A 10-year-old who feels she is trapped in a boy's body says she sometimes feels "suicidal" after being taunted at school for turning up in girls' uniform.
Livvy James has gender dysphoria. She was born a boy but says she has always wanted to be a girl. In September, she made the decision to return to her school in Worcester dressed as a girl for the first time. James has now spoken out about her experience saying she "doesn't want any more people to die of this".
James has had to deal with arriving at school and being called a "freak" and using the disabled toilets to change for PE lessons as girls at the school would tell her to "get out, you're a boy".
“The other day I was whacking my head against the wall and the bed. I just feel frustrated and angry because, at that point life wasn’t going well and someone at school had said something, annoying me and making my best friend upset. I have a few moments where I do feel suicidal."
Her mother insists the school has been brilliant throughout but other teachers struggle with teaching pupils how to accept classmates who are "different" to them.
"If they have been exposed to a homophobic school culture they can form firm ideas which have subconsciously been set.
"Students had little respect for LGBT people and viewed them as being way down the hierarchy list of acceptable people."
Despite this view, James has received widespread support after going public. Her family has launched an online petition against the use of terms in the media including "tranny" and "gender confused", which they say leave emotional scars on transgender people.
The petition, which already has 700 signatures, says those with gender identity issues are bullied, teased and intimidated, something which the press have a responsibility to discourage.
But James will have to wait until she is 12 to have hormone blockers, and 16 before she is allowed female hormones. Doctors are reluctant to give children treatment as many can grow out of the feeling they are trapped in a different body.
According to the NHS, "the exact cause is unknown" and despite increasing awareness, those who have gender dysphoria "still face prejudice and misunderstanding about their condition".