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I have a trans friend, and she has told me she always knew. That she never felt like a boy, never wanted to be a boy, ect. She's on the drugs, has changed her name, shes in the process. If I had a 4 year old son come to me and tell me he was a girl... Well I'm not sure what I'd do. I think i'd start letting him make some decisions. Take him to stores, tell him to pick out the things he wants, let him have them, see how he reacts to life. Let him grow up with choices. By around age 10 if he was determined he was a girl, i'd definitly get counseling, but not the run of the mill counseling but someone who knew what they were doing.
Then I think I'd get a doctors advice on whether it was best to wait until after puberty to start treatments or start right away. A person is who they are, and everyday I feel lucky that I was born in the right body, and I can't imagine limiting someone else from getting the body they identify with.
All in all, it depends on the kid, the facts, the sincerity.
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