gender reassignment surgery

What you need to know about Gender Reassignment Surgery?

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Some years ago, a farmer from Gujarat came to Sitaram Bhartia with his adolescent son, feeling distressed about his behaviour. He would spend hours standing in front of a mirror in a girl’s clothes and would tell everyone he met that he was not a boy. He had even told people to start addressing him as Vandana instead of Varun, the name he was given at birth.

Varun’s father ‘just knew something was wrong with him’ and so came to meet Dr. Kotwal, Senior Consultant Urology & one of the best Gender Reassignment Surgeons in Delhi/India,  at Sitaram Bhartia.

Why did Varun, who was born male, behave like a girl and want to be addressed by a female name? Was it simply a passing phase or were there deeper issues involved? Was Varun a transgender? If deeper issues did exist, how could they be addressed?

Dr. S.V. Kotwal, who is one of the few expert member surgeons of WPATH (World Professional Association for Transgender Health) from India, often meets with people whose stories begin the way that Varun’s did. With certain behaviours, they exhibit the fact that they are questioning their identity vis-a-vis their gender. But all these stories don’t always have the same conclusion.

Over the past few years, there has been a growing body of scientific evidence to indicate that gender and gender identity fall across a wide spectrum. Sometimes, people who cannot identify with their biological gender want to know if they can have a gender reassignment surgery done, which naturally gives rise to several other questions.

The list of frequently asked questions below will address some of these concerns. We invite you to reach out to us if any question on your mind has not been addressed.

Gender Reassignment Surgery : Frequently Asked Questions

What is a Gender Reassignment Surgery?
Gender Reassignment Surgery, also known as Sex Reassignment Surgery, is a surgery wherein the appearance & function of a transgender individual’s sexual characteristics  are altered to be in alignment with the gender they identify with. Or simply put, male sex organs and appearance are changed to look female and vice versa.

How is Gender Reassignment Surgery initiated?
Once the diagnosis of Gender Identity Disorder (GID) is made and it is clear that treatment is indicated, then the preliminary process for Gender Reassignment Surgery begins.

The initial steps consist of hormone treatment so the body can change physical characteristics. According to Dr. Kotwal, these hormones must be given over an extended period of time. “The guidelines in place say that hormone treatments must be given for at least six months before surgery” says Dr. Kotwal “and this individual must start living in their gender role in order to be accepted by society for at least a period of one year.”

While the hormone treatment is going on, there are other ancillary procedures going on such as laser removal of body hair or other forms of plastic surgery that change the body’s physical characteristics.

Is Gender Reassignment Surgery a complicated procedure?
The male to female surgical transition is a relatively simpler surgery and is a one-step operation that takes approximately 4-5 hours.

In contrast, the female to male surgical transition is carried out in stages and take a much longer time. “The female to male transition takes a lot of teamwork and support from staff because responsibility is shared between several specialties and professionals” says Dr. Kotwal.

Can everyone who requests a Gender Reassignment Surgery get one?
No, every individual seeking a Gender Reassignment Surgery cannot get one. “In fact, we have a high rejection rate for the surgery because upon diagnosis, people have also been certified as not-GID” says Dr. Kotwal.

“Not every individual requires surgery. The person who’s been diagnosed could be homosexual or could be a cross-dresser, which is not the same as transgender. Unless we get clearance from the psychiatrist, we don’t go ahead with the surgery.” But from this point, the individual is started on processes and counseling that last for about 18 months before surgery can be done.

What happens after an individual receives approval for surgery?
After the diagnosis is complete, the hormone treatment has begun, and an individual has been approved for surgery, the next step of the transition is to interact with other people who have undergone a Gender Reassignment Surgery.

“I will explain to the patient the nature of the surgery” says Dr. Kotwal. “But once we reach the stage of surgery, that’s when I say ‘I will not operate on you until you talk to a person who has undergone surgery, especially if you want to know how painful it was or how difficult it was.’”

Why are there so many levels of checks and approvals with Gender Reassignment Surgery?
“We do not want to make [Gender Reassignment Surgery] a commercial thing; it has to be scientific” says Dr. Kotwal. “The responsibility the treatment carries is huge and if you make a mistake, you create a person who gets ostracized by society. Therefore, there are a lot of filters and checks and balances before we do [the surgery].”

Can people lead normal lives after their surgery?
Yes, in fact many patients who have undergone Gender Reassignment Surgery have gotten married, have adopted children, and are now living normal, married lives.

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