The French documentary “Sur l’Adamant” (On the Adamant) about mental patients aboard a floating clinic in the Seine river in Paris won the prestigious Golden Bear top prize at the Berlinale film festival on Saturday night. Two films with transgender themes also won top awards.

Spanish child actress Sofia Otero, who plays an eight-year-old boy who identifies as a girl and wants to live as one, became the youngest recipient ever of the festival’s Silver Bear award for best leading performance in the Spanish film “20,000 Especies de Abejas” (20,000 Species of Bees).

Transgender German actress Thea Ehre took the Silver Bear for best supporting performance in German director Christoph Hochhäusler’s police-drugs drama “Till the End of the Night”.

Director Nicolas Philibert, 72, who spent months filming “Sur l’Adamant” aboard the floating clinic, said that winning the festival’s top award had come as a surprise but he was pleased that a major festival had given the prize to a documentary.

“It’s been a couple of years now that the Berlinale has chosen to show in competition documentary films, and that’s not the case at every film festival,” he said. “Slowly, with time, it will help all those people who make this kind of film.”

He also hoped the film could help start a reassessment of how society views and deals with mental illness.

“I hope that my film will contribute to the destigmatisation of patients, of people who suffer from psychiatric problems but that is not a foregone conclusion at all,” he said. “Why? Because the media, mainstream media, the politicians continue the cliches and stereotypes are very stubborn.”

The film makes little distinction between the Adamant’s staff and its patients as it shows them in art therapy sessions, playing music or going to a market to get free damaged produce to make jam. No one wears identifying badges or special clothing, leaving it to the viewer to determine who is who.

Philibert already had plans to show the film to the Adamant community, but said he now had to consider how winning the top award might affect that.

“Now comes the turn of reality, which means the patients of the Adamant who are very touching, very endearing and very fragile people,” he said. “So it’s also perhaps necessary not to impress upon them too much this great occasion, keep it simple.”

International Jury President Kristen Stewart said Ehre’s performance as a character who is a transgender woman was phenomenal.

“If I’m allowed to speak very plainly, this performance blew our hair back,” she said in announcing the prize. “This person has an aura.”

Ehre said she hoped the film, which shows her in a violent relationship with a policeman, would bring broader public awareness to the problems faced by transgender people.

“I hope people become aware that specifically many transwomen live in very precarious conditions and find themselves in situations that can be very toxic and transphobic,” Ehre said.

The Berlinale was the first major festival to make its acting prizes gender neutral.

German director Christoph Petzold won the Silver Bear runner-up to the main prize with “Roter Himmel” (Afire), a tragicomic take on a mis-matched foursome whose holiday on Germany’s Baltic coast is interrupted by forest fires.

Other major winners:

– Best Director to Philippe Garrel for the French drama “Le Grand Chariot” (The Plough) featuring Garrel’s own children as a family of puppeteers whose livelihood vanishes when their father dies.

– Silver Bear jury prize to the French-Portuguese film “Mal Viver” (Bad Living) about five women running a fading resort hotel.

– Best Screenplay went to German director Angela Schanelec for “Music”, a repurposing of the Greek Oedipus tragedy for modern times.

By Michael Roddy