A horrified mother has revealed how she found her four-year-old son trying to cut off his penis with a pair of scissors – because he wanted to be a girl.
Thankfully, Sarah Tyler, 39, caught her son, Danann in the nick of time, but the terrifying memory has stayed with her.
She told Closer magazine: "I found him in the playroom trying to cut off his penis with a pair of craft scissors. He was weirdly calm, saying, 'I'm going to get rid of this'. I felt sick."
At other times, Danann insisted he was a girl, and asked to wear dresses and grow his hair. His parents, Sarah and Bill, 45, from Orange County, California, struggled to explain his behaviour, and put it down to a phase.
But it was only after he was seen by a psychiatrist after he ran into traffic saying he wanted to die that an answer for his behaviour was found: Danann had gender identity disorder.
Doctors said despite his young age, he needed to start living as a girl. His loving parents now bring Danann up as their daughter; addressing him as she, wearing girls' clothes, including at school, and growing his hair.
Sarah says Danann is now happy for the first time and that she will support her son if he decides to have a sex change at 15.
In the interview, Sarah described life with her unhappy boy before they accepted his disorder.
"He'd scream when I'd try to put him in boys clothes," she said.
"When I picked him up from nursery, I noticed he'd be playing in the miniature kitchen with the girls and didn't like trucks or action figures. I assumed it was a phase."
Danann began drawing pictures of himself as a girl, which were usually illustrated with an unhappy face, and by the time he was three, his tantrums worsened.
"He got really upset when I referred to him as a boy and kept asking me why he had a penis. He'd scream if I wanted to cut his hair. I occasionally let him wear pink T-shirts and necklaces under his clothes, but Bill wasn't happy. He's a man's man - and he didn't like his son looking girly."
When doctors finally diagnosed Danann with gender identity disorder at age six, Sarah said she felt a huge relief. And watching DVD's about transgender children helped them comes to terms with the diagnosis.
She said: "He assured us there was nothing psychologically wrong with Danann - but we were shocked. Bill said he didn't want any part of it. But for me, everything seemed to fall into place.
We realised we weren't alone and other families were experiencing this. I was so sad to let go of my little boy. But I knew Danann would be happy as a girl. It seemed surreal to be making that decision, but I felt there was no alternative.
I told Danann that he'd been born with a girl brain and a boy body.
He just said calmly, "I'm a girl, I know". I explained we'd treat him as a girl, let him wear girls clothes at home and call him 'she' from now on.
"And when I said we could go shopping for clothes, Dannan couldn't stop smiling. She chose frilly pink dresses and sparkly shoes. We also bought some dolls. She was immediately less withdrawn. It was still strange - I'd never had a daughter - but I knew I had to do it for her."
Now nine, Danann is even a member of the Girl Scouts and is excelling at school.
• The Tylers story featured on a special edition of America's Anderson Cooper talk show, 'Children & Teens Caught In The Wrong Bodies'.
More on Parentdish:
It's a boy! Couple reveal 'genderless' child's sex - after keeping it secret for five years
Transgender pupil ordered to change into boys' clothes to sit GCSEs