Five times as many Scottish children are seeking help for gender identity issues today compared to just four years ago.

Equality campaigners say they believe the rise reflects a growing understanding of transgender issues, particularly in the light of high profile celebrity cases such as Caitlyn Jenner.

However, they also warn the NHS isn’t equipped to deal with the growing number of cases and young people often wait a year or longer for an appointment.

There’s a risk the delay in starting treatment can affect the long-term mental health of young people.

According to the NHS Young People’s Gender Service in Scotland, 34 children were sent for specialist help in 2013. This rose to 67 the following year, 187 in 2015 and 200 last year.

James Morton, manager of the Scottish Trans Alliance, said that youngsters with gender dysphoria – a mismatch between their biological sex and gender identity – often feel isolated growing up.

“If you speak to adult trans people, they will often say they felt when they were growing up that there was no one like them. It’s only in the last few years that people have started to see positive representations of trans people in the media.

Now, if people are struggling with their gender, they know there are services that can help them, so they ask to be referred.

“But as a consequence that service is very stretched at the moment, with only a handful of specialist staff in Scotland. They can wait a year or longer just to be seen, which can cause a lot of stress, especially as it seems a lot longer if you’re only 12 or 13. We’re pleased that the NHS has been trying to recruit, but it’s difficult.”

Currently Sandyford centre in Glasgow offers a specialist service for children and adolescents with gender issues. All young people referred to the service see a consultant child and adolescent psychiatrist. Children under 13 may also be sent for hormonal assessment.

Gender reassignment is not currently offered to under 18s in Scotland, however hormone therapy may be offered in some cases.

Stonewall Scotland also called for more support for youngsters, who they said should “feel accepted without exception”.

A spokeswoman said: “It’s important that services are equipped to meet this rising demand so that trans young people get the support they need – from gender identity clinics and child and adolescent mental health services where appropriate, but also in their schools, youth groups and sports clubs.”