The DSM-IV says a diagnosis for GID can be made if: (1) someone has a strong and persistent cross-gender identification; (2) feels a persistent discomfort with his or her sex; (3) this discomfort is not due to being intersex or hermaphroditic; and (4) the discomfort causes significant distress or impairment in their life.
Even Jazz's pediatrician told the Jennings that they had a serious problem on their hands. According to Renee, their doctor said, "'Yes, I believe your child has gender identity disorder, and I recommend that you go to a professional.' And I was -- my mouth opened up and you literally had to scrape me off the floor," Renee said.
Dr. Marilyn Volker, a therapist who specializes in sex and gender issues, later confirmed Jazz's diagnosis.
"When we began to talk, and I used -- whoops -- the pronoun 'he,' I was corrected," Dr. Volker said. Jazz told the therapist, "I'm a girl. I'm she."
Dr. Volker then brought out anatomically correct male and female dolls for Jazz to play with, and asked him to point out which one looked like his body. According to Dr. Volker, Jazz pointed to the male doll and said, "This is me now," and then pointed to the female doll and said, "This is what I want."
No one knows why children like Jazz are transgender -- there are only theories. Through the first eight weeks of pregnancy, all fetuses' brains look exactly the same: female, nature's default position.
Only after testosterone surges in the womb do male brains start to develop differently. Some scientists suggest that a hormone imbalance during this stage of development stamped the brains of transgender children with the wrong gender imprint.
With Jazz's diagnosis at hand, the Jennings explained the situation to their other children. In their home, they came to accept Jazz as a girl. There he could wear a dress or dance as a ballerina, although they still referred to Jazz with male pronouns.
In public, they kept Jazz's look more ambiguous or gender neutral, especially at preschool, where he was allowed to put on a pretty top but he had to wear pants. Officially, Jazz remained a boy.
Jazz chafed under that arrangement. He wasn't happy until he could present as a girl both indoors and outdoors. Everyday became a struggle, according to Renee. Finally, a dance recital opened the Jennings' eyes to just how unhappy Jazz was.
"She wasn't allowed to wear a tutu, like the rest of the girls. And she just kind of stood there and snapped her finger and did the tapping thing with the toe, and just looked so sad," Renee recalled. "It was heartbreaking to watch. Really heartbreaking."
The dance recital was a turning point. The Jennings then made the difficult decision to let their son become their daughter. On his fifth birthday, Jazz wore a girl's one-piece bathing suit. "He" was now "she," and an innocent pool party became a "coming out" to all of her friends.
"They referred to her as a boy. But kids are very accepting at that age. They believe what you tell them. She is a boy but she wants to be a girl, so we let her wear a bathing suit," said Renee.
"That was the first time in front of everybody, she … announced to the world, that she was a girl," Scott added.
So how does a 5-year-old biological boy begin living as a girl? For Jazz, it meant growing her hair out, piercing her ears, and wearing dresses everywhere -- even to kindergarten.