India —
The media circus around the Mafatlal property dispute
last month was mainly because the case had an
irresistible sideshow to it: Ajay Mafatlal, who was
staking claim to his family property as the elder brother
among his siblings, was not a natural born man.
Originally a woman (he’s been Aparna Mafatlal for
most of his life), he had undergone a sex change
operation to become a man.
But if you thought sex
change operations were the prerogative of the rich and
the famous, those with the money and the leisure to
indulge their whims and fantasies, think again. Cases of
sex change operation, or sex reassignment surgery, as it
is called, are on the rise in India. And the people going
in for it come from all walks of life. Points out Dr
Manohar Lal Sharma, a Delhi-based plastic surgeon,
“I have had patients ranging from schoolteachers to
MBAs, from barristers to bureaucrats.”
Dr Sharma says that up
until the mid-Nineties, he would probably do one sex
change surgery in two years. “But these days, I do
about three to five surgeries every year. I receive about
one request for a sex change operation every week, though
not all of them eventually go in for the procedure,”
he says.
But those who do, are
passionately, deeply, committed to their choice. Take
Tara, a 28-year-old teacher from Delhi, for instance. She
wanted to become a man so she could marry her girlfriend.
She underwent extensive counselling sessions and remained
undeterred in her decision to go ahead with the
procedure. The operation took place three years ago,
after which they got married. They have been living as
man and wife ever since.
So why do some people
feel compelled to transform themselves into their
opposite genders? Rocky, a 32-year-old transsexual (see
box), who went in for a sex change operation four years
ago, says he never felt like a woman. “I always felt
like a man trapped in a female body,” he says.
Explains Dr Kalpesh Gajiwala, a plastic surgeon in Mumbai
who carried out Aparna Mafatlal’s operation,
“The need for sex change is triggered by gender
dysphoria, or a gender identity crisis, where an
individual wants to realign his or her body to his or her
gender perception.” He adds: “Basically, these
are people who feel that they are caught in the wrong
body. And sex change offers them a way out of their
predicament.”
A sex change procedure
— from male to female or vice versa — involves
changing the genitalia as well as other physical
attributes like breasts or body hair. It is a fairly
expensive process and costs upwards of Rs 1.5 lakh for
male to female, and about Rs 4 lakh for female to male
operations. “It involves hormone therapy and
multiple operations, done in stages,” says Dr Mukund
Thatte, another plastic surgeon based in Mumbai. But
before that, the patient has to be counselled about the
physical and social fallout of sex change and a
psychiatrist has to give his approval that he or she is
indeed ready to undergo the procedure.
“Ultimately,
it’s the individual’s psychology that drives
the decision,” says Dr Gajiwala. Ashok, a
58-year-old businessman in Delhi, has sought a sex change
operation. “I have lived in a man’s body all my
life, but I want to die as a woman,” he told Dr
Sharma. Ashok, whose treatment is currently on, has cut
his ties with his entire family to start a new life in a
new place and under a new name.
The question of identity
is, of course, crucial in such cases. A new body requires
a new persona and in any case most people want to treat
their past as a closed chapter and start on a clean
slate. Says Dr Gajiwala, “Most of the time, the
individual relocates after the sex change operation has
been carried out. This saves them the trauma of being
questioned again and again.”
But despite the rise in
the incidence of sex change operations, social acceptance
of transgendered people is still a long way off in India.
“Few families, unless they are exceptionally
broad-minded, support a person who undergoes a sex
change,” says Dr Gajiwala. The support usually comes
from the partner and from the peer group of like-minded
people.
Social opprobrium apart,
a sex changed person has also got to deal with the
limitations of the procedure itself. “The patient
has to accept the idea that he or she will suffer a
complete loss of fertility,” says Dr Sharma. Adds Dr
Thatte, “Penile reconstruction is the most difficult
part of the surgery, which is one reason female to male
procedures may not always be satisfactory.”
Again, while most
transgendered persons report being happy with their new
life, there have been odd cases of sex change operations
with tragic consequences. A woman, a bank employee, who
came to Calcutta from Patna determined to become a man
and marry her girlfriend, broke down after her breasts
were removed. “She never came back for the remainder
of the operations and eventually committed suicide,”
says Dr Tapas Chakraborty, an anaesthetist who was part
of the team of doctors who conducted the operation.
The road to sex change
and thereafter is fraught with many a pitfall. But those
who want to correct the mismatch between their mind and
body could take heart: it’s a road that’s being
traversed more frequently now.
