A transsexual has been helped to die by doctors in Belgium, after a series of failed sex-change operations.
Two doctors concluded the 44-year-old did not have temporary depression. His case received scant media coverage.
Belgium legalised euthanasia in 2002. There were 52 cases of euthanasia on psychological grounds last year.
'Rigorous procedure' "He died in all serenity," doctor Wim Distlemans told the Belgian newspaper, Het Laatste Nieuws.
Nathan Verhelst was born Nancy into a family of three boys. The newspaper, which said it had spoken to him on the eve of his death, reported that he had been rejected by his parents who had wanted another son.
He had three operations to change sex between 2009 and 2012.
"The first time I saw myself in the mirror I felt an aversion for my new body," he was quoted as saying.
The hospital said there was an "extremely rigorous procedure" in place before any patient was put to death. "When we have a case which is... complicated, we ask ourselves more questions in order to be certain about the diagnosis," Dr Jean-Michel Thomas said.
Uncontroversial The BBC's Matthew Price in Brussels says the number of people opting for euthanasia in Belgium has risen steadily since legalisation. Most candidates are over 60 years old and have cancer.
Voluntary euthanasia for those over 18 is relatively uncontroversial in Belgium. Parliament is now considering expanding the law to under 18s as well.
Patients must be capable of deciding for themselves. They must be conscious and have to give a "voluntary, considered and repeated" request to die.
There were 1,432 recorded cases of euthanasia in Belgium in 2012; a 25% increase on the previous year's figure. They represented 2% of all deaths, the AFP news agency reported.
SOURCE: BBC