The boy waited more than nine hours for Bill Reiner. He parked his wheelchair behind the door of his family's trailer in a field outside Danville, Va., and there he sat from 8 in the morning until after 5, rooted by his hope.
"He knew who I was, so I walked in and introduced myself," Reiner said, recalling his first encounter with Scott Meyers. "He got embarrassed. He raced around and went back to his room."
It was January 1995, and Dr. William G. Reiner had been called south from Baltimore by physicians at Duke University Medical Center. They didn't know what to do with the fierce 13-year-old. They had heard that Reiner, a urologist, surgeon and soon-to-be pediatric psychiatrist from Johns Hopkins, had some experience with these mysterious cases.
His first one, in fact, had set him on a new career path. It caused him to begin questioning an idea dominant in medicine for more than 30 years, one championed by Hopkins psychologist Dr. John Money: that gender identity is not firm at birth, that it is determined as much by culture and nurture as it is by hormones.
The boy behind the door would teach Bill Reiner a lot he didn't know, and deepen his doubts about that theory.
When they met, Scott's name was Deena. It still is, legally. But Deena is a girl's name, and Scott was born a boy, on Dec. 24, 1981. His mother named him James.
He had many physical abnormalities -- including two tiny penises. Among the surgeries at Duke to correct these abnormalities was his castration. His mother was told to raise him as a girl.
This is not entirely uncommon: It remains an accepted treatment for the male child born without a penis, or with other severe sexual malformations. It is a treatment encouraged by the idea that sexuality is malleable at birth.
Peggy Meyers acquiesced, renamed her boy Deena and took him home. But almost from the beginning, Deena resisted. Reiner learned this through five hours of interviews with Scott and his mother in the trailer that night.
The interviews revealed to Reiner that Scott's impulses were those of a young boy. And they shed light on the pain that his ambiguous state had brought to his short life.
Scott's favorite toys as a child were guns and trucks. He never played with dolls. Nearly all his friend were boys. Asked what he would like to be when he grows up, he listed policeman, race-car driver and artist.
He said his favorite sports are basketball, wrestling and baseball -- this from a child who gets around only on crutches, in a wheelchair or by crawling. A boy who, under doctor's orders, spent his first few years in a dress.
"He goes to games and tries to play. They leave him out. He gets mad and tries to fight with them."
This is Reiner describing the near-constant warfare of Scott Meyers' life.
"He's been doing that a long time. Since he was 8 or 9. He'd bang them with his wheelchair. Run over their feet, knock 'em down."
Reiner, through his questioning, uncovered the moment when Scott became absolutely certain of his gender. The awareness came to him suddenly -- and drenched him with chagrin.
"It was about age 8 that he knew something was wrong," Reiner said. "By the time he was 9, he knew he wasn't a girl, but he didn't know quite what that meant. When he was 10, a boy asked him to go steady. What Scott said was, 'A boy asked me to go out.' "
"On a date?"
" 'No. To be his girl friend.' "
"And I said, 'Oh!' "
"And he said: 'It just made me sick to my stomach. I couldn't stand the thought of it.' "
"I asked why."
"He thought about it and said: 'I realized that girls are pretty. You go out with girls.' "
At that moment, Scott knew why everything was so strange and wrong in his life.
Reiner is more than impressed by his patient, particularly by the way the boy has fortified his self-identity against the opinion of the world.
"Here's a child who comes up to you and says, 'You've raised me as a girl. You've given me a girl's name. And you're all wrong.' And I say, 'How do you know that?' And he gives me answers that make sense."
Reiner recalls a snatch of dialogue in the trailer:
"I say, 'Well, how can you be sure?' And he says, 'Well, I can't be sure except that it's just that way.'
"So, I ask, 'Are you taking this on faith?' and he says, 'No. There's no faith involved. This is what I am. This is real.'
"And you listen to that and the solidity of this position. And the aloneness. By God! He's telling the whole world they're wrong. I mean the singularness of this -- he must have been phenomenally lonely.
"And I think that's why he was sitting by the door for eight hours or whatever it was, waiting for me. Because he was so desperately lonely to have another human being who would listen to him and understand."