Pride month is here!!
And while everyone is talking about how much inclusivity matters, something important is, unfortunately, going beyond the radar — sex reassignment surgery!
Sex Reassignment Surgery aka SRS is one of the most important yet most ignored matters nowadays.
Lack of access to proper healthcare and privacy has become one of the major barriers for a lot of trans people. This era demands healthcare to be more inclusive, more accessible and more affordable for those who belong to the trans community.
Community to individual
“Nothing is harsher than pretending to be the person you are not,” says Neeti Wadhwa who was born as Nitish. “I had to change multiple schools because I was constantly bullied. I also suffered from dyslexia and was not able to perform well academically. I had sensed very early that I was not a man and my male organs did not make me one. I have always thought like a woman. I was living a claustrophobic life. I had to put in so much effort to pretend I am like one of them (men). Be it in school, or at family gatherings, my mother would never allow me to wear women’s clothes!”
Neeti always felt like her female identity was trapped inside a male body. And the feeling was constantly there until she got her sex reassignment surgery done. And since she belonged to an upper-class family, the cost of surgery was affordable for her, which she believed was not exactly for everyone else.
“Last year I attended my friend’s wedding and wore a lehenga-choli. I cannot explain how happy and proud I felt with my decision of having the surgery. It is the transformation of a soul and not just the body. It is about finally being who I am,” she said.
Well, Neeti Wadhwa is just one of those lucky humans who got exactly what she wanted. However, the scenario is not the same for everyone.
Compromise instead of acceptance
The cost of surgery, depending upon the transition, could easily go up to 4-8 lakhs. On the failed facility and the fact that many people cannot afford this amount, Amrita Sarkar, a trans woman and trans rights activist, shared, “It’s not easy for the community people. Sometimes they have to go for alternative options, like the castration process, which is not approved; this leads to a lot of other health problems. It’s a combination of problems — no acceptance of trans bodies because there is no knowledge of trans bodies, no education. Therefore, there is no infrastructure that supports transgender people. Acceptance can only come at a later stage when the health care service is there. But it’s not.”
“When trans people were walking around in the hospital, they would sit down in the [outpatient clinic] and other people used to ask us ‘how can we sit beside such people?’ or ‘how can you treat people like them, here?’ Now, doctors and nurses make sure those who object to transgender people’s presence know the clinic is trans-friendly, and if they have a problem, they will have to adjust,” Dr Sameera Jahagirdar, a trans, non-binary advocate and doctor shared.
The failed society
What Dr Jahagirdar said is somewhat right. We as a society failed — we failed our people and their expectations!
The problem starts from the point where we stop accepting people and their free will. And this leads to the failed system and failed facilities that are ‘ruled by the people who never accepted’ in the first place.
“All people, regardless of gender or sexual orientation, have rights that need to be respected and responsibilities that need to be exercised.”
Planned Parenthood Federation of America, Values Statement
“Because of the social stigma attached to the transgender community, there is a fear of not feeling comfortable in crowded places. Hence, it is not surprising that many of them prefer to go to clinics which provide privacy and prioritise their needs. This kind of environment is lacking in government hospitals,” Dr Aqsa Shaikh, a Community Medicine Specialist teaching at Jamia Hamdard and a transwoman shared.
And while some private hospitals and clinics, although at a very high price, manage to offer proper healthcare services (not just SRS) to trans people, public institutions and clinics fail.
And, at instances, when those private hospitals and clinics are not able to cater to patients’ needs, people start considering places like Thailand as an option!
Sex Reassignment Surgery: Below the priority level
“In any government hospital, the priority is first given to cases such as cancer, which are malignant. This is not to say that SRS is not an important procedure but usually the approach at government-run hospitals is to slate these surgeries for later as they cannot be termed emergency cases which are related to life and death. Hence, they often are treated as low priority,” Dr PS Bhandari, consultant plastic surgeon at LNJP hospital added. “This is no easy surgery. After undergoing SRS, the organs are replaced but proper sexual health may not be possible. Since the genitals are created unnaturally, there is no chance of conceiving. Hence, many individuals opt-out of!”
Many people from the trans community lack proper knowledge and details about SRS that leads to either unhappy transitions or cancellations at the last moment. And while there is a need to educate these folks, there is a dire need to educate everyone else as well — that how normal sex reassignment surgeries are.
Respect their decisions
“A trans person does not need to have had, or be planning, any medical gender reassignment treatment to be protected under the Equality Act: it is enough if they are undergoing a personal process of changing gender. In addition, good practice requires that clinical responses be patient-centred, respectful and flexible towards all transgender people whether they live continuously or temporarily in a gender role that does not conform to their natal sex,” NHS guidance states. “Non-binary individuals, who do not identify as being male or female, should also be asked discreetly about their preferences, and allocated to the male or female ward according to their choice.”
“You cannot know someone’s pronouns or gender identity just by looking at them. Rather than making assumptions that can be very traumatic for folks, start every conversation in an open and inclusive way,” Emmeline Gregoroff, human rights and inclusion associate at HHS adds.
Healthcare to the trans community is what the COVID-19 vaccine has become to the common janta — it claims to be readily available and accessible to everyone — but only a bunch of folks are able to experience it.
Support them
“The state is constantly policing my bread and butter, housing, clothing, education, employment, marriage, privacy and sexual performances. Who is the government to decide my identity for me?”
Akkai Padmashali, Trans rights activist
“Most of the patients come in before the surgery but they are supposed to be in regular touch with the psychiatrist. A few studies have suggested that not all who undergo the surgery are happy about it but most of them think these surgeries work a miracle,” said Dr Om Prakash, Department of Psychiatry, Institute of Human Behaviour and Allied Sciences. “Family acceptance is still low in India. Families do not readily accept that their child will undergo sex change and often come into the picture much later after the surgery is completed. But once it is done, all patients get a boost to their mental health,” he added.
All we are expected to do is to support our people — support them when they socialise. We need to accept them when they start accepting themselves. Probably, that’s the only way to lead to a truly inclusive and safe society.
“And while each of us may not know trans people who are directly impacted by all of these public health concerns, transgender communities are very broad and varied, and collectively we are impacted greatly by each of these.”
National Center for Transgender Equality
This #PrideMonth, what are the changes you are trying to bring in society? Share with us and our readers. Let’s work together for a happy and inclusive society!
