Proposal for gender affirmative surgery at govt. facilities gathers dust

‘Private hospitals charging exorbitantly for the procedure’

Even as the LGBTQ community is up in arms over the death of a transwoman here allegedly owing to complications post-gender affirmative surgery, commonly known as sex reassignment surgery (SRS), a proposal to conduct such procedures at government medical colleges continues to gather dust.

The Social Justice Department had in 2018 submitted a ₹3.50-crore proposal to the government suggesting equipping the Kottayam Medical College Hospital to hold SRS on a pilot basis and then expand it gradually to all government medical colleges. It would have freed the community from the clutches of private hospitals, which alone now conduct such surgeries.

“Though the department has increased SRS assistance from a uniform rate of ₹2 lakh in 2018 when it was started to ₹5 lakh for transmen and ₹2.50 lakh for transwomen from last year, it did not help the community much as private hospitals increased the rate proportionately,” said department sources. This was in addition to ₹3,000 a month for a year for post-surgery convalescence.

Since 2018, the department has allotted nearly ₹1.30 crore as SRS assistance to 86 transwomen and 42 transmen and ₹39.51 lakh as post-surgery assistance to 69 transwomen and 40 transmen.

However, the assistance for the surgery in reimbursement mode is said to be defeating its very purpose. “That would have been defensible if the community was really empowered and could negotiate with the hospital managements from a position of strength, which is not the case. The horrors the community is pushed into to mobilise resources for the surgery are beyond description,” said academic-activist J. Devika who has always batted for the community.

She also said that it was high time gender affirmative surgery was facilitated, as she found the term SRS an affront, in government facilities. “We already have plastic surgeons who could be given advanced training, or expert hands should be hired,” said Ms. Devika.

Greeshma Saji, counsellor at the transwomen shelter home here, said the emotional trauma that transpeople underwent in pursuit of a successful surgery was immense, pushing them to the brink. “The death of Anannyah Kumari Alex reportedly owing to post-surgery complications has instilled fear among the residents, both who have undergone surgery and are about to get it done,” she added.

Psychiatrist C.J. John said continued emotional and mental health support should be extended to those undergoing the surgery before and after the procedure. “Also, there should be a regulatory mechanism for overseeing the procedure. The body of experts should clear the surgery and ensure compliance with the protocol. This will also help replace the disbursement mode of assistance and facilitate advance release of funds to hospitals, sparing the community of the difficulty involved in mobilising resources,” he said.

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