06/27/2013 AT 04:00 PM EDT
Waiting backstage for her cue, the doe-eyed fifth grader adjusted her black-and-white polka-dot dress, fiddled with her rhinestone headband and peeked out from behind the curtain. She had no stage fright, having sung and danced countless times before.
But this was no mere act for the school talent show. This was an announcement to the world: that the 10-year-old boy everyone knew as Niko was now a girl named Nikki. "I was so scared," says Nikki, now 12. "But I was like, 'I can do this.'"
Her parents, Marci and Barry, watched from their seats. "We were so nervous," Marci recalls. "She was getting up in front of everybody, all the families, the teachers. It was kind of an out-of-body experience for me."
Marci and Barry are among a small but growing number of the hundreds of families of transgender kids who have made the difficult, even controversial, decision to put their child on medication that, for Nikki, will halt the onset of the male puberty she dreads.