Beed constable, raised as Lalita, undergoes genital reconstruction to finally become the man he has always been on the inside
Lalita Salve
After years of waiting, Lalit Kumar Salve (born as Lalita) finally feels like a man inside and out. Contrary to common perception, Lalit has biologically always been a man but was born with underdeveloped genitals that appeared more like a vagina, due to which he had been declared a woman on birth. Yesterday, doctors at St George Hospital excavated the penis buried under his skin and elongated it, so he can finally urinate like a man.
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mid-day had first broken the story on November 17, 2017, about the Beed constable's struggle to make the transformation from Lalita to Lalit. After months of back and forth with the state police, the Chief Minister's Office and the high court, she finally got permission from the office of the Beed SP earlier this month to go ahead with the surgery. Yesterday's surgery was the first phase in a series of procedures that will go on for a year and half, said Dr Rajat Kapur, a renowned plastic surgeon who led the operating team.
Dr Kapur has so far performed over 70 genital reconstruction surgeries. He was on the team of experts that conducted the first sex change surgery at JJ hospital years ago. Lalit had first contacted him when he was still practising at JJ Hospital.
Man on the inside
For over a year, Lalit underwent counselling for over a year, along with a battery of tests such as X-ray scan, electrocardiography (ECG) examination and blood tests to establish fitness for surgery. In fact, it was one of these tests which revealed that Lalit was genetically male all along, with XY sex chromosomes (women have XX chromosomes). Lalit had always maintained that he was a man on the inside, but this is the first time he and his family realised that it was the literal truth. Dr Kapur explained, "Lalit is actually a man but may have developed some complications in the womb that resulted in underdeveloped genital growth."
Lalit is does not have any female genitalia, and had therefore never menstruated either. "Tests have shown that he is genetically male, as he has XY sex chromosome. He was born with small external genitalia that his parents mistook for a female's. So they brought him up as a woman until he grew up and understood the difference. So, it is wrong to say that it is sex change surgery. It is genital reconstruction surgery," added Dr Kapur.
The procedure
"His penis wasn't fully developed. Only the upper part of the penis was visible outside, and it looked like a vagina. We exhumed the whole penis, and with the help of tissues taken from the body, we also elongated it. The penis is now around 5-6 cm in length in a semi-erect state," said Dr Kapur.
Lalit was in surgery for three hours, apart from an hour spent preparing for the operation, and another hour to recover from the anaesthesia before he was wheeled away for post-operative care. The surgical team comprised 12 specialists, with four experts each from the anaesthesia, plastic surgery and general surgery departments.
The doctors constructed a conduit in his elongated penis that will help Lalit to urinate like a man for the first time in his life. But for now, they have kept the tube open; it will be closed in the next phase. "Currently, as his penis is underdeveloped, he has to urinate from a hole, in a seated position. Once we construct the whole conduit, we will connect the tube with the existing hole, so that he can directly urinate through it like a man. But until he recovers, he will have to use a catheter," said Dr Kapur.
While the surgery has gone well, healing remains a challenge, as underdeveloped organs often have dead tissues that take time for recovery. "It will take over one-and-a-half years for the entire procedure to be completed," said Dr Santosh Gite, an anaesthetic who was part of the team.
Healing bond
While time will play its role, Dr Kapur had a big hand in Lalit's emotional and pychological healing as well over the past year. After intensive counselling sessions, the doctor and patient have grown into close friends. "It's only because of this friendship that Lalit was able to open up about his feelings and requirements. His family has placed a lot of trust in me. He will always remain an extremely special case in my life," said Dr Kapur.
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