Sex change not so rare now

A scene from 'Njan Marykutty'.

Chandini, who had undergone a sex reassignment surgery. 

An increasing number of trans people in the city are now opting for sex reassignment surgery.

People from all walks of life — teachers, doctors, entrepreneurs, students and labourers — are undergoing sex reassignment surgery.

The treatment is meant for a wide spectrum of patients, and also covers those who have ambiguous genitalia, according to Dr Madhusudan Gururajarao, senior consultant, Aster CMI, who performs sex reassignment surgery.

“Due to awareness about a support system, more gender dysphoria patients are asserting their rights and coming in for surgical reassignment,” he told Metrolife.

Sporadic surgeries were done for a long time by urologists and plastic surgeons, but a structured multidisciplinary approach is now in place.

So how do patients cope after surgery? They are definitely happier but take time to adapt. The need for social acceptance prompts surgery in most people, and that means facial plastic procedures are the most in-demand.

“It is true, especially in the case of transwomen, with loss of self-esteem driving them to the surgery,” Dr Madhusudan explains. A man trapped in a woman’s body, for example, is not being able to wear male clothes till he undergoes top surgery, he says.

The surgery is done in multiple stages. It takes one or two years and the duration depends on the patient’s reassignment needs. The cost varies from hospital to hospital. Government hospitals do the procedure for free. Male to female gender reassignment surgeries are quicker than female to male.

Identity questions

Trans people sit through several rounds of counselling before they decide to go in for surgery. Dr Divyashree K R, consultant psychiatrist, Aster CMI, explains how people with a “gender identity disorder” suffer. The condition occurs when a person is not comfortable with the biological sex he or she is born with.

“We have to know the difference between sex and gender. While sex is a biological difference between male and female, involving genitalia, gender has multiple aspects and topping the list is the individual’s psychological concept of self,” she says.

What psychologists do is to help the patients and their families understand the discord between biological sex and psychological gender.

“Most times, families resort to religious practices, inflict physical punishment, and disown their children,” notes Divya. Seeing no way out, many with the condition take their lives, she notes. But she sees hope. “With increasing awareness, we see more people coming forward to seek help. In fact, in some cases, families help them through the transformation,” she adds.

NGOs don’t have it easy either. Shuba Chacko, executive director, Solidarity Foundation, says people who go through reassignment are still not considered “full” women or men, and are asked personal questions about their genitalia. “People don’t understand that this surgery is not like a cosmetic procedure. Many trans people see it as vital to their being,” explains Shuba. But quite a few don’t go through surgery, and it is important to acknowledge that, she says.

Earning a livelihood has always been a challenge for trans people, and that doesn’t really change even after the procedure.

“Many trans women end up doing sex work or seek alms, since no one gives them jobs. They also have to pay back the money if they have borrowed for the operation,” adds Shuba.

What exactly is sex reassignment treatment?

It is spread over a couple of years, and helps individuals with gender dysphoria or gender identity disorder to transform their bodies to be in sync with their psychological gender. This involves hormonal treatment, psychological support, and surgery.

Medical terms: What is what

Gender dystrophia: A condition when emotional and psychological identity don’t biological sex (male or female). Dysphoria is a profound sense of unease.

Pseudohermaphroditism: A person with primary sex characteristics of one sex but with secondary sex characteristics of another.

Intersex people: Born with sex characteristics (genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies.

Gender identity disorder: The feeling that the body does not reflect true gender.