(TELEGRAPH) — A little boy who decided he was a girl trapped in a boy’s body has become one of the youngest-ever children to have his decision backed by the NHS – aged just four.

With his blonde pigtails and purple tutu, Zach Avery, now five, has been living as a girl for more than a year – after he first refused to live as a boy when he turned three.

Little Zach was just three when he began refusing to live as a boy, instead choosing to wear pink dresses and ribbons in his long, blonde hair – because he has Gender Identity Disorder (GID).

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