(Photo: Maddy Jones / Citizen-Times)

A six-year-old in North Carolina has shown the impact of political activism after a year-long fight to safely use the toilet.

Six-year-old Emma started to show an interest in traditionally feminine toys and clothes in 2014.

She was assigned male at birth and her parents, Amy and Kevin, originally thought that she was just going through a phase.

However, as Emma grew and was more able to express her wishes, her parents realised that this was a permanent feature of their child’s personality.

Kevin told the Huffington Post: “She’s always been petite, she’s always been sweet like a little girl. Before we ever realized, she was always wanting pink and girls’ toys – dolls.

“We didn’t really know what was going on with it; we just thought: ‘Pink, blue, what makes a difference? We don’t care.’”

As she grew, Emma started to call her mother ‘he’, much to Amy’s confusion. “We thought she was just really confused and we needed to explain to her the difference in gender,” she said.

“I said, ‘Let’s explain this: Boys’ pronouns are he and him. Girls’ are she and her.’ But Emma kept saying, ‘You’re he!’”

Emma explained to her: “Well, if I’m a boy, you’re a boy.”

Amy and Kevin turned to Facebook for advice and eventually discovered that Emma was transgender.

Amy said: “I think that we just got online to make sure that we weren’t going to damage her and that we were doing things right.”

Contrary to some beliefs, transgender children like Emma do not undergo any form of medical transition or hormonal treatment.

Medical interventions such as hormone blockers may be discussed once a child has reached puberty.

However, these are reversible and simply pause bodily changes that are more difficult to reverse after puberty.

Emma started school in 2016, in the middle of a fierce battle between lawmakers and trans rights activists in North Carolina.

North Carolina hit the headlines last year for the introduction of ‘bathroom bill’ House Bill 2 (HB2).

HB2 required public institutions, such as schools, to insist transgender people used the bathroom facilities that match their sex assigned at birth, rather than their gender identity.

Although HB2 has since been revoked, the replacement bill HB142 has been criticised for maintaining the same discrimination.

With HB142, regulation of multi-occupancy toilets was left up to the state, while local authorities won’t be able to pass anti-LGBT-discrimination laws until December 2020.

And while Emma’s parents were supportive of Emma’s gender and social transition, her school was significantly less so.

Amy and Kevin informed Glen Arden Elementary School that their child was transgender, and that though her birth certificate contained a different name, her name was Emma.

The school refused to acknowledge this.

Amy and Kevin recalled that her teacher would repeatedly tell her in front of other students that boys didn’t wear skirts or have long hair.

Kevin said: “The teacher she was with from day one disagreed with it, and expressed her feelings to Emma daily.

“Emma would say she had girl hair and the teacher would tell her: ‘No, you’ve got boy hair. You’re a boy.’”

If Emma argued, she would be told off for talking back.

Kevin added: “Several times she came home crying over the teacher telling her about being a boy…they actually punished her for telling them that she was a girl.

“She’s there to get an education, not to worry about whether her teacher thinks she’s a boy or girl.”

Referring to HB2, Glen Arden staff insisted that Emma use single stall bathrooms or the boys’ bathrooms.

Glen Arden Elementary School’s grounds total a huge 70,000 square feet. There are 10 gendered sets of bathrooms.

There are only four single-stall bathrooms, and if Emma couldn’t reach any of these facilities, she was forced to either use the boys’ bathroom or wet herself.

Emma was unable to reach adequate bathrooms twice during her time at Glen Arden Elementary, each time when members of staff would not allow Emma to travel to the single stall toilets.

Prior to the second incident of Emma wetting herself, a member of staff told the six-year-old: “You’re going to have to hold it.”

Her parents realised what had happened when they discovered Emma’s urine-soaked clothes in her backpack.

Amy said they were “very mad, just upset.

“Where do you have to be in your mind to be forced to urinate on yourself or go in the boy’s bathroom?

“What kind of choice is that for a child?”

The family began working with trans rights charity Tranzmission to lobby the local authority and school board into implementing an inclusive policy for trans students across the area.

At the end of the school year, the family decided to move Emma to another school, separating her from her sibling, who remains at Glen Arden Elementary.

Emma’s parents have said that changing school has made a significant difference. “I go pick her up and she’s smiling; it’s just night-and-day different.

“She’s a different child.”

Watch an interview with Emma and her parents here: