If someone says, “I am Napoleon,” we don’t reply, “Yes, Your Majesty,” and gift him or her with a fancy uniform and a hat with gold tassels. We give the patient needed therapy. But if a boys says, “I am a girl,” or a girl says, “I am a boy,” we say, “Yes, you are.”

When I discussed this problem with a very bright teenage boy, he replied, “Some of my friends are uncomfortable.” In my rather long life, I have never met a comfortable teenager. My job was to help them become more comfortable with reality, not to enable their attempts to deny reality. My job was to ease their discomfort at reality, not to join in their rejection of reality. My job was not to say the equivalent of “Yes, Your Majesty.”

Please, no more three-cornered hats. Mental illness is a serious, sometimes tragic, problem. Ignoring it won’t make it go away. We learned that many years ago. Time to relearn it.