MADRID (Reuters) - Gabriel Diaz de Tudanca is a 19-year-old Spaniard who, although born a girl, identified as male from early childhood.

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“When I was three years old I came back from school and said to my mother that when I grew up I was going to be a man called Oscar,” he says.

Supported by his family and friends, he has undergone surgery and hormone treatments, changed his name and renewed his identity documents to reflect what he feels is his true gender.

Reuters photographer Susana Vera accompanied him for three years through his process of change.

In terms of lesbian, gay, bisexual and trans (LGBT) rights, Spain ranks relatively high in surveys. But authorities require a mental health diagnosis before allowing gender change on official documents, as being transgender is classed a mental illness.

This is the case in the majority of European countries.

“I didn’t take it that badly, being diagnosed as ‘mentally ill’,” he says. “But I feel angry that you have to get that diagnosis to be able to change documents, get hormone treatment or surgery.”

The World Health Organisation ruled in June that being transgender should no longer be classified as a mental disorder. It now considers “gender incongruence” under sexual health conditions.

At 17, Diaz de Tudanca started with hormone treatments aimed at developing secondary sex characteristics such as voice deepening and a masculine pattern of hair and fat distribution. Around two years ago he underwent surgery to remove his breasts.

“It was a huge change in my life,” he says of no longer having breasts. “It’s a great liberation.”

He is now accepted socially as a man, although he has received rejection from some. One childhood male friend said he would not consider him a man as he didn’t have a penis.

Now dating a girl, Diaz de Tudanca is proud of his transgender identity and has taken part in a Madrid council awareness campaign to prevent hate crime, putting his face to a series of posters that appeared around the city’s metro network.

“The hate and intolerance of others comes from ignorance about trans people,” he says.

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