A Belgian transsexual has died by lethal injection administered by a doctor after a sex-change operation left him "disgusted" with himself.
Nathan Verhelst, 44, died after choosing euthanasia on the grounds of "unbearable psychological suffering", Britain's Daily Mail reports.
Mr Verhelst's lethal injection was administered by a doctor who last year also ended the lives of congenitally deaf twins who were also going blind.
Mr Verhelst was born a girl, Nancy, but began hormone therapy in 2009 to become a man.
The hormone therapy was followed by surgery, to remove his breasts and construct a penis.
But he said he was "disgusted" by the outcome.
The Daily Mail reports that he told Belgium's Het Laatse Nieuws: "I was ready to celebrate my new birth. But when I looked in the mirror, I was disgusted with myself.
"My new breasts did not match my expectations and my new penis had symptoms of rejection. I do not want to be... a monster."
His family only learned of his death when they received a farewell letter.
There is fierce debate in Belgium about euthanasia. The number of deaths by euthanasia increased 25 per cent last year, from 1,133 in 2011 to 1,432 in 2012.
Euthanasia is legal in Belgium if people can makes their wishes clear and they are suffering unbearable pain, according to a doctor.