Isabelle is 11. She's an Australian girl born in a boy's body, and she's telling her story.

By APARNA BALAKUMAR.

Isabelle is 11. She is an Australian schoolgirl who was born a boy, and her story is the starting point for a startling documentary about transgender children that screens on the ABC tonight.

“If you don’t be yourself,” Isabelle says, “then you’re going to be miserable for your whole life.”

And she’s more than right.

For children like Isabelle, the process of adolescent self-discovery is a complex one. For some, it involves undergoing the process of changing their biologically determined gender– by definition or through medically transitioning.

It was just one year ago that Isabelle revealed the truth to her parents: she might have been born in a boy’s body, but in her heart, she identifies as a girl.

“I just said to my mum that I didn’t want to be a boy. I felt like a girl…I’m sick of living in this body,” Isabelle revealed on an ABC Four Corners report to air tonight.

And Isabelle’s mum, Naomi, is 100 per cent behind her girl’s decision. “We only have one job here,” she says, in a sentiment that should make every parent stand up and cheer, “and that’s to help her create a future that she can live with.”

Despite Isabelle and her family’s certainty of her transgender status, current laws ensure that accessing medical transgender treatment– should she seek it–will be anything but a simple process.

Currently, children wishing to change gender must wait until they are 16 to apply for irreversible cross-changing hormones from the Family Court. The court will assess whether they have the capacity to consent to treatment – to basically prove they have the maturity to make such a decision –  known as the Gillick competent.

Chief Justice Diana Bryant of the Family Court says the Gillick’s component helps courts ensure a child is “psychologically in a position where they could make these decisions.”

But many families and doctors are unhappy about the various legal loopholes and costs associated with this process, believing the decision to transition can be left in the hands of children, their families and medical professionals.

“I don’t think going back to court is a good thing at all. I don’t think it is necessary to be honest,” Dr Telfer says.

Dr Telfer is a paediatrician at the gender clinic at the Royal Children’s Hospital in Melbourne and one of Isabelle’s doctors.

She has observed an increase in patient referrals to her department from one in 2003 to a hundred new ones over the past year.

In her experience, children are usually already assessed by up to five medical professionals, including psychiatrists, adolescent physicians, and endocrinologists, before being able to access round one of medical treatments– puberty blockers.

In light of this, the debate remains: do courts need to re-establish consent if round one of treatment has begun? And why should children, if medically determined to be ready for treatment, have to wait until 16 to access it?

Chief Justice Bryant hopes to see the court’s jurisdiction tested going forward. She tells Four Corners the High Court should consider examining gender identity cases thoroughly to determine if court involvement is needed at all.

“I think society is changing about these issues as well, and I think it is important to remember that.

“I think from what we’ve seen it’s completely innate and when you read all the psychiatric reports and all the reports about how it affects young people, it is undoubtedly innate.”

That it certainly is.

A staggering 99. 5 per cent of people who identify as transgender in adolescence continue to do so throughout their adult life. The regret rate after surgery is less than half a per cent, including regret around hormone treatment, surgical treatment and poor surgical outcomes.

Associate Professor Dr Campbell Paul, a psychiatrist at the Royal Children’s Hospital in Melbourne, confirms that delaying treatment can have devastating effects.

“As doctors, every decision we make on a clinical basis is about weighing up the risks versus the benefits. And in this case what we have is a risk of self harm and suicide that is extremely high, and yet a risk of regret that is very small,” she says.

One child told Four Corners their life would be “very dark, very bleak and very short” if any support or access to medical treatment had further been taken away from them.

Another, Jamie, 14, agrees court involvement should be minimised if possible.

“I don’t think it’s necessary that we have to go back to the court so they can decide if I’m Gillick competent cause that’s just up to the parents and doctors I think,” she says.

“They will make just a good a decision as anybody even better ‘cause they’re the experts.”

Some 18,000 Australian students currently identify as transgender. The number of them seeking treatment and feeling safer in coming forward is slowly increasing as our society evolves. Whether Australian legislation is updated to reflect these changes is yet to be seen.

At least, for now, the conversation has started.

BEING ME, reported by Janine Cohen and presented by Kerry O’Brien, goes to air tonight, Monday 17^th November at 8.30pm. It is replayed on Tuesday 18^th November at 11.00am and 11.35pm. It can also be seen on ABC News 24 on Saturday at 8.00pm, ABC iview and at abc.net.au/4corners.