A transgender man has been helped to die by doctors in Belgium after a series of failed gender reassignment operations.

Nathan Verhelst died in Brussels on Monday after being allowed to have his life ended on the grounds of “unbearable psychological suffering”.

The 44-year-old asked to die after undergoing a series of failed gender reassignment surgeries to transition from female to male. He had undergone hormone replacement therapy in 2009, and underwent the surgeries last year.

Prior to his death, Mr Verhelst had told Belgian newspaper 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.”

Two doctors concluded that the 44-year-old did not simply have temporary depression, and his request to be helped to die via medical euthanasia was granted.

Dr Distelmans, the doctor who administered Mr Verhelst’s lethal injection, told The Telegraph: “The choice of Nathan Verhelst has nothing to do with fatigue of life. 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 counseling for six months.”

Dr Jean-Michel Thomas added: “When we have a case which is… complicated, we ask ourselves more questions in order to be certain about the diagnosis.”

In 2002, Belgium became only the second country after The Netherlands to legalise medical euthanasia, which has since been legalised in Luxembourg also.

Euthanasia carried out by doctors differs from assisted suicide, whereby the patient is helped to take their own life.

Guidelines set out by the country’s parliament specify that patients wishing to end their own lives must be conscious when they ask to die. They must also be under a “constant and unbearable physical or psychological pain” resulting from an “accident or incurable illness”.

Patients must also give a “voluntary, considered and repeated” request to die.

There were 1,432 recorded cases of euthanasia in Belgium in 2012; a 25% increase on the previous year’s figure. They made up 2% of all deaths, the AFP news agency reports.