Riley Grant claims he is a 10-year-old girl in a boy's body. He was given the name Richard at birth but now goes to school with long hair, girls' clothing and the name Riley.
The child was diagnosed with Gender Identity Disorder. He is biologically a boy but is convinced he is a girl.
"I want a dress. I'm a girl, Mommy, I'm a girl," Riley would tell his mother at around age two, according to ABC's 20/20.
When Riley was still Richard, the child would wash his hair with one hand while keeping a washcloth over his genitals with another, Stephanie Grant ("Grant" is an alias being used to protect the family's privacy), the mother, told 20/20.
Richard would say "heart-wrenching prayers" in the middle of the night and tell his mother, "I'm so mad at God, because God made a mistake. He made me a boy, and I'm not a boy, I'm a girl, Mom. Every night I pray that God gives me a girl body but when I wake up I'm still a boy. God won't take back His mistake. He won't make it right," Grant recalled, according to the news program.
Commenting on Riley's situation, Dr. Warren Throckmorton, associate professor of Psychology at Grove City College in Pennsylvania, said, "If a person believes that faith teaches they should remain the biological gender they were born as, then they would want to work with a counselor and try to accommodate themselves."
But it's difficult for young children; they don't understand, noted Throckmorton, who specialized in children before teaching at Grove City College.
"His (Riley's) religious views are going to be skewed by his problem," he told The Christian Post, adding that it's hard for parents no matter what their faith teaches them about this issue.
Fearing their child may try and harm himself after he began talking about jumping out of windows and having regular breakdowns and had a severe panic attack, the Grants were directed to a gender specialist who diagnosed their son with Gender Identity Disorder.
At seven years old, Richard became a full-time girl and eventually changed her name legally to Riley, ABC reported. At school, however, peers would tease her and call her a boy. And at home, Riley would fight with her fraternal twin sister, Allie, who is everything Riley wants to be, the mother noted.
As Riley approaches adolescence, some doctors say puberty is crucial for a child's development and should be allowed to take its natural course. Other specialists say early intervention is a better option. This includes hormone blockers to keep the child at a pre-pubertal state, as Dr. Norman Spack, an endocrinologist at Harvard University, told ABC. And later, estrogen is taken, in Riley's case.
"I want Riley to have a good life, and for more people to understand the way she is," Neil Grant, the father, told ABC.
Cases like Riley's are rare, noted Throckmorton, who has only treated five children struggling with gender identity in 25 years. "They are not frequent cases," he said. But they do occur.
While transgender children can only be assessed on a case-by-case basis, Throckmorton recommends seeking not only medical or psychological specialists, but also theological ones. And even if it may seem impossible to draw one resolution when bringing all three opinions together, Throckmorton advises parents to try to find some common ground.
"What an evangelical Christian basically wants to do is order his entire life around his faith," he said. "You can't make decisions unless ... the circumstance you're in is evaluated from a theological point of view."