Is the rebirth clinic a ray of hope for gender correction seekers?

Sitting outside the Gender Reassignment and Cosmetic Surgery outpatient department OPD at St George Hospital Rita Devi appears shifty and anxious She has only a couple of hours to get a slew of tests done before flying back to Assam the next morning Clutching a folder containing documents Devi is soft spoken to the point of being barely audible But she makes herself heard when she needs toThe 36yearold born in Hojai district of Assam approached the hospital authorities for gender dysphoria a condition in which a person does not identify with the gender they were born withThe term made its way from medical circles to the Mumbaikars living room when Lalit Salve a police constable from Beed fought a long and hard battle to retain his job after a gender reassignment surgery His case not only inspired others to explore the possibility of gender change but even prompted the staterun St George Hospital to open the ward Launched on September 26 it aims to provide a safe and nonjudgmental space for those considering sex reassignment Until then authorities would receive calls from individuals who were considering the step but had no dedicated section to cater to them With the rise in enquiries we felt it was time we started one says Dr Rajat Kapoor who operated on Salve Its for the first time in Mumbai that a staterun hospital has acquired this facility Since they opened they have received queries from 13 persons who are in various stages of presurgery procedure The demographic is a mix of candidates from metros and smaller townsThe sex reassignment OPD was launched on September 26Back at the hospital Devi is waiting for her sonography reports Like Salve she too works for a government agency the Assam electrical board and had to seek permission from the state for surgery Its only after I get my name changed and my hormonal imbalance treated that Ill be able to go ahead with the surgery she reveals This wont be any time before next year The fact that it can be a long drawn process and requires patience and mental fortitude is something that doctors warn patients beforehandWe expect patients to get a comprehensive understanding of the procedures hormones and other risks involved in such operations says Kapoor The hospital has set up a sixmember committee to examine the individuals who wish to undergo gender change The procedure also involves a mental health test to assess a persons readiness to undergo the physical and emotional stress that accompanies the transition And then there is the real life test where she must take on the role of the desired sex in everyday activities both socially and professionallyCross dressing helps them understand what it takes to live as a person of the other gender It needs to be done for a minimum of six months If they dont feel comfortable they have time to rethink their decision says Kapoor While women transitioning to be men dress in androgynous clothing its the men to whom this rule applies more he addsDr Rajat KapoorAmeya name changed on request a teen from Kothrud Pune was told to take the real life test when he visited the hospital a month ago But to him it made no difference Born a girl Ameya has lived the life of a boy for 18 years From going to a mens hair salon and dressing up like a dude to dating girls he has always identified as male Curiously though he says he wasnt born this way When my mother was pregnant the family was hoping for a boy since they already had a daughterSo unwittingly they ended up treating me like a boy Although a student at a girls school he would dress up like a boy when outside I started loving this life because most people were accepting of me When I suddenly started getting attracted to girls at age of 14 is when it got difficult he says The period was tumultuous he recalls until he began accepting his feelingsDr Yusuf Matcheswalla PsychiatristHe even started a Facebook account with his new identity and would receive flirtatious messages from girls It was a good feeling he gushes This went on until one day when he was 16 the parents decided it was time their daughter started behaving like one They wanted me to change my attitude They started forcing me to dress like a girl but it was too late I had internalised my masculine identity I couldnt and did not want to changeHe came out to his parents a few of years later Today he has his mothers support This parental backing says Dr Yusuf Matcheswalla senior psychiatrist practising at Gokuldas Tejpal Hospital and professor of psychiatry at Grant Government Medical College is one of the most visible changes he has witnessed in the last five years Matcheswalla has treated scores of patients battling gender identity disorder Earlier when doctors would refer patients for a psychological evaluation they would come alone Today they are accompanied by their families It shows a growing level of acceptance he saysMatcheswalla says candidates for gender reassignment surgeries must undergo extensive psychiatric evaluation and remain under the supervision of a therapist for at least two years But the suggestion is often met with resistance The thing is you cant reverse it once its done Sex change regret can lead to crippling depression and even physical harm which is why you need to be absolutely sure But patients feel we are prolonging their suffering by recommending the test Once they have managed to raise or save funds for their surgery they want it done at the earliest The cost of surgery ranges from R3 lakh to Rs 7 lakhIn the past Matcheswalla has rejected patients for being mentally ill prepared He recalls the case of a medical student from Mumbai who was suffering from dysphoria but also had a schizoid personality disorder a condition in which people consistently avoid interactions It was important to treat this particular aspect before giving the green signal After months of therapy I have now given him the green signalWhile there is eagerness to undergo surgery there is also fear of repercussions says Salve who often receives calls from individuals mulling the transition They are scared of the side effects but doctors lay all facts on the table For instance for a transsexual man assigned female at birth genital surgery generally offers him male genetalia that can be used during sex It does not however give him functional testiclesPregnancy then becomes an issue he says But its the financial strain that has led many to wait up Getting the surgeries done in private hospitals is not cheap We are trying to subsidise the cost of the surgery making it onethird of what it currently is says Madhukar Gaekwad medical superintendent St George HospitalMoney will not be an issue for Amey But convincing his parents might be Somebody told my mother that the surgery is risky and might affect the kidneys which is why she is not taking the initiative to complete it I hope she gets over these fearsCatch up on all the latest Mumbai news crime news current affairs and 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