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Blowing out the candles on the big pink-iced birthday cake, Joseph Hughes wishes he was a girl.

Dressed in a new stripey dress, handbag and Minnie Mouse shoes with matching belt, the nine-year-old’s look is completed with a blonde wig.

With family by his side, he ventures outside for the first time as Ellie-Jo.

But in September, the youngster is hoping to return to school as a female with the backing of his proud mum, Sam.

Princesses and dolls for Christmas

The mum-of-six from Rhyl said Joseph has wanted to be a girl since the age of two.

Instead of toy soldiers and trains, he asks for princesses and dolls for Christmas and birthdays.

So it came as no surprise when Joseph’s latest birthday must-have was a wig to go with his new wardrobe.

“When Joseph puts on dresses, he seems much more content and happy in himself, his attitude changes completely,” explained Sam, who bravely agreed to speak out to raise awareness and help others.

“Almost his entire life, he’s enjoyed dressing up as a girl - I have five other children who have all played dressing up - but with Joseph, it was different, more natural somehow.”

Pink cake for fourth birthday

Flicking through photographs over the last seven years, Joseph’s love for all things “girlie” is clear.

In some of the earlier images, the youngster can quite easily pass for a girl with an angelic face and pretty long blonde curls.

On his fourth birthday, Joseph wears a Cinderella dress and tiara as he blows out the candles on his pink princess castle cake.

A picture taken at the age of eight shows him painting his toenails.

Began 'very early on'

“I can’t remember the exact day when it all started but it was very early on,” admitted Sam.

“As Joseph’s personality formed, he developed an interest in wearing princess dresses.

“I remember when he was at Ysgol Llywelyn when he was four, the teacher asked him what was wrong and he said he was upset because he wanted to be a girl.

“For school dress-up day, he insisted on taking in a blue princess dress to wear.”

With plans to grow his hair long, Joseph loves “anything girlie” and is an avid fan of the Barbie films, princesses and ballerinas.

'Thought it was a phase - but never grew out of it'

He sometimes sleeps with girls sheets and duvet covers on his bed and prefers to wear knickers instead of underpants.

“I thought it was a phase at first,” explained former Ysgol Glan Clwyd pupil, Sam, who moved away from North Wales two months ago.

“Instead of playing football with his brothers, Joseph would always prefer to be with the girls and play with their toys.

“When he started putting his older sister’s clothes on, I didn’t think much of it at the time, but it turned into something he never really seemed to grow out of.”

Sam took Joseph to see specialists at CAMHS (Child and Adult Mental Health Services) and after a few appointments, he was referred to a children's clinic in Rhuddlan.

“The doctor saw him twice and said there was nothing more they can do until Joseph’s 11, when his hormones start to kick in,” Sam said.

“Since then, we’ve just been left to get on with it really.”

'Whatever makes him comfortable'

So Sam took to the internet to research gender identity but the forums she came across only related to older children.

She added: “I couldn’t really see anything relevant to Joseph at this stage in his life so I’ve carried on allowing him to do whatever makes him comfortable.

“To me it’s clear that he has gender dysphoria but I wanted to give Joseph time to think for himself and do what comes naturally to him.”

Wants to go to school as Ellie-Jo

Joseph is settling in to his new school well but has asked Sam if he can start the new September term as a girl called Ellie-Jo.

“I’ve been in touch with the school and we are having a meeting to discuss this possibility,” she said.

“The headteacher said there is another school in the vicinity that has allowed a child to transition their gender so it’s likely that they might allow Joseph to do it too.”

Already, Ellie-Jo has taken steps to embrace the transition by venturing out to the supermarket and park with Sam and siblings Victoria, 20 Francesca, 15, Owen, 11, Guy, seven, and six-year-old, Eric.

Shared 'girl' pictures on Facebook

Afterwards, his mum bravely took to Facebook to share her pictures, along with a post that read: “As some of you may know, Joseph wants to be a girl.”

Sam told the Daily Post: “This isn’t something that Joseph has grown out of, what nine-year-old boy would want to go outside dressed in girl’s clothes if they weren’t serious about gender transition?”

The number of children aged 11 and under referred to the NHS for help in dealing with transgender feelings has increased five-fold in the past five years from 139 cases in 2010/11 to 697 in 2014/15, according to figures from the Tavistock and Portman NHS Trust - the UK’s only specialist centre for gender issues in under-18s.

'Pupils are to be treated equally and fairly'

A spokesman said: “Why we have seen an increase is a complex issue and there are, no doubt, a number of factors: increased awareness and acceptance, better access to the service through outreach...CAMHS and other services can refer more easily, allowing greater equity of access. It is also probably fair to say that young people are increasingly interested in exploring gender.”

Elly Barnes, founder of the charity Educate and Celebrate, said: “If Ellie-Jo identities as female then the school has a duty to use her preferred pronoun.

“Schools adhere to the Equality Act 2010 where gender identity is one of the nine protected characteristics, therefore pupils are to be treated equally and fairly.

“Ofsted criteria from section 5 briefing 2013 explore if pupils ever get picked on by other children for not behaving like a ‘typical boy’ or ‘typical girl’, if they do then intervention is needed to make the environment safe, preferably through LGBT+ (Lesbian/Gay/Bisexual/Transgendered) inclusive lessons to increase the visibility and where difference is celebrated.”

At the moment, Sam said the family refer to Joseph as Ellie-Jo only when the blonde wig is being worn.

“You can definitely tell the difference in Joseph when he becomes Ellie-Jo, he’s much more confident,” she said.

“It’s his identity and he is the one who’s got to cope with it, not me. All I can do is be here for him and prepare him for the fact that people may laugh and make fun.

'Who am I to stand in the way?'

“His wardrobe contains a mixture of boys’ and girls’ clothes and I leave it up to him to decide what it is he wants to wear.

“I fully support Joseph with whatever he wants to do and I am so proud of his bravery, if he changes his mind in later life, that’s entirely his choice.

“I am his mum and I will be here for him no matter what, all I want is for my children to be happy.

“If being Ellie-Jo makes Joseph happy then who am I to stand in the way?”