Mr ya Miss?

Sex change operations are on the rise in India and are being resorted to by people from all walks of life, report Shuma Raha, Gouri Shukla and Anirban Das Mahapatra

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, 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.

(Some names have been changed on request)
WITH ADDITIONAL REPORTING BY PRITHVIJIT MITRA IN CALCUTTA

appeared in the Telegraph Calcutta