Written by: Uma Sathwika Manda
Yay, it’s Pride Month! And we should learn about Gender Affirmation Surgery on this occasion. Well, I didn’t know much about this until recently when I read a lot about it. For the layman, this is the surgery that transgender people undergo to ‘change genders.’ Unfortunately, due to the underrepresentation of the trans community by the media, most of us are ignorant about this process. I personally had many questions, and after extensive research, I am to answer all your queries about Gender Affirmation Surgery.
Gender Affirmation surgery is for people that don’t associate with the sex assigned to them at birth/ transgender people undergo to confirm their gender. It is also addressed as Gender Confirmation. There was a discussion about this with the team. After talking to someone belonging to the trans community, we decided upon sticking to the term Gender Affirmation since they were comfortable with the same. Also, changing Genders is another term used to refer to the same, and this implies that one’s gender changes after the surgery have been performed (which isn’t true). Many are unaware of the process, and your questions concerning Gender Affirmation shall be answered in this article.
Gender Dysphoria is the reason behind people opting for gender affirmation surgeries. According to Mayo Clinic, Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their assigned sex at birth or sex-related physical characteristics. It is often described as a feeling trapped in the body of the wrong sex. Although every trans person does not experience this, some people might be at ease with their bodies.
On that note, it can also be overcome through medical intervention (Gender Affirmation Surgery). The surgery helps trans people by improving their mental health, boosting self-image and self-esteem, paving the way for a better quality of life, and the ability to ‘blend with society.’
According to Trans Equality, Transitioning is the time period during which a person begins to live according to their gender identity, rather than the gender they were thought to be at birth. This can look different for different people. This may (or may not) include things like changing names, pronouns, appearance, etc. Some get their name and gender changed on official documents (passport, license, bank accounts, credit cards, birth certificate, medical records, etc.). This is because they might be subjected to harassment if their appearance and gender don’t match with the one mentioned in the documents. Some others opt for hormone therapy, while others also go for gender affirmation surgery. However, not every transgender person necessarily needs to transition, but most do.
Hormone therapy helps trans folx deal with gender dysphoria that has been haunting them for years. In this, individuals that have been Assigned Female at Birth (AFAB) are administered Androgens to develop ‘secondary male sexual characteristics’ such as beard and chest hair. Those individuals that have been Assigned Male at Birth (AMAB) are given Estrogen and anti-Androgen hormones to make their bodies look more ‘feminine’ with a decrease in body hair. Hormone therapy helps trans people feel better about themselves since their physical features align with their gender.
A person first receives testosterone replacement/hormone therapy. After this, they can undergo the following procedures based on how they want their body to be:
1. Hysterectomy (partial/total)
The procedure begins with the individual undergoing estrogen/hormone therapy alongside supportive counseling. Later, they sit for other surgeries (the first three in the following list are quite easy).
1. Facial Feminization Surgery (FFS)-
2. Breast Augmentation-
3. Body Feminization Surgery-
4. Gender Affirmation Surgery-
Also, according to a study by Karolinska Institute, people have a risk of suicidal tendencies, deaths, and psychiatric morbidity. Besides this, one might not be pleased with the results after the surgery has been performed (though this is not the case with most people).
According to a Yale School of Public Health survey, trans people who undergo this procedure are less likely to seek therapy for mental well-being. According to WebMD, trans people are more likely to seek care to overcome anxiety and anti-anxiety medication about 6 times and 3 times, respectively (before surgery). Though gender affirmation isn’t the panacea, the study found out that people who underwent surgery were 8% less likely to seek help for mental well-being. Undergoing the procedure isn’t an easy thing, and it is important to analyze if it would be beneficial because the physical appearance of an individual doesn’t define their gender!
The surgery is expensive, and this discourages many from opting for it. A ‘male to female’ transition can cost anywhere between Rs. 2-5 lakhs and a ‘female to male’ transition ranges from Rs. 4-8 lakhs in case of a private hospital. The one year of compulsory therapy costs around Rs. 50,000 to 70,000. In the case of government hospitals, the procedure is performed for free, but the staff there are reportedly highly insensitive. Also, this procedure is not encompassed by Ayushman Bharat. As a result, people wishing to undergo surgery are forced to approach private hospitals only. Another reason people prefer going to private hospitals because there is this taboo surrounding transgender people that makes them choose privacy. Many also get this done in Thailand since the costs are way less there.
The Madras High Court, on 7th June 2021, issued an order (do give it a read) which is expected to pave the way for mainstreaming the people belonging to the LGBTQIA+ community. It aims to increase awareness by educating parents as well as students about sexuality. Every single individual is entitled to the ‘right to privacy’ and the ‘right to lead a dignified existence,’ and that these rights have been protected through the Constitution.
Justice N Anand Venkatesh, who gave this judgment, said, “I have no hesitation in accepting that I too belong to the majority of commoners who are yet to comprehend homosexuality completely. However, ignorance is no justification for normalizing any form of discrimination.” Also, in any cases involving two consenting adults from the LGBTQIA+ community, the police must close the case without harassing them.
“I would have never guessed” is a common phrase that trans people often get to hear. This is because there’s this notion that trans people look ‘visibly trans.’ The truth is that trans people are everywhere- even if you don’t think you know of one, you will most probably do! On this note, a small reminder to everyone who doesn’t identify themselves as trans people – IT’S NOT A SIN FOR ONE TO BE THEMSELVES! Also, never ask a trans person about their surgical status (or genitalia) or birth name. Let them bring these up if they wish to. Please let others define themselves. Be a safe space for them. This is how you will become a better ally to the community as well.
Finally, HAPPY PRIDE MONTH!
Graphic design by: Ruta Shelke
Feature image is for representational purposes only