"Whatever you write about me, please, don't say, Marco was born a boy and now he's a girl. I was always a girl, it just took some time to share it with the world".

We're sitting around the kitchen table of a family's home, Mum and Dad and two daughters, a shaggy dog in the background. The rest of the family is listening quietly as Marco, now 21, explains how, even though she had been raised a boy, she had always identified as a girl, and how she slowly shared it with the rest of the world.

"When I was little, maybe five or six, something felt off, different. I couldn't find the words to describe it. I didn't really understand it. It didn't really bother me but I really enjoyed doing things that boys typically weren't meant to do. I wanted to look the way some of the girls did."

When she was about nine, Marco first heard the word transgender, but it wasn't anything to feel good about. The transgender people she first saw were bizarre fiends on TV crime shows or distressed people yelling at their relatives on tabloid-style day time TV.

"I was really seeing a very warped, exaggerated, kind of horrible version of what it means to be transgender. I went into this massive identity crisis and denial. For the next few years it was a cycle of denial, then eventually I'd acknowledge it and take a step slightly out of the closet, but that would be too much, just horrible, and I'd go running back. I felt very alone."

Despite a close, loving family, life was bleak and confusing for Marco for some time, until a lesbian friend at high school suggested coming along to a support group for same-sex attracted and gender diverse young people.

"My whole world was blown right open. Through the group I met a transgender young person, and found that they weren't these horrible exaggerated stereotypes living miserable lives or punching out their relatives on TV. They were happy and healthy and loved."

At 15, Marco began volunteering with the support group Minus18, and started having some slightly shy conversations with others there about feeling that she might not be a boy and might not ever have been one.

It took another couple of years before Marco was able to approach her family. One day, feeling very "wound up" about what had become a kind of double life, with some friends in the gay and transgender community aware but her family still in the dark, Marco burst into her sister Sophie's room and started to talk.

Sophie, just two years younger and always a close friend, was immediately kind and supportive.

"I think at first the furthest I could go was saying something about questioning my gender. What was so good about Sophie's reaction was that it was very supportive but kind of let it exist on my terms. 'If you need anything I'm here, but we go at your pace'. I'm very lucky."

A few months later, late last year, Marco handed a letter to her parents as they sat in the lounge after a family dinner. Then she walked out of the room, and sat on the stairs with Sophie, waiting for their reaction.

"I was a mess. It felt like hours but it was probably 20 minutes. Dad came out, he walked straight over to me and hugged me. He said, 'I love you, I'll always love you and we're here for you'."

Sitting around the table recently with Marco and her family recently, it's clear the response from both parents has stayed the same. Marco's father Max says, "you have your kids and your job is to love them unconditionally, that's it."

Mother Pat says although she had felt bad that they hadn't seen what Marco was going through earlier, she was grateful that Marco was finally "living her truth" and deeply thankful for the support from groups such as Minus18.

"I knew this child had been struggling and I felt so grateful that she hadn't been alone".

There's a tender moment around the table when Max is talking and refers to Marco as he, not she. He clearly feels bad: "I still do that some times, I really don't mean to and I know it's important". But Marco smiles, "He's trying so hard and he knows that it matters".

Marco's experience of coming out to the world has been largely positive, but it's not this way for many transgender children and young people. Several studies have found high rates of psychological distress, self-harm and suicide.

Many parents argue that the legal challenges faced by transgender children are contributing to these severe mental health problems.

Because Marco is now over 18, she no longer requires legal permission to have hormone treatment, although this is not an area she wants to discuss. Following a legal appeal last year, children under 18 can obtain first stage treatment, or puberty blockers, on the advice of a medical team, but must apply to the Family Court for approval for stage two treatment, or cross changing hormones. Both treatments are completely reversible.

Parent groups are arguing that this legal obstacle to getting the second phase of treatment, which can cost up to $30,000 and involves long wait times, is causing huge distress, even leading to suicide and self-harm.

Sarah, the mother of a transgender child, says the current legal process is no less than "profound discrimination".

She says her daughter had been suicidal at age seven, and is convinced she would have taken her own life if she had had to go through puberty as a boy.

"The court system is glacially slow. We almost missed the opportunity for her not to have any physical changes of a permanent nature," she says.

Sarah says the cost of the legal steps required is beyond many families, leading to severe mental distress for the child. She says some desperate families look for treatment drugs on the black market.

"There's a tiny number of cases where the child and family aren't agreed (on the need for hormone treatment), most often everyone, doctors, family and child, are in fierce agreement."

A Latrobe University study of 189 transgender people, aged 14 to 25, found about half had been diagnosed with depression and 38 per cent had had suicidal thoughts.

Released late last year, the study also found that about two-thirds of young people had suffered verbal abuse and one-fifth had experienced physical abuse.

Most of those who had been physically abused had suicidal thoughts in response to that experience.

Marco is among those to have suffered verbal abuse and has at times been frightened for her safety.

Having a supportive family is clearly a protective factor, with the Latrobe study finding that those with supportive parents fared better both in terms of their mental health and in getting access to appropriate mental health professionals.

School is also often fraught for transgender children, with many hiding their gender from peers and teachers for fear of bullying and discrimination.

The senior project officer with the government-funded Safe Schools Victoria, Joel Radcliffe, says many young transgender people face discrimination and abuse at school. These include bullying, teachers not using the correct pronoun (he/she), lack of flexibility about uniform, change rooms and toilets, too much time spent in gender-based groups and lack of flexibility around social events.

But he says schools that were willing to make changes to become more supportive of transgender children had made a huge difference for the better in a relatively short space of time.

He says the keys issues for schools to address are policy that specifically mentions gender diversity, curriculum that incorporates this issue and supporting student-led changes.

"What we're seeing is a willingness from a really diverse range of schools to work with us. The point is that diversity exists within every school."

Sarah says her daughter was not supported at her first school and was put in situations that added to her anxiety.

"I had other mothers accusing me of child abuse, as though this was something I was forcing on her," she says.

However, a new school has been a much better experience for her daughter.

Sarah says while awareness and attitudes are improving, and many people have been kind, those that aren't can have a devastating impact.

"There needs to be a little shift in consciousness about the idea that people choose this for themselves, the idea that it's a choice, rather than that it's innate. Once people accept that it'd be a much kinder world, more compassionate."