In a particularly tragic divorce proceeding, a mother who forces a transgender identity on her 6-year-old son James is accusing the boy’s father of child abuse because he refers to the boy as male. The father responded by offering James a choice of boy’s clothes and girl’s clothes, and the boy constantly chooses the male options while away from his mother.

Dr. Michelle Cretella, executive director at the American College of Pediatricians, told PJ Media that the mother may be suffering from a mental disorder. “This case is consistent with a diagnosis of Munchausen by proxy,” she said.

“This is a disorder in which an adult feigns either physical or psychological condition in a child for their own subconscious reasons,” the pediatrician explained. “Most often the perpetrator is the biological mother and she often has a background in health or medicine.”

“In the case of imposing gender dysphoria on a son, there are cases in the scientific literature of severe maternal depression triggered in a mother longing for a daughter,” Cretella added. “The mother’s depression lifts when the boy dresses and acts as a girl. This has been termed ‘gender mourning.'”

The pediatrician admitted, “I obviously cannot diagnose anyone based on newspaper reports.” She further insisted “this may not be malicious on the mother’s part. She may sincerely believe she is doing right by James.”

WebMD confirms Cretella’s description of the mental disorder “Munchausen syndrome by proxy (MSP).” MSP “affects a primary caretaker, often the mother,” and a “person with MSP gains attention by seeking medical help for exaggerated or made-up symptoms of a child in his or her care.” As medical professionals tend to the child or proxy, “the deliberate actions of the mother or caretaker can often make the symptoms worse.”

Walt Heyer, a speaker and author who once identified as transgender and now runs SexChangeRegret.com, drew attention to James’ case last week in a Federalist article. As Heyer noted, a medical diagnosis of “gender dysphoria” involves a “persistent, consistent, and insistent” identification with the gender opposite one’s birth sex. But James’s identity is inconsistent.

“Meanwhile, Dad isn’t seeing signs of gender dysphoria. In the father’s home, James appears to be a normal boy and doesn’t identify as a girl. He has a choice of boy’s or girl’s clothes there, and he chooses to dress as a boy,” Heyer reported. “The fact that James changes gender identity depending on which parent is present makes the diagnosis of gender dysphoria both dubious and harmful.”

In fact, Cretella told PJ Media that not only is James “happy behaving like a stereotypical boy,” but “one time he actually cut up the girl clothing” his father provided.

“Whenever he’s with his mother, his mother addresses him by the name Luna and only permits him to dress in girl clothing,” Cretella added. The mother chose a therapist who specializes in gender transition, and the therapist seems unwilling to acknowledge James’s masculine identity.

“The fact that the therapist ignores the obvious amounts to child abuse,” the pediatrician told PJ Media. “This therapist and the mother are conditioning James to identify as transgender and to begin the road of puberty blockers and cross-sex hormones. This will destroy his life.”

These medical “treatments” for gender dysphoria have irreversible effects, and many who “transition” eventually reject their transgender identities.

Indeed, Heyer himself had a similar story to James’s. “I lived through a similar scenario when I was his age. I was cross-dressed for two-and-a-half years by my grandmother, who made a purple chiffon dress for me. Somewhat like James, my cross-dressing occurred under one adult’s care, but away from grandma’s I was all boy with my mom and dad. Also, just like James, I found my way into the office of a gender therapist, who quickly started me toward transition,” Heyer wrote.

“What this mom is doing to James looks very much like what my grandmother did to me by affirming me in the purple dress. My grandmother didn’t intend to harm me, but her actions destroyed my childhood and my family and consumed nearly 50 years of my life,” he confided.

In James’s case, Cretella said, “It is possible that the court and therapist may be facilitating a disorder in the mother that will be devastating to James’s physical and mental health.”

Sara Scott, a family friend who runs the website savejames.com, explained that “in Texas the mother has complete rights to psychiatric/psychological care and does not need the father’s consent. The therapist specializes in aiding transition. Jeff [the father] has not been allowed to get a second opinion.”

Scott also told PJ Media that “the custody evaluator has been made aware of James’s preferences at home,” but still favors the mother in the proceedings. As of now, “Jeff has the standard shared custody agreement … which is two hours every Thursday evening and every first third and fifth weekend of the month.”

The campaign has raised more than $22,000 of its $75,000 goal on the crowdfunding site GoGetFunding. According to the site, Jeff has spent roughly $250,000 in legal fees and is still fighting for more custody of his two sons.

While many assume opponents of transgender identity are bigoted, thousands of former transgender people have de-transitioned. Many have spoken out, condemning hormones and surgery as “not a cure at all,” and lamenting life-long scars.

Unlike these people, who were “persistent, consistent, and insistent” about their transgender identity before their de-transition, James vacillates between two identities. Forcing him to side with his mother and to embrace a female gender identity will have disastrous long-term effects.

It is truly heartbreaking to see a family split apart, but even worse to see a mother and father at odds over whether their son is a boy or a girl. The mother may also suffer from a mental disorder, which a therapist and a court seem willing to indulge. What has America come to?

Follow the author of this article on Twitter at @Tyler2ONeil.