I am wondering if, maybe, the parents are just letting the kid's true nature come out. In other words, could gender identity be something that runs along the lines of left-handed vs right-handed? I remember in the old days when parents would bind a kid's left arm to prevent them from writing left-handed.One couple at our church have a son, about 10, who has beautiful shoulder-length wavy black hair, with bangs. He tends to flip it with his hands or otherwise handle it with gestures normally regarded as feminine. On top of that, they dress him in androgynous clothing, shorts that look more like culottes, etc. I do a double take every time I find myself in the restroom at the same time. OTOH, the father is probably 250, 6'4", together with man bun, so go figure...
I don't think years and years of counseling or therapy is going to make much of a difference in this instance. Just my two cents.
If it is innate, then a kid is setting himself/herself up for being a target of bullying.