It all begins with one chromosome. Sometimes, nature plays a cruel joke on people. They may be given sexual organs of one sex and even the general appearance of someone of that sex, but the person knows, as they get older, that something is wrong. A child may tell the parents that they are not a boy, they are a girl, or the other way round. They identify with the other sex, having the same interests or desires, or they may simply hide their feelings and become androgynous in appearance. This is gender dysphoria, commonly known as being "transgender." Other times, even before puberty, individuals know that they are attracted to the same sex. Many of their pals and playmates know this, as do some siblings, before they finally tell their parents that they are gay. It takes courage and many people take years, even to adulthood, before they come out to the world.