MADRID—A 16-year-old Spaniard has had a sex change operation, becoming the country's first minor to undergo a procedure that few countries in the world allow for people so young, a doctor said Tuesday.
The two-and-a-half hour surgery was performed in Barcelona three weeks ago and the patient is doing fine, reconstructive surgeon Ivan Manero, who did the surgery, told a news conference in Spain's second largest city.
Manero said the patient had been undergoing hormonal and psychiatric treatment for two years, after deciding he wanted to undergo surgery to have the body of a woman. The boy "said he felt like a woman from the age of four or five," Manero said. The patient's name has not been disclosed.
The surgery was authorized by a judge, as required by Spanish law for minors seeking such an operation.
Probably fewer than 50 sex change operations are carried out each year in Spain, said Monica Martin, founder of the Spanish Association of Transsexuals.
The association's position on minors is that they think very, very carefully before undergoing such surgery.
"We are not against it, but it is a life-changing decision," Martin told The Associated Press. "It is a good idea to wait until the person has achieved maturity, legal and otherwise."
The World Professional Association for Transgender Health, based in Minneapolis, Minnesota, sets guidelines for when to offer sex changes that many Western countries follow.
According to their guidelines, surgeries should not be carried out prior to adulthood, or prior to a real-life experience of at least 2 years in the gender role of the sex with which the adolescent identifies. It says the threshold age should be 18.
In Spain, regional governments run their own health care systems and three of them -- Catalonia in the northeast, the province that includes Madrid, and Andalucia in the south -- pay for sex change operations.
In this case, the boy's family paid for the surgery in a private facility. No state-run hospital in Spain performs it on minors.
Spain is among just a handful of countries in the world that where the law specifically allows minors to undergo sex change operations, said Jameson Green, a manager at the Center of Excellence for Transgender Health, at the University of California in San Francisco. Australia and the Netherlands are others, he said.
There have also been a few sex change operations carried out on minors in Germany. But these countries are the exception.
In Thailand, for instance, transsexuals and transgender men are a common sight, appearing on soap operas and working at all levels of Bangkok society. But the rules on sex change surgery stipulate that patients must be over 18, undergo a mental evaluation before the surgery and continued follow-up visits with a psychiatrist afterward. Candidates cross-dress for a year.
In the United States, there is no federal law -- and few if any state laws -- explicitly banning transsexual surgery for minors.
There, the standards are that such surgery should not take place before age 16, and cases like the Spanish one are rare but not unheard of, Green said.
"Generally, I think what people are concerned about is that young people don't have the capacity to know who they are. And I think we are learning -- and this is one of the reasons that you are seeing this happening in Spain -- that actually in some cases indeed young people do know who they are."
Associated Press writers Grant Peck in Bangkok and Kirsten Grieshaber in Berlin contributed to this report.