Editor's note: Some of the images in this story include harsh language that may be offensive.
Tony Ferraiolo always understood who he was, even if he wasn't always believed.
"I knew I was transgender from around the age of 5," Ferraiolo, a certified life coach and author in Connecticut, tells TODAY.com. "I remember my brother and I taking off our shirts while playing outside and my mom screaming, "Put it back on! Only boys take off their shirts.' When I said, 'I am a boy' she said, 'No you're not, you're a girl.'
"At the time, no one used the word 'transgender,'" he notes. "The first time I looked in the mirror after having top surgery (as an adult), it took my breath away."
Ferraiolo wanted to help transgender children live more authentically so he created a support group for teens to connect about their experiences at home and in school.
"No one was doing this," he says. "I had to wing it."
Ferraiolo recalls the first meeting in which two transgender teens showed up. "Angel, a 16 year-old, snuck her 'girl clothes' into a backpack," he says. "She changed into those clothes for the meeting, then with a big sigh, dressed in her 'boy clothes' before leaving."
"A lot of the kids did that," he says. "It broke my heart."
After growing demand, Ferraiolo created more groups: One for parents of transgender children and a workshop where kids expressed themselves through art.
"I wanted parents, educators and mental health providers to understand what these children were going through or at least get a sense of their pain," says Ferraiolo. “Creating art is how I got away from self-harm."
In 2015, Ferraiolo compiled many of those drawings into a book titled "Artistic Expressions of Transgender Youth;" its second volume published three years later.
TODAY.com contacted several of the artists, who are now adults, to reflect on their lives since creating these pieces.
“I would buy my freedom ... my chest!” —Max, 17.
Yisreal Kogut (formerly Max), a nonbinary transgender person who uses the pronouns zhe/hir and they/them, was adopted into a Roman Catholic family.
"I was raised to be a nice young lady and future wife and mom," Kogut, 31, of Oakland, California, tells TODAY.com. “I didn’t even know that transgender people existed."
Feeling lost, Kogut briefly considered becoming a nun.
"(The idea of) living together in a community and sharing a common experience seemed really beautiful," says Kogut.
Confiding in a supportive teacher helped Kogat eventually understand and express that they were "trapped inside the wrong body." The realization, they say, was "a relief."
Kogut joined Ferraiolo’s support group a few months after coming out. "Drawing is a great medium for kids to explore who they are before they have other words for it," they say.
Their drawing, hastily scrawled during the last few minutes of class, depicts two figures separated by an operating table used to perform a double mastectomy. One is Kogut wearing a chest binder, the other is a surgeon. Kogut titled the drawing "Freedom."
"The word 'freedom' symbolizes the ability to breathe ... and a light at the end of the tunnel," says Kogut.
Ferraiolo has inspired Kogut to mentor others.
"With Tony's help, I ran a yearly art workshop for nonbinary folks," says Kogut. "At one point I realized, 'Whoa, I am the adult in the room now.' It's a life that I hadn't ever conceptualized."
“Hiding myself ... it sucks the life out of me.” — Hannah, 6.
"From as long as I can remember — from 2 or 3 years old — I gravitated toward more traditionally feminine ways of presenting myself through toys, games or clothes," Hannah Szabo, a 20-year-old transgender woman in New Haven, Connecticut, tells TODAY.com.
"My family let me take the lead in how I identified without passing judgment," she says. "There was a lot of freedom to experiment and I was really lucky. Most of my friends were girls, I played with dolls, I wore girl clothes to school and I grew my hair out."
On weekends, Szabo felt freer. "Around first or second grade, I'd have my mom drive me a few towns over where I'd be less likely to see people and I used a different name and pronouns."
Ferraiolo’s support group, which Szabo attended from ages 6 to 9, was exciting and a place to meet other gender-nonconforming people.
Szabo recalls her drawing: a frown-faced figure with a worm-like body under a spiked ceiling to reflect "feeling trapped, caged and withheld," she says.
At age 10, Szabo came out as transgender. "This was not as much of a politicized issue a decade ago because it hadn't become a right-wing talking point yet or covered by the media in the same way," she says.
Ferraiolo was the first person Szabo told.
He represented the idea that "trans people exist into the future and at the most basic level," says Szabo. "I can't stress enough how important that is."
“I am sad when people label me. I become less than human, I become what people make me out to be. I am an outcast. I am ugly. I am a bitch. No one tries to look beyond these labels to see who I am.” — Maeve, 17
Maeve, a 24-year-old transgender woman (who asks TODAY.com to omit her last name for privacy) calls her mother her "biggest advocate," buying her Barbie dolls and validating her identity in other ways as a child.
At school, Maeve hung out with girls. "I was viewed as a weak boy. Being called 'a girl' was meant as an insult but I didn't take offense."
Maeve came out on three different occasions — as gay, gender fluid, and finally transgender.
At 17, Maeve contributed two drawings for Ferraiolo's book, one of which landed on the cover of volume two.
Maeve drew the answer to "What makes you sad?" illustrating herself with long rainbow-colored hair. Behind her, people yell "Bitch," 'Ugly" and "Ew" in her direction.
A slur is written in bold letters on the top of the page.
"People said this to me all the time," says Maeve. "They tried to find anything synonymous with monstrous or deserving of hate."
"The rainbow hair means 'This is something beautiful about myself that no one can take from me,'" says Maeve.
Maeve also drew her answer to "What do you want to be when you grow up?" which was a mother. Her drawing of a mom hugging her child was used as the cover image for the book's second volume.
"I simply want to be a mother of a happy family," she wrote alongside the drawing. "I won't be lonely and will be needed/wanted and loved."
Now, Maeve dreams of becoming a mortician or a death doula, a person who gives emotional support to those in their final chapter in life.
"Trans people deserve to be respected and exit this world with dignity," says Maeve. "Many are buried with the wrong name, pronouns or clothing. That's another way to erase us. I want to help people through one of the most profound parts of life and (make sure) they're OK."
