I think the thing is that Frankie's mom thought she was a "tomboy" when she was younger, as then as she aged, assumed that she was gay. But being transgender is a person who feels they are in the wrong body - in Frankie's case, she was born with a male brain but in a female body. She obviously doesn't have male genitals, since her mother would have seen that when Frankie was born, and when she changed diapers and such. Since the youngest daughter yelled at their mother "Frankie is not gay, she's a boy!" that gives the impression that Frankie is transgender. I have about 15-20 friends and acquaintances that have gone through some or all of the surgeries and currently take hormones; I also have a small few that started hormone therapy before or just at the start of puberty, so they never developed secondary sexual characteristics (like breasts, or facial hair, etc.). I know both male to female as well as female to male transgender people - I have a 1st cousin and a 3rd cousin who are female to male transgender, they have just had "top" surgery (their breasts removed and made to look like a male chest). The "bottom" surgery is not really perfected to male a penis from a vagina, so many go without - for now. All of my friends who are male to female transgender have had breast implants and had their testicles removed, but only about a handful have had the full surgery to turn their penis and scrotem (used to make the labia) into a vagina, including making the glans (head) of the penis made into the clitoris (of those, many have had an extension on the vagina by having 5"-7" of large intestine used in the building of the vagina, because the intestine self lubricates). If you feel I am being too graphic, I am just explaining what transpeople have to go through to look on the outside how they feel on the inside.
I left out facial feminization/masculizing, shaving of the Adam's apple, rhinoplasty, rasping of the brow area, solid silicone hip implants, and many other medical procedures that are done from the neck up to aid in giving the person the look of a male or female.
I think Sam might start Frankie with a therapist, as is the normal legal procedure, who after confirming that the person is really transgender, would start Frankie on hormone therapy.
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