A teenager has told how he began his transition from female to male at the age of just 13.
Isaac, now 17, from New York, describes his parents' initial resistance, judgement from his school and peers, and how a mastectomy and puberty-blocking drugs stopped him developing a feminine shape.
In an interview with New York Magazine, he says he longed to be a boy from early childhood.
'Around six, I just started getting pissed at girls who wore pink,' he said. 'Why are you doing that to yourself?'
He successfully convinced his parents that it was more than a passing phase after presenting himself as male at a sixth grade summer camp.
'I'd been to the same school since I was two and never had a blank slate,' he explained. 'I couldn’t stop myself.'
Predictably, his parents were stunned when they arrived to collect their daughter at the end of the camp, only to find that they had a son instead.
The couple, both artists and completely accepting of their child's desires, had assumed that Isaac was just 'gender-queer'.
But this was just the first stage in what would be a long and difficult process, as the family now had to address the impending puberty process, which Isaac was desperately keen to prevent.
But despite the support of the city's top medical and psychiatric opinions, the prospect of puberty-blocking drugs was too much for his mother, who insisted that he wait.
'I instinctually didn’t want to start messing with Isaac’s endocrine system. I said no,' she admitted.
Isaac's distress at getting his first period was the moment that changed her mind, and by the start of the next summer, he began taking the drug Lupron.