A German boy, now 14, is believed to be the youngest patient in the world pursuing gender reassignment after convincing doctors two years ago he wanted to live as a female.

Doctors say the boy, born “Tim,” has considered himself female since he was two.

According to his parents, Tim tried on his older sisters clothes and played with her Barbie dolls, announcing, “I’m a girl.” The boy was distraught after every haircut, they said, and at four, he took a pair of scissors and threatened to “cut off my thing!” After that incident, Tim was called “Kim” by his family.

“We always saw Kim as a girl, but not as a problem,” the father, who was not identified, told Der Spiegel. “In fact, our life was surprisingly normal.”

Puberty brought about a drop in Kim’s voice and concern for the child’s future.

“At that stage we realized that she was terrified of growing facial hair and her voice breaking,” said the father.

The family sought medical advice about a possible sex change for Kim, with mixed results.

“Hormone treatment! Gender adjustment! How could you possibly do this to the child?” the family’s pediatrician asked the father. Some psychiatrists suggested Kim be placed under observation in a psychiatric hospital.

Eventually, the family contacted Dr. Bernd Meyenburg, the head of a clinic for children and adolescents with sexual identity problems at Frankfurt University. He concluded that Kim represented the “rare … clear-cut case” for intervention before puberty initiated irreversible changes to his body.

“It would have been a crime to let her grow up as a man,” Meyenburg said.

According to Dr. Achim Wuesthof, the endocrinologist who is treating the teen, the procedure to arrest the course of male puberty has been successful thus far. Even though children under 16 are not permitted to undergo sex change in other countries, he and his colleagues thought it best to start early in Kim’s case.

“To the best of my knowledge, Kim is the youngest sex change patient in the world,” Wuesthof told the London Sunday Telegram. “According to German law, two independent psychiatrists must confirm that the child is indeed transsexual and approve the sex change. Once that has been done, it is best to start as early as possible.”

For legal reasons, surgery to remove Kim’s male genitals cannot be performed until age 18.

“From a purely medical standpoint we are dealing with the mutilation of a biologically healthy body,” said Meyenburg. “We face a real dilemma. If we do something about it, it’s irreversible. And if we allow nature to take its course, that too is irreversible.”

Meyenburg said he had mixed feelings about the fact that more and more – and younger – patients are seeking him out for advice.

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