"I found I really wanted to be a girl since I first started to remember things," said Liu, who has already had breast surgery and face-lifts. "But the cruel truth is I am a man. I have been puzzled by the problem all my life."

"Transsexualism is not an abnormality but a disease," said professor Song Jianxing, vice director of the cosmetic surgery department of Changhai Hospital and the doctor in charge of Liu's operation on Tuesday. "The sufferer is healthy mentally, and what he or she needs is proper treatment."

Liu decided to get a sex change when he was 18, but he hesitated for years because of the importance of the operation. Eventually, Liu said he could no longer stand being a man.

Doctor Song came to know Liu's case when he attended a medicine forum in Guangxi this year. It was there he decided to help Liu realize his wish.

"We are going to use a part of his gut to make a vagina for him," said Song. "This will leave no harm to his skin and won't affect his sex life."

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