A four-year-old child is receiving special help from education authorities in Australia to undergo transition for a change in sex.
The situation has drawn criticism from psychologists who say four is too young to start gender transition.
They maintain pre-school children are still at a very early stage of their development for such a major decision to be made.
Yet the New South Wales Department of Education has rolled out a support package for the toddler, who is not due to start kindergarten until next year.
The shock development comes amid an explosion in the number of young children of both sexes considering sex changes.
The youngest child involved is just three years of age.
The New South Wales government has revealed there are a number of children in the state’s schools transitioning their gender.
Referrals to the Sydney Children’s Hospital for gender services have tripled with one doctor confirming they had escalated rapidly across Australia.
In another major hospital in Melbourne, some 250 children are being assisted by the gender dysphoria unit.
A decade ago, there was just one case.
Gregory Prior, NSW Education Department deputy secretary of school operations, said helping transgender kids was part of the Safe Schools programme.
“We have a number of students who are going through gender transition in our schools, with the youngest being a four-year-old at the moment.
“The Safe Schools is only once resource that can be used in how we would support that family, student and school to accommodate a child going through transition.”
Transgender advocate and Australian of the Year finalist Catherine McGregor advised caution and said proper checks needed to be in place to ensure premature mistakes were not made.
“I would have thought four is pretty young for any official policy support,” she said.
“In my experience, kids with strong cross-gender identification tend to get it right.
"However, I can understand there would be caution on the part of the department and medical practitioners on making any irreversible decisions at that stage.”
Clinical psychologist Rose Cantali said age four was “absolutely too early” for a child to change gender.
“I would be very hesitant and other psychologists would say the same. Everything is developmental at that age.”
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