Treating transsexuals in India: History, prerequisites for surgery and legal issues

Abstract

Authors in their clinical practice came across transsexual patients, who were determined to get their gender affirmed by undergoing a change of sex. This motivated the authors to review the literature extensively regarding transsexualism and report their experience. Opinions were taken from legal luminaries practicing in related fields. They also took inputs from several patients who were at various stages of psychiatric analysis and hormone therapy and also those, who had completed their treatment procedures. A paucity of the Indian inputs in medical literature concerning transsexualism was noted by the authors They also found deficiencies in the Indian Law, as applied to the individuals undergoing gender affirmation surgery (GAS). In this paper they have enumerated these deficiencies. Though GAS has been legally allowed in U.K. since 1967, in America since 1972, and in various other countries, Indian Laws are silent on the issue. An Indian surgeon dealing with transsexual patients is faced with a number of issues like consent for the procedure, safe guarding the surgeon or gender team from future litigation. Another issue is postoperative sexual and legal status of the patient. Present Indian Laws regarding marriage, adultery, sexual and unnatural offences, adoptions, maintenance, succession, labour and industrial laws will require modifications when dealing with these individuals and protecting their rights. Authors have tried to deal with all these issues that an individual surgeon faces when he manages a transsexual patient.

Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

“…Therefore, the question remains as to how far these most recent high standards of care for TS individuals can be interpreted and applied in culturally diverse countries with more traditional values. Indeed, in communities with more traditional values, the challenges faced by TS individuals differ from those faced by TS persons in urban western societies with a prescribed standard of care [12, 13]. In such societies, those who do not express their sexuality or gender in traditionally accepted ways may feel unwelcome [14].…”

Application of embryonic equivalents in male-to-female sex reassignment surgery

“…Meerwijk and Sevelius in their meta-analysis study published in 2017 revealed in the USA that 390/100,000 adults are estimated to be transgender. [ 6 ] No definite figures are available for India,[ 7 ] but transgender population is palpably on the rise.…”

Where medicine meets the boundaries of manhood and womanhood

“…[12][13][14] This may be related to the fact that their cultures do not view transsexualism as an expression of moral depravity but rather as an expression of the diverseness of nature, including human nature. It has been hypothesized that in cultures with a rigorous definition of manhood and womanhood, men who fail to fulfill the exigencies of manhood would resort to a transsexual state, but in the author's experience, this is not the case.…”