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A Belgian man who was in distress after a failed attempt to sex change has been euthanised. The doctors agreed to the mercy-killing on psychological grounds.

Nathan Verhelst, 44, died in a Brussels hospital yesterday. Belgium is the second country after Netherlands to legalize euthanasia in 2002.

“He died in all serenity, we could clearly say he was in unbearable psychological distress,” said doctor Wim Distlemans to daily Het Laatste Nieuws.

Nathan went under three consecutive operations to change sex between 2009 and 2012 but felt uncomfortable with his body.

“The first time I saw myself in the mirror I felt an aversion for my new body,” he said, according to The Australian . “I had happy moments but in the end the balance tipped to the wrong side.”

Belgium has recorded more than thousand cases of euthanasia in 2012. In 2004, only six cases of euthanasia were recorded over psychological grounds. However in 2011 it jumped to 33 and 52 in 2012.

Euthanasia is currently legal only for those over 18. The strict laws governing the consists of conditions like patients must be capable and conscious to have the euthanasia.