Theresa Avery's five-year-old likes to wear pink dresses and is obsessed with the cartoon character Dora the Explorer.
But unlike other children, her son Zach, who likes to be addressed as a girl, is one of the youngest people to ever be diagnosed with Gender Identity Disorder in Britain. The Telegraph reports that Zach began refusing to live as a boy at the age of three.
Ms. Avery told the newspaper he used to be a "normal" boy who liked Thomas the Tank Engine, but then suddenly decided he wanted to identified as a girl.
"He just turned round to me one day when he was three and said: 'Mummy, I'm a girl.' I assumed he was going through a phase and just left it at that. But then it got serious...," Ms. Avery said. "He used to cry and try to cut off his willy out of frustration."
Concerned, Zach's parents took him to several doctors. Specialists with Britain's National Health Service eventually diagnosed him with Gender Identity Disorder, which means although he is biologically male, he identifies as female.
Ms. Avery told The Telegraph that Zach's family and school are very supportive of him, and that she wants him to be happy. "We leave it up to him to decide what he wants to do – if he changes his mind and wants to be a boy again then he does, but if he doesn't, he doesn't."
But judging from the reaction of readers, not everyone is convinced a child so young can really determine his gender.
"Kids this young do NOT have 'Gender Identity Disorder'. Period. At this age you aren't old enough 'to know'," one commenter wrote.
Another responded by saying the diagnosis is legitimate: "This has nothing to do with political correctness. This is about a child who has been diagnosed with a syndrome which is recognised across the globe and has existed for millenia [sic]"
In an online poll, more than 87 per cent of Telegraph readers said a five-year-old is not capable of choosing to be a different sex. Only about 12 per cent of the more than 10,000 respondents voted for the answer: "Yes, a child instinctively knows which sex it is even at a very young age."
Meanwhile, The Associated Press reports that the medical journal Pediatrics has noted a growing number of teens and children are receiving sex-changing treatments, which raises concerns about the potential harm of receiving irreversible treatment at a young age.
At what age are children able to determine their gender?