And a private child psychiatrist in Newcastle who specialises in issues associated with gender identity agrees.

There's "simply not enough people to do the work", said Dr Yolandie Goodyear, who has more than 50 clients on her books and a two-month wait for appointments.  She said time was precious to some transgender adolescents.

"For some of these children entering puberty they feel like they already don't fit in their skin, and then their skin is changing very rapidly. They get really distressed," she said.

West Wallsend's Daryl Park, who helps to run a fortnightly support-group for transgender boys and their families in Lake Macquarie, wants a service established at John Hunter Children's Hospital for transgender minors.  His son came out at the age of 13. 

"It's bigger than Ben Hur what's happening to these kids," Mr Park said. "It affects every level of concept they have of the world, spirituality, sexuality. The normal things kids judge themselves against ... these kids don't get that chance.

"My son's breasts were growing, in a girl that would be a celebration, for him it was degrading and made him just hate his body. My son said to me 'there is no god, if there is why is he doing this to me?'" 

Mr Park said most of the parents' meetings were spent trying to navigate the Hunter's medical system.

"There's so many factors and lots of doctors are so scared of anything to do with gender, which makes it really difficult," he said. 

A Port Stephens mother told the Herald that her child, who was born anatomically female and raised as a girl, told her he was transgender in 2018. 

What followed, she said, was “heartbreak and frustration”.

It has taken the family a year to find a mental health professional willing to assess her son, who is now 14, for gender dysphoria, the medical term for the distress people feel when their sense of gender identity does not match the gender they were assigned at birth. 

Without a positive diagnosis, adolescents cannot access puberty blockers, a reversible medication that slows down the appearance of secondary sexual characteristics such as breasts and facial hair. They are administered by an endocrinologist. 

“He’s been cutting and taking painkillers to deal with it," she said. "He just needs the recognition that he’s male. Without the proper psychiatrist saying, 'yes, you are male' there’s nothing you can do. But I’m more concerned with his mental health. Him not wanting to be here if he can’t be what he wants to be.”

Initially, her son was seeing the Child and Adult Mental Health Service run by Hunter New England Health for his self-harming. When she raised that her son was feeling distressed about his gender identity, they referred him to Maitland Headspace.

A spokesperson for CAMHS told the Newcastle Herald the service could provide "diagnostic clarification and support" for young people with gender dysphoria but only if they presented with another "acute mental illness".

The mother said she was told by Headspace that they could help her son with anxiety and self-harming but not gender dysphoria. 

Maitland Headspace told the Herald that while they saw young transgender people, they did not diagnose or offer treatment specifically for gender dysphoria. They run an LGBTIQ support group, but it's only for people over the age of 16.

After receiving a referral for Dr Goodyear in October 2018, she was told her son would get an appointment in March or April 2019. That was later pushed back to June or July.

Her son was referred back to the Child and Adult Mental Health Service earlier this year, when he brought a packet of painkillers to school. The service then offered to assess him for gender dysphoria.

Dr Goodyear said it was not rare that teenagers and families experienced a "non-linear" path to diagnosis and treatment for gender dysphoria. She said it was in part due to a "reluctance" of mental health professionals.

"I think it's a lack of knowledge and support, and a worry about doing the right thing," she said. 

Australian treatment guidelines do not specify that children have to see a child psychiatrist specialising in gender dysphoria to be assessed. 

"If the child is little, the treatment looks quite different than for a prepubescent, they mainly need someone who can help them deal with anxiety and support the child. Any mental health worker is able to do that," Dr Goodyear said. 

She said another factor contributing to the gap in support for transgender adolescents was the worldwide increase in the number of minors presenting to health services as transgender or gender diverse in the past decade. 

Mr Park said John Hunter Children's Hospital should receive extra funding in line with the increase, in order to reduce waiting times for its endocrinology service. He said members of the support group had waited up to 18 months to get an appointment.

Westmead Children's Hospital received an additional $160,000 in the 2018 to 2019 financial year from NSW Health to establish a multidisciplinary gender dysphoria service. A spokesperson for the hospital said it had seen an increase from one referral for gender dypshoria in 2013 to 56 in 2017.

A spokesperson for John Hunter Children's Hospital said it had also seen an increase in referrals for gender dysphoria, with 44 referrals to its endocrinology service in 2018. The unit, which deals with a range of other health issues, received a total of 919 new referrals that year.

Hunter New England Health said the wait for "pubertal" transgender teens should reduce to four to six weeks as of this year, as an extra clinician had been hired.  

Emmett, 16, who asked for his surname not to be used, said mixed messages from hospital staff about waiting times had contributed to his anxiety.

After an initial appointment with the clinic in July, for which he had waited four months, he was told by hospital staff he would have an appointment in two weeks to receive his first dose of puberty blockers. 

"It wasn't until mid-way through October I started," he said. "It ended up being a few months.  I noticed in those few months I was developing a lot more of a female body and I was getting my period still, which was highly upsetting for me. I was anxious to go outside and anxious to do things. I was too scared of people reacting negatively to me. 

"I had to be medicated and I'm still on medication," he said. Thanks to the care of the unit, however, Emmett has progressed in his medical transition and says his life has "greatly improved".

"I still don't have the body I have been dreaming of since I was a kid but it's eased a lot of the dysphoria. When people find out I'm trans, they are surprised. That fills me with joy," he said. 

Lifeline: 13 11 14

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