The child´s therapist encouraged medical intervention, Kelly said, but while Kelly supported social transition outside the home, she made it clear that her child would have to wait until she was 18 for hormones and top surgery.

For many, their worries were compounded when clinicians swiftly affirmed their childrens´ transgender identities and recommended medical intervention without fully assessing whether other potential underlying causes of distress were present.

The talented teenager, who has inherited her mother's polished sense of style, is also understood to be an accomplished cellist, and has honed her skills in tennis, sailing and gymnastics at an American summer camp.

But there may be a darker reason for the growing interest: a harrowing documentary recently laid bare the damaging health consequences of incestuous families through the eyes of the deformed, inbred Whittaker family in West Virginia.

From the wife who discovered she married her cousin to the daughter who realized her late father had been swapped at birth, here Dailymail.com rounds up the most jaw-dropping family surprises to come from tracing your roots.

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Corey Basch, a professor of public health at William Paterson University in New Jersey who researches health communication and teens´ use of social media, said she fears that some adolescents are susceptible to making faulty self-diagnoses without adequate input from medical professionals.

Leonor was still in primary school when she began carrying out royal engagements and made her first speech in 2018, aged 13. It marked a full-circle moment for her proud father Felipe, who was the same age when he made his first public address.

"One of the false narratives is that young people are being lured in and directed somehow against their will to become transgender, which is not at all the case," said Dr Dan Karasic, professor emeritus of psychiatry at the University of California San Francisco and lead author of the mental health chapter in WPATH´s new Standards of Care.

Leonor and Sofia proved they have both inherited their mother's understated style. Leonor, who is heir to the Spanish throne, donned a simple black vest top, while Sofia opted for a breezy long-sleeved blue tunic. 

Leonor was born during the reign of her grandfather, the now-disgraced King Juan Carlos who left Spain in August 2020 after becoming the target of several probes in Spain and abroad over alleged tax avoidance and questionable dealings in the Middle East.

She has carried out a number of solo engagements, as well as ones undertaken alongside her parents and beloved sister.    During the school holidays, Leonor returns home to Spain where she carries out royal duties.

In interviews with Reuters, they expressed worry that some adolescents assigned female at birth may be dealing with significant mental health issues in addition to questions about their gender identity, or may be seeking to transition as a refuge in a culture of internalized misogyny, body hatred and early sexualization of girls.

"I wanted to do the treatment that would fix that," Mosley, now 24, told Reuters. Isolated and miserable, she sought friends online, where she met a group of people on Tumblr who told her that if she hated her body, felt suicidal and didn´t fit in with her gender, she was transgender.

She was a co-author of WPATH´s new Standards of Care for adolescents. Some patients may see others touting huge improvements in their quality of life after transitioning, and so they think, "`I´m having these same problems, and transitioning to a different gender will help me feel better,´" said Dr Laura Edwards-Leeper, a clinical psychologist in Oregon who specializes in treating transgender children.

In a statement posted on his website, Mosser said: "We are profoundly disturbed by the extent to which misinformation, prejudice and fanaticism threaten trans, nonbinary and gender expansive people´s access to life-saving care." After receiving an "overwhelming number of violent threats" in August, Dr Scott Mosser of the Gender Confirmation Center in San Francisco announced he had paused accepting new adolescent patients for gender surgery.

"I knew people were looking at me and perceiving me in a way I didn´t like," Hurlbert said. Wearing a chest binder was uncomfortable and didn´t ease their distress. Pained by their appearance, Hurlbert avoided taking showers and removed a full-length mirror from their room. Floor Hurlbert was a middle-school student in Connecticut when, around the start of puberty, they began to suffer from severe chest dysphoria.