The curious case of Ann C

April 22, 2016 03:38 pm | Updated October 21, 2016 06:41 pm IST - Chennai

The Govt. Hospital for women and Children, Egmore, at whose predecessor Ann C was diagnosed. Photo: R. Ragu

The Govt. Hospital for women and Children, Egmore, at whose predecessor Ann C was diagnosed. Photo: R. Ragu

The Tamil Nadu Government has been in the vanguard of recognising that transgenders are an integral part of society. They have been accorded status in law, ensured admission in mainstream courses and permitted to apply for Government jobs. When you look at these efforts, you feel sad for the number of centuries that it has taken for us to become inclusive, even to a small extent. It also brings to mind one of the first modern medical records in India of a transgender being recognised as such, and that took place in Madras.

It was the year 1862. R.S. Mair, MD, Fellow of the Royal College of Surgeons, Edinburgh, Deputy Coroner of Madras and Surgeon, Infantry Volunteer Guards, Madras, was at home when an Englishwoman of 21 or 22 years of age was ushered in. Identified thereafter as Ann C, she had come with a problem that needed consulting in private — she had never experienced monthly cycles. Mair assumed that this was a case of some obstruction and conducted a preliminary test only to be puzzled by what he saw — the patient had underdeveloped organs of a male, and the regular ones of a female. He then permitted himself a closer look at the facial features of the patient and came to the conclusion that this was a masculine woman with hard features and a voice that was neither that of a man or a woman. She had, however, been brought up as a woman.

The patient was admitted to the Lying-In Hospital, the predecessor of the Egmore Government Maternity Hospital, and which was then ‘near the Egmore Station, facing the Cooum’ — most likely where the CMDA is. There followed two months of close observation. A battery of surgeons led by Major J. Shaw, then head of the hospital, conducted a detailed examination after sedating the patient, only to discover the complete absence of a uterus and ovary. On recovery, Ann C had a request. There were two marriage proposals pending. Was there no surgical procedure to be made a woman? To this, the surgeons had to answer in the negative.

Mair records that the patient, ‘abruptly left Madras for Calcutta and thence to England’. We can only hope that Ann C found some happiness somewhere. But the case sent the surgeon into further research. He corresponded with other doctors in Europe and came to find that much confusion abounded on what such people were and that almost everyone agreed that no treatment was possible. His study resulted in a detailed article on ‘Abnormal Formation of Genital and Urinary Organs’, which was published in the Madras Quarterly Journal of Medical Science brought out by the Garrison Surgeon at Fort St. George in collaboration with the Madras Medical College and published at the Gantz Press, Vepery.

It is interesting to note that the city where Ann C’s case was discussed is where enlightened thought has now made a beginning.

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