Lack of access to sex reassignment surgeries (SRS) for transgender people has been a major concern for the community members, which they feel is a violation of their right to self-identification of gender.
Addressing this, doctors and experts from NIMHANS, along with the community members, have come out with a report recommending that the government ensure such surgeries are conducted for free in all government hospitals. Now, these surgeries are done for free only in Victoria Hospital, where nearly 50 have been done so far. The surgeries are done at a subsidised cost in M.S. Ramaiah Hospitals.
The report, released on Friday, has documented the experiences of members from the community who faced difficulties in getting SRS done.
Doctors from NIMHANS, Victoria Hospital and M.S. Ramaiah Hospitals, along with community members, had been deliberating on the need for uniform guidelines in India for such surgeries, in the last few months. A committee comprising these experts was set up and this committee prepared the report, said transgender rights activist Akkai Padmashali.
Karnataka’s Transgender Policy that was approved by the State Cabinet last month has suggested free SRS for transgender people. “We want the government to implement this policy at the earliest. The free procedures should also include counselling and hormone therapy,” she said.
Recommending the creation of a database of approved doctors and remedial centres based on the guidelines, she said SRS should also be included in medical education curriculum.
D. Muralidhar, professor in the Department of Psychiatry Social Work at NIMHANS, said a combination of factors, including financial barriers and lack of healthcare providers (psychiatrists and surgeons), resulted in the community members succumbing to crude methods of sex reassignment. “This is dangerous for them, and most of them even go into depression and need medical help,” he said.
The report recommended that the terms “gender dysphoria” and “gender incongruence” should be used instead of “gender identity disorder” because of its pathological nature in certification. While recognising that legal gender identity does not require endocrine therapy or surgery, the report has said there is no role of medical gatekeepers for determining legal transgender identity.
With reference to clients who seek medical support, doctors should respect their gender identity and preferred pronouns and not refer to them by their birth-assigned sex/gender in case records, talks and publications, stated the report.
