Nickie* is a perfectly normal, happy 16-year-old girl. But it hasn't always been that way.
Born a boy, the bullying she endured at secondary school was sustained and horrendous. "She was assaulted, punched, kicked, spat at, pushed around and called names," says her mother Sharon. "When she wore a skirt, boys used to try and pull it up to expose her genitals. They'd shout, `Show us your dick' or ask if she'd had it cut off yet."
Nickie attempted suicide four times until her mother pulled her out of school. "It was a nightmare," Sharon says. "The school wanted to deal with the bullying as and when, but half the time Nickie didn't even know the name of the person abusing her. It would have been so much better if the pupils had been informed. Kids will accept most things if they're presented in the right way."
Such vicious bullying is almost a rite of passage for transgendered pupils. Transgendered children and teenagers are three times more likely to commit suicide than others, an American survey reveals.
The most recent victim in the UK was 10-year-old Cameron McWilliams from Doncaster, who hanged himself last year having expressed a desire to be a girl. Two cases of bullying also featured in the media last month when a 12-year-old and then a nine-year-old boy went to their respective schools dressed as girls.
Parents of transgendered children have reacted angrily to the coverage, saying it fails to differentiate between transgendered and transsexual children. Both may feel trapped in the wrong body, but the vast majority of transgendered people (95 per cent) will never have gender reassignment surgery.
The reports also make out that this is a very rare occurrence, according to Natacha Kennedy, a former primary school teacher who is transgendered. In fact, whether they know it or not, teachers are likely to encounter a number of transgendered children during their career. A primary school of 300 children will usually have three transgendered children on roll - a large secondary even more. Others will have a transgendered parent or close relative.
Although the average age of sex change surgery is 42, most children will have realised they are transgendered around the age of six or seven, says Ms Kennedy, who has researched widely into the issue. So while the "coming out" may be rare, it's not through any lack of awareness. Instead, pupils usually conceal their gender identity issues out of fear.
"I realised I was transgender when I was four or five, but it was a case of repressing it," Ms Kennedy says. "It was quite clear from early on that it wasn't acceptable. I played football as a sort of macho defence mechanism."
During her 20 years as a "male" primary school teacher, Ms Kennedy remembers six children who were definitely transgendered. One 10-year-old boy went home on a Friday and came back as a girl on the Monday. The school told the girl's class, their parents and staff, but decided not to inform the whole school or every parent, so as not to draw too much attention to the girl.
Other schools are also finding ways of supporting transgendered pupils. One learning support mentor at a secondary school was aware that a newly transgendered pupil was at risk of bullying. He began by de- sensationalising the situation and inviting other pupils' questions. "Burying your head in the sand makes it worse," he says. "I could not find a scrap of evidence to suggest a positive outcome of leaving pupils' questions unanswered."
Nineteen pupils approached the learning support mentor, asking about "the heshe" or the "tranny". "They get a frank and factual chat and every single one has left the session with some level of respect for her courage."
Staff have researched the subject and are kept regularly updated by the head of year. The school's anti-bullying policy has been updated to include the word "transgender", and concessions made to make the girl feel more secure. For instance, her PE timetable has been suspended, she's allowed to use the supervised unisex toilet in reception and can take refuge with friends in reception or in her tutor room during breaks.
It's common sense, insists her mentor. Slowly, her confidence is growing and she is able to integrate more. The name calling and low-level bullying has not disappeared, but she is better placed to deal with it. She is particularly thankful for the two sessions a week with her mentor when she can "just be herself".
The mentor insists they've done nothing unusual or special. "It just comes out of staff having a genuine desire to care for her, make sure she has a fair chance at being happy with who she is, and is at peace with the world she finds so hurtful at times."
Wendy can only dream that her 15-year-old transgendered child had such a supportive school. From day one at her secondary school, Sally was bullied on a terrifying scale. She had her hair set on fire, was splattered with yoghurt and drinks and has been hit around the head with bags, branches and fists - even ending up in Aamp;E with suspected concussion.
Sally soon refused to go to school. Even when Wendy, a secondary school teacher herself, drove her in, she wouldn't stay for long. The education welfare service took Wendy to court for her daughter's truancy.
Sally started running away - three times over the course of two weeks this summer - and started to drink, steal and be verbally and physically abusive. She was revolted by her body and dropped to six and half stone in an attempt to halt puberty.
"I can deal with Sally, I can deal with the CAMHS (child and adolescent mental health services), the clinic, the home tutoring and everything else, but when the school plays games, it just gets too much," says Wendy.
She's referring to the fact that there was no single person for her daughter to go to for help; that staff wouldn't return her calls for days; that Sally was offered no alternative accommodation where she could take her GCSEs; that the school hasn't taken up the training offered by the LGBT (lesbian, gay, bisexual and transgender) police and that the school insisted the multi-disciplinary meetings could no longer be held in her home, despite it being the only place where Sally feels safe.
"I know kids can be cruel, but I'm angrier with the school for how it has, or hasn't, dealt with it," says Wendy. "I'm so glad my child is transitioning away from school. It's a relief for her that she can be herself now."
But schools are often placed in an undeniably difficult position, trying to balance the needs of an individual with that of the wider school population. The recent media reports focused on the anger of parents at the school. They complained that they hadn't been properly informed and that their children were tearful and confused. "My son is too young to really understand the significance of what's happening," one primary school mother was reported as saying.
Polly Carmichael says the media coverage highlights the level of anxiety and confusion around this subject. But as a clinical psychologist at the Gender Identity Development Service at the Tavistock and Portman NHS Trust in London - the only gender clinic in the UK for children so young - she believes schools need to explore the topic more, not less.
"I understand schools' nervousness," she says. "It's clearly an issue that arouses strong feelings, so schools need to be sensitive to that and think through the implications carefully. But if you put time into the planning you can save time on picking up the pieces. Schools need to think about the `what ifs' and how they will adequately support the child."
Teachers could start by discussing the complex biological factors behind gender. Ms Carmichael also works with children with Disorders of Sexual Development (DSDs) - something that hit the headlines when Caster Semenya, the South African runner who won gold in the 800-metre women's race in August's world athletics championships, was found to have both male and female characteristics.
"Issues of gender are quite profound but we stick with a rigid dichotomy of it," says Ms Carmichael. "A more fluid approach to gender would reveal it's not always so black and white."
If approached sensitively in primary schools, the topic doesn't have to be shocking or even that much of a big deal. "Things that we don't understand are frightening," adds Ms Carmichael. "Nine-year-olds won't balk if you tell them that most of us feel at home in our bodies, but that some people don't. They may find it a bit confusing at first, but teachers can reassure them that it's not catching or anything to be scared of, it's just different. Without that information, they may feel threatened and that can lead to prejudiced views."
Gendered Intelligence is an organisation that tries to raise awareness of these issues, through school-based drama and art workshops and teacher- training programmes.
"Young transgender pupils' main barrier is the huge lack of knowledge around trans identities," says Jay Stewart, a trans man from the organisation. "Poor understanding and behaviours around the lives of LGBT people is endemic in our schools. It's still very difficult for a person who has been assigned the male sex at birth to express any sort of feminine behaviour."
But Gendered Intelligence has encountered resistance getting into schools. Some do not see it as a priority worth spending money on. Others are worried that parents may complain. Instead of treating gender variance as bad or even contagious, Mr Stewart would like to see it openly discussed and even celebrated in schools. With support and guidance, teachers can "stand tall when they receive criticism or challenges", he adds.
Schools could start by recognising transgendered children do actually exist and need to be catered for, says Ms Kennedy. Just as a classroom should be dyslexic-friendly, whether you know of any dyslexic pupils or not, so it should be trans-friendly too.
"Even if you don't think you have any trans pupils, use the word, so they can at least go away, Google it, access youth support groups and realise they're not alone."
Nickie is proof that young trans people can become happy, well adjusted and fulfilled. When she was 13 and a half, her parents took her to the US for puberty suppressing medication. It can only be prescribed to over-16s in the UK, by which time a lot of distressing pubertal changes will have already taken place. Without the blockers, Nickie would have grown to an estimated 6ft 4in, with masculine hands and feet that no surgery could reverse. Instead, she is 5ft 11in and nobody at her college suspects she was born a boy. Nickie is now on hormones and is due to have surgery when she turns 18. "She wanted it when she was six years old, so she's pretty focused," her mother says.
For every happy ending, however, there are dozens who are scarred for life as a result of their school experiences. By rising to the challenge and facing the issues head-on, teachers can help reverse that ratio for good.
*Some names have been changed