When a man wants to be a woman (and vice versa)
Opting for a sex change operation is a choice made by some who feel trapped in the wrong body and gender.
Drag queen Bobby Darling appeared on a reality show recently, proclaiming that he was on the show just to earn money for a sex change operation as he felt like a woman trapped in a man’s body. On the other hand, Chaz Bono the daughter of singer Cher has just undergone a sex change to acquire a male identity. “I want to feel vibrant and be able to enjoy my life in a male body and not wait until I am old,” she said.
Most of us know that people’s sexual inclinations differ, and that accepting others’ preferences is important to our socialisation. The recent decriminalisation of homosexuality is a move forward, as it has given some legitimacy to gay rights in the country. But harder to accept and understand is the issue of gender confusion, which is a subject well beyond same sex inclinations. From transvestites who would like to dress and behave like the opposite sex to intersexuals who are born with ambiguous genitals, many people face an identity crisis regarding their sexuality.
Transsexuals are a group of people who feel as though they are trapped in the wrong body. Though they have homosexual inclinations, these are compounded by discomfort with their sexual organs, which they want changed. This desire sets them apart from homosexuals.
LINKED TO GENES
WHILE this urge of transgenders to have a different biology may seem ‘ abnormal’, this is not so.
” In most cases, people are born with a sense of discomfort about their gender. Research has proven that the brain of certain individuals is designed that way,” says Dr S V Kotwal, senior consultant urologist, who performs sex change operations at Sitaram Bhartia Institute of Science and Research.
Recently, Australian researchers claimed to identify a gene which leads to transsexuality.
Published in the journal Biological Psychiatry , the study involved DNA analysis of 112 male transsexuals and identified a significant link between a gene involved in testosterone action and transsexuality.
Usually for transsexuals, having a gender change is the only solution.
Twenty five- year- old Rehana ( name changed) was born a boy but has never felt like one. ” I had the same interests as any other woman. As a teenager,
I was more attracted to boys than girls. I used to get ragged about this every single day and I got seriously depressed and had suicidal tendencies. Then one day, I saw a TV show on sex change and related to it completely,” she recalls.
Two years ago, Rehana underwent a sex change operation and acquired female organs. ” I felt reborn after the surgery. The good thing is my parents and friends were supportive throughout, and said that it’s better to make a choice rather than live with a mixed sexual identity,” she says. Today, Rehana is a doctor and has a boyfriend too. ” I don’t face any social hostility.
Even my neighbours, who used to frown at my feminine behaviour earlier, express happiness at my decision,” Rehana claims.
A CAREFUL DECISION
SEX reassignment is a tedious and time- consuming procedure.
Though various small clinics perform the procedure without any set guidelines, big hospitals follow the criteria developed by German endocrinologist Harry Benjamin in the 1950s. First of all, two independent psychiatrists assess the patient to ascertain that it’s a genuine case of transsexuality. ” It’s not just an operation to change your genitals — your whole life undergoes a change. A homosexual or a cross dresser may regret their decision after the procedure. To ascertain that candidates are sure about what they are doing, we ask them to live the life of the opposite gender for one year. They take on new names, mannerisms and clothes. They also face society during this time with support from family and friends. This offers them a glimpse of the life that lies ahead,” says Dr Kavita Arora, consultant psychiatrist, Sitaram Bhartia Hospital.
After one year, hormone therapy is initiated. This involves the replacement of one’s natural hormones with those of the opposite sex. Women receive androgens while males are given estrogen and progesterone.
Changes become evident very soon after hormone therapy begins. Men will stop sprouting facial hair and may lose the characteristic hair growing on his chest. A woman receiving androgens will experience facial hair growth as well as changes in the pattern of fat deposits in her body. Voices in both sexes will change only minimally because the size of the larynx and the vocal cords are unchanged by hormones.
COMPLEX PROCEDURE
THE process is enhanced by the surgical removal of the genitalia and reconstruction of genitals of the assumed sex. This is a difficult procedure in either sex, but more so in the female since her genitals are internal. ” The surgical procedure on the male involves removal of the penis and the scrotum with the testes. A pseudo- vagina can be constructed from the skin of the penis. It is generally done in a single session of six hours. Construction of female breasts is accomplished by hormone therapy but if the patient is not satisfied, he can go for breast augmentation surgery,” says Dr Kotwal.
Removal of the scrotum and testes also removes the source of the male hormones, so the therapy with female hormones assumes dominance.
The newly created woman will be required to take female hormones for the remainder of her life. Her reconstructed vagina will enable her to have sex with a male, though of course she will not able to bear children.
Surgery on the female transsexual is more complex. The female reproductive organs are internal, so an incision is required to remove the ovaries, uterus, and vagina. The breasts are also removed, leaving a small scar. An implanted penile prosthesis will enable him to attain an erection, but he will be unable to father children. The surgery on males would cost around Rs 1 lakh whereas on females it can range from Rs 1.5 lakh to Rs 5 lakh depending on the number of sessions required.
