Rosie’s comment underscores that Poppy’s gender dysphoria won’t magic disappear until society changes and accepts people who are different. Even with hormones and surgery, Poppy will likely still feel out of place in some way. Poppy’s well-being depends on everyone, which, Frankel points out, is difficult because the world is unlikely to radically change anytime soon. Rosie is right in thinking that Poppy isn’t sick, but Poppy’s life will still be difficult. Rosie’s decision to go to Thailand (and take Poppy) comes right after Penn brings up sex reassignment surgery, which suggest that Rosie, to some extent, is trying to avoid facing this possibility.