Richard's double life put a strain on the Grant's marriage, and they almost separated. Richard, now four, was going to school as a boy but wanted to be a girl full time. Stephanie knew about Richard's heart-wrenching prayers in the middle of the night.
"He said, 'Mom, I'm so mad at God, because God made a mistake. He made me a boy, and I'm not a boy, I'm a girl, Mom. Every night I pray that God gives me a girl body but when I wake up I'm still a boy. God won't take back his mistake, he won't make it right,'" Stephanie recalled.
At one point, Richard became so despondent that his parent's feared he may try and harm himself. Richard began talking about jumping out of windows, prompting the Grants to constantly lock their windows shut.
Richard also began to have regular breakdowns. After one particularly severe panic attack, in March 2003, Richard's face turned blue and he had to be hospitalized. Feeling helpless, Stephanie spilled all of her secrets to Richard's principal.
The response took Stephanie by surprise: Why couldn't Richard come to school in a dress, the principal asked. Then the school directed the Grants to a gender specialist who diagnosed Richard with Gender Identity Disorder.
For Stephanie, the diagnosis came as a relief. "Oh my God, we're not making this up. This is real. There's a diagnosis," she said.
So Richard, only seven years old, began to transition from a boy to a girl. He -- now she -- pierced her ears, grew her hair out, wore girls' clothing and took the name "Reggie." Her father, Neil, who once rejected her, took her shopping for dresses. He finally understood after seeing the look on his daughter's face.
Reggie eventually changed her name legally to Riley. But when she showed up at school in the third grade wearing a dress, her life became increasingly difficult. She was only allowed to use the bathroom in the nurse's office, and the bullies had a field day.
"It became a nightmare. It was horrible. She was known as the girl with a dick," said Stephanie. Riley came to believe that the only kids who liked her were the ones who didn't know that she used to be a boy.
Riley told Barbara Walters that the constant teasing makes her angry. "Some people call me a boy. But I just tell them to shut up," Riley said.
Riley also has a tough time being around her twin sister Allie, and the two fight often. Stephanie explained, "Her sister has always been right. Her twin was born with the right body. Her twin is going to get the breasts. She has to hate her sister in order to survive." neil added, "Her twin sister is everything she wants to be."
But the most difficult time for Riley, Stephanie says, is when she's alone with her body. Stephanie recalled how once, when Riley was still Richard, she peeked into the shower and saw him washing his hair with one hand while keeping a washcloth over his genitals with another.
Stephanie said, "He was hiding from himself. He didn't want to see his own body."
Now on the cusp of adolescence, Riley's anxieties over her body will only surely grow. According to Dr. Norman Spack, an endocrinologist at Harvard University, puberty is especially frightening for transgender children.