Nathan Verhelst

A Belgian has undergone euthanasia because of "unbearable psychological suffering" after a botched sex-change operation. Nathan (born Nancy) Verhelst died on Monday after a lethal injection from the country’s best-known euthanasia doctor, Wim Distelmans. The death was recorded and broadcast by a local TV station.

The circumstances of the death were particularly tragic. The 44-year-old grew up in a family in which she was despised for being a girl. "While my brothers were celebrated, I got a storage room above the garage as a bedroom,” he told the Het Laatste Nieuws newspaper shortly before dying. 'If only you had been a boy', my mother complained. I was tolerated, nothing more." (Her mother confirmed her contempt for her daughter to the media.)

In 2009 Nancy received hormone therapy and last year had reassignment surgery. But Nancy, now Nathan, was horrified by the result. "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. "

Nathan’s example has already prompted one of his best friends, Dora, the second person in Belgium to have a male-female sex reassignment operation, to ask for euthanasia. The 53-year-old, who held Nathan in her arms as he died, said that she was tired of being rejected.

The Verhelst case is sure to provoke debate about the increasing number of euthanasia cases in Belgium. In 2012, it recorded a new high of 1,432 cases, an increase of 25% from 2011. Parliament is even studying whether to extend "mercy killing" legislation to children.

One development which has passed under the media’s radar is the rise in the number of double euthanasia by elderly couples. The euthanasia of deaf twins last December was reported around the world, but Dr Distelmans told the media recently that there had been several cases of elderly people who wanted to die together. The practice appears to be growing more common.