You'll notice that the letter writer is identified as "North Carolina mom"
I grew up in the next state north, and I got called "queer" (as in "gay") and picked on by both adults and children for no more reason than that. I also had it explained to me, in every way possible, that I was an utter failure as a boy, for pretty much the same reasons. For some inexplicable reason, I've never had much interest in moving back there. (Equally inexplicably, I've never seen any value in Masculinity(tm))