In a family of prominent Jewish educators, Norman Spack could be called the rebel. He became a doctor.
"I'm the only one who didn't go into Jewish education," says Spack, a senior associate in the endocrine division at Boston's Children's Hospital, where he has worked for 39 years.
Spack's father, Abraham, was a nationally acclaimed Jewish educator in Boston, and his brother, Eliot, is a recognized Jewish educational leader. But now the 68-year-old physician and assistant professor at Harvard Medical School in his own fashion has joined the family business.
As the co-founder of the country's first clinic devoted to treating children with gender disorders, and as a leading authority on transgender youth, Spack has found himself at the forefront of efforts to educate the public about a widely misunderstood condition and to help transgender people secure their fundamental rights.
"If we shun people, we never get the experience of knowing how special they are and understanding how courageous they are," Spack says.
Spack was first exposed to transgenderism, a medical condition in which individuals do not identify with the gender into which they were born, in the mid-1970s.
Spack at the time was treating street kids as a volunteer on a medical van in Boston. Many of the young people were "throwaway kids," Spack says, having been shunned by their families and schools for gender-variant behavior.
A decade later, a colleague referred a transgender patient to Spack -- a young adult Spack referred to as M. Unlike the street kids he'd seen earlier, M was a Harvard graduate.
M would open up a whole new world for Spack. In exchange for medical care, he introduced the doctor to his friends, other young adults who were transgender. "It was this unique opportunity to see life from a different perspective," Spack says. "M did it for me."
The experience proved to be a turning point. Spack began providing medical care for young adults and, later, older adults who were transgender.
In 2007, Spack co-founded the Gender Management Service Clinic, or GeMS, at Children's Hospital. The clinic has treated nearly 100 patients, most for birth disorders or other sexual development conditions.
About a third of the patients are treated with hormonal suppressants that delay the onset of puberty -- a controversial treatment that is fully reversible. Nearly a quarter of the patients who come for a first visit have committed some act of violence against themselves.
"If your neighbor is bleeding by the side of the road, you shall not stand idly by the blood of your neighbor," Spack says, quoting Leviticus as his inspiration.
It's a lesson Spack learned the hard way. About six years ago M, his first transgender patient, committed suicide. M's parents initially had great difficulty accepting him.
Nevertheless, Spack learned that M's rabbi had officiated at his funeral, which was a source of great comfort to the family.
Spack describes his own childhood in suburban Boston in warm terms. His small Brookline neighborhood was like a little shtetl, he says, and he grew up near Kehillath Israel, where his father was education director and where he attended religious school.
"Later, I realized I was exposed to some of the finest role models a human can ask for," he says, rattling off the names of admired leaders in the Boston Jewish community.
Spack went on to become one of those leaders, serving as board chairman of Boston's Hebrew College, where he earned an honorary degree in 2002, and as chair of the medical team for Boston's Combined Jewish Philanthropies, a post in which he led three medical missions to Israel.
In 2008, Spack was part of a coalition that included the Jewish Alliance for Law & Social Action, Keshet and the Anti-Defamation League, that persuaded the Massachusetts legislature to adopt a transgender rights bill.
Transgenders have also made inroads in Jewish life in recent years. A growing number of trans-friendly Jewish resource and advocacy organizations have sprung up nationwide -- including JewishTransitions.org  and TransTorah.org , websites that provide resources aimed at helping transgender Jews assimilate more fully into communal life.