Sean has felt since the age of 2 or 3 that he was a boy in a girl's body. Telling his parents at age 11 was difficult but coming out as transgender among his seventh-grade classmates was like walking into a lion's den.
When Sean first shared his sexuality with his mother, "She didn't take it well," he said. "She cried for about a week, but then went on the Internet and understood it better."
About a month before Sarah's "transition" to Sean, his mother informed school officials, but no one told teachers or students.
"One day I was Sarah with female pronouns and Monday I was Sean with male pronouns, without any explanation," said Sean, a pseudonym for the central New Jersey teen who wants a fresh start in high school this fall.
"I was bullied every day, shoved into lockers, beaten up and made fun of," said the 14-year-old. "The teachers were standing right there, saying nothing or just not aware of it."
Things got so bad for Sean that he dropped out of middle school, and his mother home-schooled him for the remainder of the year.
Like Sean, an increasing number of lesbian, gay, bisexual and transgender -- LGBT -- children are "coming out" earlier than high school because of greater cultural acceptance.
But in the immature and sometimes predatory world of middle school, Sean's experience is not uncommon, according to advocacy groups.
Taunting and bullying often goes unnoticed by teachers, and administrators have few policies in place to handle it. Only 11 states have enacted laws to protect schoolchildren from being bullied specifically because of sexual orientation. At Sean's school there wasn't even a sex education program, according to his mother.
In a 2005 study conducted by Harris Polling, "From Teasing to Torment," teachers reported that middle school students were 30 percent more likely to be teased about their sexual orientation than high school students.
"There seems to be something about the onset of puberty that makes those years different," said Kevin Jennings, founder and executive director of the Gay, Lesbian and Straight Education Network. "Moving from small to larger schools, cliques and social pecking order are a bigger deal."
Most children are aware of their sexuality between the ages of 8 and 11, according to Jennings, but are told they are "too young" to know their orientation.
"That makes it even harder for them," he said. "People don't believe them."
In the last year, the Gay, Lesbian and Straight Education Network has seen a "huge surge of interest" in addressing anti-LGBT bullying in middle schools. Much of it has been a reaction to the February killing of openly gay student Lawrence King. The 15-year-old was shot twice in the head by a classmate in California.
In 2007, students from 520 middle schools participated in a Day of Silence to raise awareness about sexual orientation. After King's 2008 murder, 1,046 middle schools participated in a vigil.
Today, the network sponsors about 110 gay-straight alliances -- or GSA clubs to support lesbian, gay, bisexual and transgender students -- nationwide. But that number, compared with 3,000 such clubs at the high school level, may still not be enough.
Josh Rivero enrolled in a virtual high school after he was repeatedly threatened at his Brevard County, Fla., middle school after trying to start a GSA club.