The number of children calling Childline about transgender issues and gender unhappiness reached a new high this year.
A report from the NSPCC charity, which runs the helpline, revealed it held 2,796 counselling sessions in 2015/16, equivalent to eight calls a day, some with children as young as 11 who felt their biological sex was wrong.
It is a dramatic increase in numbers. When the service began recording figures in 2012/13, there were 1,102 sessions on trans and gender dysphoria issues while for 2014/15, the figure rose to 1,299.
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"I don't think we can be clear in why there is a big increase in the number of calls. I think we're slowly trying to talk more openly about trans issues," said Emily Cherry, the head of children and young people participation at the NSPCC.
The confidential service does not keep records on the number of individual children and teenagers who make contact, but says it is probable some have called several times throughout the year.
Callers frequently discussed suicidal thoughts, self-harming or mental health issues, often stemming from abuse, bullying and a lack of support, says Childline.
Cherry said: "We're hearing about a huge amount of anxiety about talking to trusted adults about transitioning. One thing we give them is confidence and help with finding the words to talk to parents."
One 16-year-old boy who identified as a girl told counsellors: "I hate my body and feel hopeless and frustrated by mental health services. It's really difficult to talk to my parents as they just don't understand. I can't cope with another year like this one."
NSPCC chief executive Peter Wanless says it is "vital" that adults support young people as they navigate "confusing and complex feelings".
He added: "We cannot call ourselves a modern society if we stigmatise children just because they feel different."
The latest figures mirror increases in the number of referrals of young people to gender identity clinics across the UK, says The Guardian.
In July, the newspaper reported that referrals to the Tavistock clinic, the only centre for children and adolescents in England, doubled from 697 in 2014/15 to 1,398 in 2015/16.
