A 72-year-old man from Beijing received gender reassignment surgery in Huizhou, Guangdong province, on Wednesday.
Xin Yue was given breast implants and underwent vaginoplasty as part of the operation, which lasted several hours.
"I have completed my wish to become a woman," she told local media after the surgery.
Xin had to complete a series a tests and answer more than 1,000 questions before going under the knife, to ensure he was ready for gender reassignment.
As a child, he was one of three sons, but said he would often dress like a girl.
"My father and mother actually wanted to have a daughter at that time," Xin said.
He married in 1970 and fathered a daughter three years later.
Xin arrived in Huizhou for the surgery accompanied by his wife Leng Rui, who said she fully supported her husband's decision. The couple have been retired since 2000.
"Xin has gone from being my husband to being my close female friend and our relationship now is more like sisters," Leng said.