From Boy to Girl: Inside the Gender Change Process, Surgeries, and Legal Steps in India
Gender transition is becoming more common worldwide, including in India, where individuals are increasingly undergoing sex reassignment surgery (SRS) to align their physical bodies with their gender identities. Whether someone transitions from male to female or female to male, the journey involves several stages, including counseling, hormone therapy, and surgical procedures. This article breaks down the entire gender change process, the surgeries involved, costs, and legal aspects in India.
Who Can Undergo a Gender Change?
Dr. Narendra Kaushik, a well-known expert in sex reassignment surgery, explains that any adult over the age of 18 can opt for a gender change. For minors, however, counseling with psychiatrists and psychologists is mandatory. Even adults, before surgery, are required to undergo counseling to assess gender dysphoria or gender incongruence—a condition where a person’s assigned sex at birth does not align with their gender identity.
Is Testing Required?
According to Dr. Kaushik, no specific medical tests determine the need for a gender change. Instead, it’s the recommendation of psychiatrists and psychologists that plays a critical role. A certificate from these professionals serves as approval for undergoing sex reassignment surgery.
What is the Process of Sex Reassignment Surgery?
The gender transition process typically begins with hormone therapy. This involves administering hormones to initiate changes in the body that align with the desired gender. For instance, if someone assigned male at birth wishes to transition to female, estrogen and other hormones are introduced to develop feminine characteristics. Over time, these hormones lead to noticeable physical changes, after which surgery is performed.
For male-to-female transitions, the surgery generally includes four key procedures:
- Vocal Surgery: Alters the pitch of the voice to sound more feminine.
- Genital Surgery: Replaces male genitalia with female genitalia.
- Facial Feminization Surgery: Modifies facial features to appear more feminine.
- Breast Surgery: Involves breast augmentation to create a fuller, feminine chest.
Each of these surgeries is done in stages, and the entire process can take up to 18 months to complete. After undergoing all surgeries, individuals usually need a recovery period of around two months before they can fully resume normal activities.
Is Motherhood Possible After Gender Change?
For male-to-female transitions, individuals cannot biologically conceive children post-surgery. However, options like surrogacy or adoption are always available. Dr. Kaushik assures that individuals who undergo this process can lead a normal life and have fulfilling relationships similar to any other woman.
Is the Process Painful?
The physical discomfort involved in gender change surgeries is comparable to any other significant surgical procedure. Patients may experience some pain and need time to recover, but modern medical advancements have made these procedures safer and more comfortable. The degree of discomfort varies from person to person, based on their pain tolerance and the complexity of their surgeries.
Are Legal Approvals Necessary?
Dr. Kaushik notes that sex reassignment surgeries do not require prior legal consent in India. However, following the surgery, individuals must apply for revised identity documents, such as birth certificates or identity cards, through the district magistrate, as stipulated in the Transgender Persons (Protection of Rights) Act, 2019. This process ensures that their legal identity matches their gender.
Costs of Gender Change Surgeries
The costs of gender transition surgeries can vary significantly depending on the procedures involved and the hospital where the surgery is conducted. On average, the total cost can range anywhere from ₹4-5 lakh to ₹20 lakh. Hormone therapy, surgical complexity, and hospital fees contribute to the final expense.
What Does the Law Say?
According to Advocate Prem Joshi from the Delhi High Court, India’s legal framework allows for gender reassignment surgery, with no legal restrictions preventing adults from undergoing the procedure. The Mumbai High Court's ruling in the Bidhhan Baruah case (2012) set a precedent affirming that no law prohibits gender change surgery. Any individual over 18 is free to pursue this transition.
Moreover, the Transgender Persons (Protection of Rights) Act, 2019 under Section 7 states that after surgery, the person must submit an application to the district magistrate to obtain a revised identity certificate. This certificate enables individuals to update their legal records without affecting their rights.
The gender change process is a life-altering journey that involves multiple stages of medical procedures, counseling, and sometimes legal formalities. While the process takes time and can be physically demanding, it allows individuals to live in alignment with their true gender identity. With evolving medical techniques and supportive laws in India, the road to gender transition is becoming smoother for those who choose to embark on this path.