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. In terms of lesbian, gay, bisexual and trans (LGBT) rights, Spain ranks relatively high in surveys. But authorities require a mental health diagnosis before allowing gender change on official documents, as being transgender is classed a mental illness. This is the case in the majority of European countries.