Gabriel Diaz de Tudanca is a 19-year-old Spaniard who, although born a girl, identified as male from early childhood. "When I was three years old I came back from school and said to my mother that when I grew up I was going to be a man called Oscar," he says. Supported by his family and friends, he has undergone surgery and hormone treatments, changed his name and renewed his identity documents to reflect what he feels is his true gender. Reuters photographer Susana Vera accompanied him for three years through his process of change. REUTERS/Susana Vera SEARCH "VERA GABRIEL" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY. Matching text: SPAIN-LGBT/ THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES 

Transgender teenager Gabriel Diaz de Tudanca, 18, waits to be taken to the operating room to have his female to male chest reconstruction surgery in Madrid, Spain, October 26, 2016. "We have to be diagnosed with gender dysphoria in order to get medical treatment. My breasts always made me feel very uncomfortable, I couldnÕt wait to get them removed, but I've always disliked the term gender dysphoria because I don't feel like I have a mental disorder," Diaz de Tudanca said. REUTERS/Susana Vera SEARCH "VERA GABRIEL" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES 

Joe Wong, 31, poses for photograph at his apartment in Bangkok April 3, 2015. Joe Wong, a 31-year-old transgender man from Singapore, underwent surgery to remove his breasts in 2007 and legally changed his name from Joleen to Joe. He had his uterus removed in 2009, and is legally recognised as a male. Wong is one of the many lesbian, gay, bisexual and transgender people in Asia who faced abuse and violence from his family. To escape the violence and find acceptance, many LGBT people migrate abroad - including Wong, who moved to Bangkok, where he currently works for the rights group, the Asia Pacific Transgender Network. To match Thomson Reuters Foundation Feature GAY-RIGHTS/ASIA Picture Taken April 3, 2015. REUTERS/Athit Perawongmetha 

Petra van Dijk, 51, walks along the Amstel after changing her officially registered gender from male to female at the City Hall, in Amsterdam July 1, 2014. Dijk is among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Damian Jackson (C), 51, shows family members his new documents after changing his officially registered gender from female to male, in the City Hall in Amsterdam July 1, 2014. Jackson is among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Petra van Dijk, 51, signs documents as she changes her officially registered gender from male to female, in the City Hall in Amsterdam July 1, 2014. Dijk is among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Damian Jackson (L), 37, and Petra van Dijk (R), 51, enter the City Hall to change the gender section on their official documents, in Amsterdam July 1, 2014. Jackson changed his officially registered gender from female to male while Dijk changed hers from male to female. They are among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Damian Jackson (front L), 37, and Petra van Dijk (front R), enter the City Hall to change the gender section on their official documents, in Amsterdam July 1, 2014. Jackson changed his officially registered gender from female to male while Dijk changed hers from male to female. They are among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Petra van Dijk, 51, displays her new documents after changing her officially registered gender from male to female, in the City Hall in Amsterdam July 1, 2014. Dijk is among the first to obtain new documents on Tuesday, when a new law came into effect, legalising the registration of a transgender person's preferred gender in official state documents, including identity cards and passports. It eliminates the previous law, which required hormonal treatment, surgery or sterilization before any change in gender registration is allowed. REUTERS/Cris Toala Olivares (NETHERLANDS - Tags: SOCIETY LAW) 

Qian Jinfan, an 84-year-old transsexual who prefers to be addressed as "Yiling", chooses a dress at a shop in the town of Foshan, in southern China's Guangdong province, July 6, 2012. Qian, who told Reuters during an interview that she always felt she was a woman and experimented with hormone cream, tablets and injections at the age of 60, is believed to be the oldest transsexual to live openly in China. The retired Chinese Communist Party official said she would not undergo a sex-change operation until it fully guaranteed her a female body that was complete with a woman's bodily functions. She admitted her days may be limited, but hopes that speaking to the media can help break down traditional assumptions and initiate discussions about transsexuals in society. About 2,000 people in China have undergone sex-change surgery and up to 400,000 could be considering one, according to a report in 2009 by state newspaper China Daily. Picture taken July 6, 2012. REUTERS/Tyrone Siu (CHINA - Tags: SOCIETY) 

Qian Jinfan, an 84-year-old transsexual who prefers to be addressed as "Yiling" holds up a photo taken at the age of 59, in the town of Foshan, in southern China's Guangdong province, July 6, 2012. Qian, who told Reuters during an interview that she always felt she was a woman and experimented with hormone cream, tablets and injections at the age of 60, is believed to be the oldest transsexual to live openly in China. The retired Chinese Communist Party official said she would not undergo a sex-change operation until it fully guaranteed her a female body that was complete with a woman's bodily functions. She admitted her days may be limited, but hopes that speaking to the media can help break down traditional assumptions and initiate discussions about transsexuals in society. About 2,000 people in China have undergone sex-change surgery and up to 400,000 could be considering one, according to a report in 2009 by state newspaper China Daily. Picture taken July 6, 2012. REUTERS/Tyrone Siu (CHINA - Tags: SOCIETY TPX IMAGES OF THE DAY) 

Transvestite Julio Yoaris Alvarez changes outfits at his home as the world celebrates International Day Against Homophobia in Havana May 16, 2009. From an early age, Alvarez dreamt of having a sex-change operation and is currently awaiting his turn for one under the Cuban health care system. The surgery, like all other health care in Cuba, will be free of charge for applicants. REUTERS/Claudia Daut (CUBA SOCIETY HEALTH) 

Transvestite Julio Yoaris Alvarez (R) and his boyfriend El Moro kiss at their home as the world celebrates International Day Against Homophobia in Havana May 16, 2009. From an early age, Alvarez dreamt of having a sex-change operation and is currently awaiting his turn for one under the Cuban health care system. The surgery, like all other health care in Cuba, will be free of charge for applicants. REUTERS/Claudia Daut (CUBA SOCIETY HEALTH) 

Transvestite Julio Yoaris Alvarez adjusts his brassiere while getting dressed at his home as the world celebrates the International Day Against Homophobia in Havana May 16, 2009. From an early age, Alvarez dreamt of having a sex-change operation and is currently awaiting his turn for one under the Cuban health care system. The surgery, like all other health care in Cuba, will be free of charge for applicants. REUTERS/Claudia Daut (CUBA SOCIETY HEALTH) 

Transvestite Julio Yoaris Alvarez adjusts his brassiere while getting dressed at his home as the world celebrates the International Day Against Homophobia in Havana May 16, 2009. From an early age, Alvarez dreamt of having a sex-change operation and is currently awaiting his turn for one under the Cuban health care system. The surgery, like all other health care in Cuba, will be free of charge for applicants. REUTERS/Claudia Daut (CUBA SOCIETY HEALTH IMAGES OF THE DAY) 

Transvestite Julio Yoaris Alvarez looks at a wig at his home as the world celebrates the International Day Against Homophobia in Havana May 16, 2009. From an early age, Alvarez dreamt of having a sex-change operation and is currently awaiting his turn for one under the Cuban health care system. The surgery, like all other health care in Cuba, will be free of charge for applicants. REUTERS/Claudia Daut (CUBA SOCIETY HEALTH) 

Hussein Rabei, 33, who underwent a sex change surgery, speaks to journalists in the Bahraini capital of Manama October 26, 2007. Formerly known as Zaineb, Rabei was raised as a girl after being born with genitalia that more closely resembled a vagina than a penis. Rabei returned recently from an operation in Thailand to correct his gender --a procedure for which he obtained consent from both Sunni and Shi'ite clerics, and is the first Bahraini to go public with news of such an operation. To match feature INTERSEX-ARAB/ REUTERS/Hamad I. Mohammed (BAHRAIN) 

Hussein Rabei, 33, shows a photo of himself in traditional women's wear before he underwent a sex change surgery, in the Bahraini capital of Manama October 26, 2007. Formerly known as Zaineb, Rabei was raised as a girl after being born with genitalia that more closely resembled a vagina than a penis. Rabei returned recently from an operation in Thailand to correct his gender --a procedure for which he obtained consent from both Sunni and Shi'ite clerics, and is the first Bahraini to go public with news of such an operation. Picture taken October 26, 2007. To match feature INTERSEX-ARAB/ REUTERS/Hamad I. Mohammed (BAHRAIN) 

Hussein Rabei, 33, shows a photo of himself in traditional women's wear sitting on a Saudi-registered car with his brother before he underwent a sex change surgery, in the Bahraini capital of Manama October 26, 2007. Formerly known as Zaineb, Rabei was raised as a girl after being born with genitalia that more closely resembled a vagina than a penis. Rabei returned recently from an operation in Thailand to correct his gender --a procedure for which he obtained consent from both Sunni and Shi'ite clerics, and is the first Bahraini to go public with news of such an operation. To match feature INTERSEX-ARAB/ REUTERS/Hamad I. Mohammed (BAHRAIN) 

Topher Logan relaxes at home in his Brooklyn apartment, February 14, 2007. Logan, 28, refers to himself as a "queer transman", meaning he was born as female, but identifies as a male and has relationships with women, men and other transgender people. He injects himself with testosterone, known as "T", twice a week in order to create and sustain traditionally masculine gender traits such as facial hair and a deeper voice. Two years ago he underwent a bilateral mastectomy, known as top surgery, to modify his chest. Logan believes in gender fluidity, and binary gender as a social construct. REUTERS/Erin Siegal (UNITED STATES) 

Topher Logan gives himself his bi-weekly injection of testosterone in his Brooklyn apartment, New York, February 18, 2007. Logan, 28, refers to himself as a "queer transman", meaning he was born as female, but identifies as a male and has relationships with women, men and other transgender people. He injects himself with testosterone, known as "T", twice a week in order to create and sustain traditionally masculine gender traits such as facial hair and a deeper voice. Two years ago he underwent a bilateral mastectomy, known as top surgery, to modify his chest. Logan believes in gender fluidity, and binary gender as a social construct. REUTERS/Erin Siegal (UNITED STATES) 

Topher Logan looks in the bathroom mirror at home in his Brooklyn apartment, New York, February 18, 2007. Logan, 28, refers to himself as a "queer transman", meaning he was born as female, but identifies as a male and has relationships with women, men and other transgender people. He injects himself with testosterone, known as "T", twice a week in order to create and sustain traditionally masculine gender traits such as facial hair and a deeper voice. Two years ago he underwent a bilateral mastectomy, known as top surgery, to modify his chest. Logan believes in gender fluidity, and binary gender as a
social construct. REUTERS/Erin Siegal (UNITED STATES) 

Topher Logan gives himself his bi-weekly injection of testosterone in his Brooklyn apartment, New York, February 18, 2007. Logan, 28, refers to himself as a "queer transman", meaning he was born as female, but identifies as a male and has relationships with women, men and other transgender people. He injects himself with testosterone, known as "T", twice a week in order to create and sustain traditionally masculine gender traits such as facial hair and a deeper voice. Two years ago he underwent a bilateral mastectomy, known as top surgery, to modify his chest. Logan believes in gender fluidity, and binary gender as a social construct. REUTERS/Erin Siegal (UNITED STATES) 

Topher Logan cuts the hair of a client named Jill during a training session in a hair salon in Brooklyn, New York, February 14, 2007. Logan, 28, refers to himself as a "queer transman", meaning he was born as female, but identifies as a male and has relationships with women, men and other transgender people. He injects himself with testosterone, known as "T", twice a week in order to create and sustain traditionally masculine gender traits such as facial hair and a deeper voice. Two years ago he underwent a bilateral mastectomy, known as top surgery, to modify his chest. Logan believes in gender fluidity, and binary gender as a social construct. REUTERS/Erin Siegal (UNITED STATES) 

AUSTRALIAN TRANSSEXUAL MIANNE BAGGER PLAYS A SHOT FROM THE ROUGH DURING THE PRO-AM FOR THE WOMENS AUSTRALIAN OPEN IN SYDNEY. Australian transsexual Mianne Bagger plays a shot from the rough as storm clouds gather above during the Pro-Am tournament, held before the Women's Australian Open at Concord Golf Course in Sydney March 2, 2004. Bagger had sex-change surgery in 1995, and will become the first transsexual to play in a women's tournament when the Australian Open begins on March 4. NO RIGHTS CLEARANCES OR PERMISSIONS ARE REQUIRED FOR THIS IMAGE REUTERS/David Gray 

TO MATCH FEATURE STORY BC-HEALTH-SEX CHANGE - Brenda Reimer was an awkward child, who did not engage in girlish activities and was mercilessly teased by schoolmates for her gunslinger stride and lack of interest in boys. Doctors told her that her discomfort was due to a passing phase of "tomboyishness." What they didn't tell her was that she had in fact been born "Bruce" and had been subjected to gender reassignment surgery at 18 months, 10 months after doctors botched a circumcision and destroyed most of his penis. Instead of raising their child as a boy, Bruce's young parents took the advice of a famous American medical psychologist, John Money of Johns Hopkins Medical Center in Baltimore, who said that Bruce could be a happy "Brenda" with the proper treatment and hormones. He was later known as David Reimer.

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TO MATCH FEATURE STORY BC-HEALTH-SEX CHANGE - Brenda Reimer was an awkward child, who did not engage in girlish activities and was mercilessly teased by schoolmates for her gunslinger stride and lack of interest in boys. Doctors told her that her discomfort was due to a passing phase of "tomboyishness." What they didn't tell her was that she had in fact been born "Bruce" and had been subjected to gender reassignment surgery at 18 months, 10 months after doctors botched a circumcision and destroyed most of his penis. Instead of raising their child as a boy, Bruce's young parents took the advice of a famous American medical psychologist, John Money of Johns Hopkins Medical Center in Baltimore, who said that Bruce could be a happy "Brenda" with the proper treatment and hormones. He was later known as David Reimer.

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