heiligman says, “Vincent would not have been Vincent without Theo.” Heiligman splits her time between the two books, working one day on Spirits and the next on Vincent and Theo. “If it’s Tuesday,” she posted on Facebook recently, “it must be Vincent.”

But one of the aspects of van Gogh’s personality that keeps Heiligman engaged is that “he is so teenage.” Wading through the artist’s voluminous correspondence, she is struck by how even when “he’s thirty-something, he feels like a teenager: ‘I want to do the thing that I can do best in the world.’ He’s a very all-or-nothing kind of person, very emotional. Which I relate to. ‘Things are terrible! Things are wonderful!’ So it just immediately puts me in touch with that part of myself that is still a teenager inside.”

Back at the Hunter elementary school, two dozen third graders sit on the floor in the library. Books are all around them: packed into shelves, lined up in baskets, propped on tabletops, and piled onto desks. The children have been sitting cross-legged, their faces tilted up towards Heiligman, but now that she has asked them for questions they are climbing up on their knees, waving their hands wildly in the air, and grunting with excitement. Heiligman nods at Sophie, a girl in a red shirt whose brown braid is held in place with a matching red rubber band.

“Um,” Sophie begins. “How do you know you’re a writer?”

Heiligman smiles and points a finger at Sophie. “You mean how do you know you’re a writer?”

Sophie nods, beaming. “Yeah.”

“I think,” Heiligman begins, slowly, “that if you love to write, and it gives you pleasure and joy, you’re a writer. Now that I’ve said that, most writers I know hate to write, and it gives them grief and agony. So.” She pauses again to reconsider. “I think, if you asked me that question…” She puts her hands on her knees and leans over so her forehead is just inches from Sophie’s. “…You’re a writer. That’s what I think. And I think if you’re a reader, and you love to read—”

“That’s me!” Sophie interrupts.

Heiligman smiles. “—you may grow up to be a writer.”