Marci Owens, center, jokes around with her instructor, Tyrone Miller, right, and fellow young artists at a music camp at the Experience Music Project Museum in Seattle on Aug. 3. (David Ryder/For The Washington Post)

In a studio at the Experience Music Project Museum here, Marci Owens sits cross-legged among a group of teenagers attending a sort of hip-hop summer school.

She wears a stylish blue-and-pink head wrap, a spaghetti-strap tank top and painted nails.

Last year when Owens was in the program — a partnership of the museum, the city’s nonprofit Arts Corps, and artists Macklemore and Ryan Lewis — she had a short Afro, wore no makeup and was known by the other kids as Marcelas, the boy creating fresh hip-hop tunes.

A few also knew of another tag that applied: the Obamacare Kid, the boy in the suit and a purple tie borrowed from the White House, looking on as the president signed the Affordable Care Act in 2010.

“She [identified as] a boy last year, but to me she’s the same person . . . still a homie making great music,” said Ian Hence, another teenager in the program.

On Owens’s 17th birthday in March, her grandmother and guardian, Gina Owens, told friends and family in a Facebook post that her firstborn grandchild was on a new life path and wanted to be referred to as “she” — not “he.”

It was an important message for this family, and it came at a time when social and political awareness of transgender rights were just beginning to drive a new civil rights movement in this country.

And it was noteworthy for another reason, too: The way people connect with Marci Owens is tied to her being a boy — and for some, to being that boy, the 11-year-old in the iconic photo standing next to President Barack Obama.

“You’re going to be part of history,” Obama told Owens that day after the two had goofed around playing with yo-yos in the Oval Office.

Three years earlier, Marci, then Marcelas, channeled a 7-year-old’s grief into activism after her mother, Tifanny Owens, died at 27 without insurance. Marci’s was the small voice in a raucous debate over national health care.

She told her mother’s story at public rallies and in more than 100 radio, TV and newspaper interviews in both Washingtons.

The media dubbed her “the Obamacare Kid.”

Ten-year-old Marci Owens, then known as Marcelas, tells the story of her mother to Rep. Jim McDermott (D-Wash.). Marci’s mother, Tifanny Owens, died at 27 after she lost her job and health care. (Youtube/HouseDems)

Now at the onset of adulthood, Owens is creating a new identify for herself.

“I don’t want to erase all the history,” she said, “but I want people to know who I am and to stand on my own . . . as Marci.”

Marci Owens has a broad network of support — much of it from people who watched her grow up and who marched and protested alongside her, first for access to health care and later for other social-justice causes.

After coming out, she challenged the bathroom policy and graduation policies at the high school she attended through junior year. She is also part of a Seattle Times video project on race, entitled “Under Our Skin.”

At a transgender pride rally in June, she spoke about unity. Later that month she celebrated LGBT pride with President Obama at the White House — the first time she had seen him since the signing of his health-care legislation. At the three-week hip-hop program at Seattle’s EMP Museum, where Owens was one of about 40 area teenagers, the only thing anyone seemed to care about was whether she could produce good music.

Owens creates an instrumental track on a computer at a music camp in Seattle this past August. (David Ryder/For The Washington Post)

She knew she would face challenges. She’s been shoved on the street by strangers. Inside and outside her former school, she has felt the sting of rejection, much of it from young people who knew her growing up and are unwilling to accept who she now openly is. For her senior year, she transferred to Middle College High School, a small, innovative high school housed at Seattle University, where she said she’s felt more welcome.

“I think it’s been what I expected. . . . It’s not necessarily good or easy, but it’s not caught me off guard, either,” she said. “I guess I expected people to be rude.

“But honestly, my biggest problem is in myself, when I look in the mirror and see a bunch of stuff I wish I could change. When you are not born the way you identify, it’s hard to cope with it. So I don’t look at myself in the mirror much.”

Owens is undergoing gender evaluation at Seattle Children’s Hospital as a prerequisite for hormonal treatment, if the psychologist determines that’s the proper course. She has not decided on a course beyond that.

Before the Affordable Care Act’s passage, many health insurance plans, including Medicaid, excluded coverage for any medical treatment related to gender transition. Some plans justified denial of coverage by considering gender-identity matters a preexisting condition.

The ACA prohibited insurance companies from denying people coverage based on preexisting conditions, and it included a nondiscrimination provision that covers transgender people.

But not every state interpreted that provision to mean that plans had to provide treatments such as surgery or hormone therapy for transgender people. Washington was among 11 states that explicitly prohibited Medicaid and health insurance plans sold in the state from excluding transition-related care.

The U.S. Department of Health and Human Services clarified its guidance by issuing a rule that took effect in July forbidding HHS-funded health-care providers from denying health care based on gender identity.

Social and political advancements have reduced discrimination and expanded opportunities for transgender people, who account for 0.6 percent of the population, said Raffi Freedman-Gurspan, who became the first transgender person to serve as the White House’s lesbian, gay, bisexual and transgender liaison when she was appointed in March.

Owens looks out the window as her sister, Myanna Gaston, 12, braids her own hair at their Seattle home. (David Ryder/For The Washington Post)

A year ago, Owens summoned the courage to share her secret with her grandmother, who raised her three grandchildren after the death of their mother, her only child.

The secret reached back to kindergarten and the uncomfortable feeling Marci Owens said she got when teachers separated her and her classmates by gender. She always believed she was in the wrong group.

In the second grade, she had gone on the computer in her grandmother’s house and first looked up “gay” — a label that didn’t feel quite right — before finding a description for “transgender.”

Last year, she began borrowing clothes from her younger sister Monique, and the two went shopping together for new outfits. Monique, 14, not yet permitted to wear makeup, helped Marci apply eye shadow and eyeliner, the two at times having to consult YouTube tutorials.

Then Marci would wipe it all off when grandmother Gina Owens walked into the room.

From left, sisters Monique Gaston, 14, and Myanna Gaston, 12, listen as Owens shares tracks she created. (David Ryder/For The Washington Post)

Marci Owens uses her computer while chatting with her grandmother, Gina Owens, at their home in Seattle. (David Ryder/For The Washington Post)

One evening last fall, in the modest townhouse they share in central Seattle, Marci Owens slipped downstairs to where her grandmother was watching television. Nervous but determined, she blurted out her news.

Gina Owens said her immediate concern was for her grandchild’s safety. A longtime activist with Washington Community Action Network, a local grass-roots organization, she fully supported the LGBT movement, but she hadn’t had a personal connection to it.

She remembers exactly what she told Marci: “It would be my preference if you would stay the little boy your mom give birth to. But I’m not you; you have to live your own life, and I am going to accept who you are.”

President Obama gives a high-five to 11-year-old Marci Owens, then known as Marcelas, after holding a March 2010 rally celebrating the passage and signing into law of the Affordable Care Act. (Jewel Samad/Agence France-Presse via Getty Images)

Owens continues to make music, a passion that for her transcends gender.

Last summer at the EMP program, she wrote rap lyrics; this year she produced what her instructors described as neo-soul beats to accompany the songs her classmates were writing.

Owens wants to build a business around a platform she’s created called SWXVE (pronounced “suave”), where transgender people and others can create good music and “build their own power,” she said.

“It will be about allowing people to be just who they are.”

Owens at her home in Seattle on Aug. 3. (David Ryder/For The Washington Post)