A Kuwait court has approved a request by a Kuwaiti man who had sex-change surgery to change his gender officially to female, setting a precedent in the conservative Muslim Gulf Arab state. 

The Personal Status Court of First Instance ruled that the plaintiff had suffered physiologically and psychologically since childhood due to hormonal imbalances, defence lawyer Adil al-Yahya told Reuters on Sunday. 

Saturday's ruling has to be referred to a higher court before the decision becomes final, al-Yahya said, adding the process might take up to a month. 

Al-Yahya said he presented the court with an edict issued by Egypt's al-Azhar, Sunni Islam's top religious institution, that allowed people to change their gender if medical reports showed this was to their benefit. 

"We have evidence, a fatwa from al-Azhar, because we have a case of illness, not a case of switching gender or as they call it in Kuwait a third-sex case," al-Yahya told Reuters. "This is a very rare condition...and the court ruled according to that condition." 

The 25-year-old plaintiff, who wants a name change to Amal from Ahmad, had a sex-change operation in Bangkok in October 2002, the Arab Times daily reported.