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A Spanish clinic today revealed it had performed a male-to-female sex-change operation on a 16-year-old, making her the youngest patient to undergo the operation in the country's history. The unnamed teenager had been taking hormones to change her body since she was 15, according to doctors who treated her at Barcelona's hospital clínico, and she had been seeing doctors and psychiatrists for even longer. "The patient has been in treatment for nearly three years," said the surgeon who carried out the operation, Dr Iván Mañero. A sex-change operation on a minor requires the approval of a Spanish court to override a law that sets the minimum age for such operations as 18. That permission was given in November by a judge after the the child's parents had themselves made the request. The operation was carried out in December, though news of it was only released on Monday. The teenager had reportedly tried to commit suicide on several occasions. As a child she was convinced that she was really female, but had been born in the wrong body. "The judge consulted many medical experts and doctors, all of whom have recommended that he be operated on … she is very happy," Mañero told El País. Gina Serra, president of the Catalan Association of Transsexuals, said it was possible from an early age for a child to be conscious that they were in the wrong body. "An eight-year-old child knows already what they want to be and what they do not want to be," she said. "In the end, everything depends on the support that they find within their own family." "It is a condition that one is born with but which you cannot operate for until they are 18 years old," said Mañero. "That, for a doctor, is something of a shock. No one could imagine that if your child was born with, say, leukaemia, we would say we must wait until 18 before operating." He said the question of whether children under 18 should be operated on was more an ethical and social debate than a medical one. "The younger the patient is, the simpler the operation generally is," he said. "To deny people transsexuality until they become grown-ups only lengthens the suffering of young transsexuals," Mar Cambrollé of the Spanish Federation of Gays, Lesbians, Transsexuals and Bisexuals, said. However, others believe that it was better to wait until someone was 18 to have an operation. "We are not against it, but it is a life-changing decision," said Monica Martín of the Spanish Association of Transsexuals. "It is a good idea to wait until the person has achieved maturity, legal and otherwise." The World Professional Association for Transgender Health also says the threshold age should be 18. Sweden, which pioneered sex-change legislation, sets the limit for operations at 18, though, like some other countries, it helps young transsexuals to start reversible hormone treatment well before that. Mañero said transsexuals were now being taken seriously by the Spanish health service. "Not so long ago they were not even considered to be patients. They were thought of as being capricious," he said. "As doctors, we are confronted by a condition which, as such, is covered by the health service." The socialist government of prime minister José Luis Rodríguez Zapatero passed a law two years ago allowing transsexuals, with or without surgery, to formally change their gender of birth. Further information