GLOUCESTER -- At just 16 years old, Gavin Grimm said he can feel the weight of the world on his shoulders. Born in a female body, but always identifying as a male, the transgender teenager has lived in the national media spotlight in his hometown of Gloucester, Virginia after he sued the Gloucester School system over the right to use the boys' restroom. While the principal originally granted Grimm permission to use the boys' bathroom, the county's school board later reversed the decision after receiving complaints. Grimm must now use the girls' restroom or a single-unisex facility.
"It's not something any human being should have to face. It's dehumanizing," Grimm said. "I have been given a forum that has the potential to help many, many people other than myself."
Grimm has been diagnosed with gender dysphoria, a medical condition in which people feel strongly that they are not the gender they physically appear to be. Grimm said he experienced depression and anxiety because he was treated differently than his fraternal twin brother.
"I didn't have the all-American boy experience that I so desperately wanted," Grimm recalled. "I wanted the have the same conversations with my dad that my brother had. I wanted to have the same interactions- being treated the same, being looked at the same, because it's just how I felt and I was robbed of that."
At age 15, Grimm took measures to change his life.
He legally changed his name and began the process of transitioning his body to that of a male. He took hormone replacement therapy to give him the physical characteristics of a male.
While Gavin may feel isolated in his hometown, he is not alone in his transition.
The number of younger transgender patients has more than quadrupled over the past five years, according to the Human Rights Campaign, the world's largest lesbian, gay, bisexual and transgender civil right's group. Those teens and young adults have turned to plastic surgeons for help in the transition.
Richmond plastic surgeon Matthew Stanwix, M.D., said his practice has seen a big increase in interest from the younger generation. Patients, he said, have requested everything from simple body contouring to gender reassignment surgery.
Patients under the age of 18 must receive parental permission before undergoing medical procedures. They must also receive professional counseling.
"These individuals have been through counseling for a while, they have thought about surgery for a while, and their parents are very accepting," Dr. Stanwix said.
Stanwix said his patients are grateful to finally feel comfortable with their bodies.
Blue Clements, a University of Virginia graduate student, said surgery has changed life for the better.
"I didn't expect how- it was immediate after surgery - I still had the tubes in and (it was like) that's my chest - this is my body," Clements said.
Clements recently underwent top surgery to remove breast tissue. Clements said the surgery has offered confidence and peace of mind.
"Since transitioning, I've felt really loved for the first time," Clements said. "I've felt like myself for the first time."
While the story of Caitlyn Jenner has boosted public acceptance of the transgender community and more health insurance companies are covering surgical procedures, studies showed transgender students still face harsh treatment.
Three out of every four transgender student in Virginia reported they were harassed in school, according to a recent survey by the National Center for Transgender Equality. More than a third said they have been physically assaulted. Suicide remains a huge problem in the transgender community.
"You don't feel like you exist, and you don't feel like you matter," Clements said.
Can surgery change those feelings?
Some people question the ethics of allowing minors to make such life-changing decisions at such a young age. Gavin Grimm's mother Deirdre said for her family, there was no question her son made the right decision.
"As a parent, you just know. They can't live any other way," she said. "There's no other option for my child other than to be who he is."
Gavin Grimm's case now rests in Virginia's 4th Circuit Court of Appeals. In October, the U.S. Justice Department filed a brief in support of the Gloucester teen. Grimm said while his court battle is personal and painful, it has the ability to change the lives of thousands of transgender people, far beyond his small community.
"I understand it's not an opportunity many people get," Grimm said. "It's probably not one I'll ever get again."