A 44-YEAR-OLD man who was born a woman has been euthanised in Belgium on the grounds of "unbearable psychological suffering."

The Telegraph reports that Nathan Verhelst, who was born Nancy, was given legal euthanasia by Wim Distelmans, a cancer specialist who made headlines last year when he gave 45-year-old twins Marc and Eddy Verbessem a lethal injections because they feared they were going blind as well.

Verhelst told Belgian newspaper Het Laatste Nieuws that he had hormone therapy in 2009, followed by a mastectomy and a penis constructed in 2012 but "none of these operations worked as desired".

"I was the girl that nobody wanted," he said in the hours before her death. "While my brothers were celebrated, I got a storage room above the garage as a bedroom. 'If only you had been a boy', my mother complained. I was tolerated, nothing more."

"I was ready to celebrate my new birth," he told the newspaper. "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. "

Dr Distelmans has defended his call to proceed with the euthanasia.

"The choice of Nathan Verhelst has nothing to do with fatigue of life," said Dr Distelmans. "There are other factors that meant he was in a situation with incurable, unbearable suffering. Unbearable suffering for euthanasia can be both physical and psychological. This was a case that clearly met the conditions demanded by the law. Nathan underwent counselling for six months."

Jacqueline Herremans, a member of the national euthanasia committee, told RTL television he had been examined by two doctors, including a psychiatrist, to make sure he was not suffering from a temporary depression.

The case has revived the debate in Belgium over whether euthanasia should be given to those who are psychologically troubled or only to terminally ill patients. The country is also deciding if it should extend euthanasia to children.

While there were only six cases of euthanasia recorded on psychological grounds in 2004, there were 33 in 2011 and 52 last year.

Belgium recorded a record number of 1432 cases of euthanasia in 2012, up 25 per cent from the previous year. Euthanasia carried out by doctors is only legal in three European countries, the Netherlands, Belgium and Luxembourg.