Sex Reassignment Surgery in India 2020: Gender Reassignment surgery cost in India

Sex reassignment surgery, gender reassignment surgery, Transgender Surgery, sex affirmation procedures, and sex-change operation are a series of genitoplasty procedure done to change the genitals of a transgender person from one gender to another.

Gender identity disorder or Gender dysphoria is the conflict which many people face about what their true gender is

Between a person’s assigned or physical gender and the way he/she/they instinctively associated themselves with.

The procedure helps people to associate themselves with their identified gender and match their physical gender with the way they feel emotionally and instinctively about their true gender.

The procedure can be

• Male to Female Sex reassignment surgery or
• Female to Male Sex reassignment surgery

It is important to note that Transgender Persons (Protection of Rights) Act, 2019 provides various protection and reservation for transgenders across India,

But, A transgender person is identified as male or female only after applying for a revised certificate to the district magistrate, post-sex reassignment surgery

At the end of the day, it’s an individuals choice to determine what gender he associates himself with and

whether a Sex reassignment surgery is something he/she/they need to undergo for expressing their true gender.

This blog intents to spread more awareness about Sex reassignment surgery in India by educating people

So let’s look explore further and learn in detail about Sex reassignment surgery in India

Sex reassignment surgery in India

• What is Sex reassignment surgery?
  
  
• What is the procedure of Sex reassignment in India
  
  • Male to Female Sex reassignment surgery
    
  • Female to Male Sex reassignment surgery
    
    
• Gender reassignment surgery cost in India
  
  
• History of Sex reassignment surgery
  
  
• Ethical issues concerning Sex Reassignment Surgery
  
  
• Final Thoughts
  
  

What is Sex reassignment surgery?

Sex reassignment surgery is primarily a series of genitoplasty procedures performed to treat gender dystrophia, these procedures change an individual’s genitals from one gender to another.

While many transsexual, transgender, and gender-nonconforming individuals find comfort with their gender identity, role, and expression without surgery,

for many others, surgery is essential and medically necessary to alleviate their gender dysphoria

Sex reassignment surgery can be only performed on individuals above 18 years in India

The procedure primarily involves

• Vaginoplasty (Construction of Vagina): Penile Inversion and Sigmoid Colon for Male to Female (Trans Women)
• Metoidioplasty or  phalloplasty (Construction of Penis) for Female to Male (Trans Men)

Both the procedures may require necessary procedures like orchiectomy (removal of testicles), penectomy (Removal of the penis), mastectomy (removal of breasts) or vaginectomy (Removal of the vagina), Hysterectomy (Removal of the uterus)

What is the procedure of Sex reassignment in India

The World Professional Association for Transgender Health has laid down the standard of care for the health of Transsexual, Transgender, and Gender Nonconforming People

You can read the complete document by clicking on this link

Prior to surgery, the individual is subjected to hormone therapy-specific for Male to Female and Female to Male

For the Male-to-Female (MtF) Patient

Feminizing Hormone Therapy

Feminizing hormone therapy is recommended for M2F patients, This primarily involves 3 hormones (The dosage and duration of this therapy can be different for everyone)

• Estrogen: Everyone has a unique body ecosystem and therefore dosage of the pills, use of oral estrogen pills or transdermal estrogen should be determined after a discussion with your doctor
  
  
• Anti-Androgen: These are hormones that basically suppress or reduce male factor hormones testosterone in the body,
  
  This has clear physical symptoms like diminishing masculine characteristics such as body hair
  
  Common anti-androgen include Spironolactone, Cyproterone acetate, and 5-alpha-reductase inhibitors
  
  
• Progesterone: Use of progestins have been quite controversial in Feminizing hormone therapy,
  
  Progestins play a vital role in breast development but the effect of progestins in hormone therapy has been argued to be ineffective by many researchers
  
  There are also been concerns that progesterone can lead to depression, weight gain and lipid changes
  
  

Surgical Procedures May Include the Following:

1. Breast surgery: Breast augmentation
   
   
2. Genital surgery: penectomy, orchiectomy, vaginoplasty, clitoroplasty, valvuloplasty;
   
   
3. Surgical interventions: facial feminization surgery, liposuction, lipofilling,
   
   
4. Voice modulating surgery, thyroid cartilage reduction, gluteal augmentation (implants/lipofilling), hair reconstruction, and various aesthetic procedures
   
   

For the Female-to-Male (FtM) Patient

Masculinizing Hormone Therapy

The primary hormone involved in the therapy is

1. Testosterone: Testosterone generally can be prescribed orally, transdermally, or Intramuscular injections,
   
   Testosterone is available in females also but by taking additional testosterone one can boost the masculine characters like body and facial hair.
   
   

Surgical Procedures May Include the Following:

1. Breast Augmentation: subcutaneous mastectomy, creation of a male chest
   
   
2. Genital surgery: hysterectomy/salpingo-oophorectomy, reconstruction of the fixed part of the urethra,
   
   which can be combined with a metoidioplasty or with a phalloplasty (employing a pedicled or free vascularized flap),
   
   vaginectomy, scrotoplasty, and implantation of the erection and/or testicular prostheses;
   
   
3. Other surgical interventions: voice surgery (rare), liposuction, lipofilling, pectoral implants, and various aesthetic procedures.
   
   

Gender reassignment surgery cost in India

If you live in India and are looking to get a gender reassignment surgery it will cost you from ₹1,00,000-₹7,00,000

• Average Gender reassignment surgery cost in India – ₹229,200.00
• Starting cost of Gender reassignment surgery in India – ₹97,857.00
• Most costly Gender reassignment surgery in India – ₹7,00,000.00

The average cost of gender reassignment surgery in different states of India

Name of State	The Average cost of gender reassignment surgery
New Delhi	₹291,000.00
Bengaluru	₹272,000.00
Mumbai	₹246,000.00
Kolkata	₹204,000.00
Gujrat	₹220,000.00

If you are traveling for gender reassignment surgery from outside India it will cost you around $20,000 (₹1531400.00). Which is less as compared to other countries

Name of the Country	The Average cost of gender reassignment surgery
USA	$30,000 (₹22,97,100)
UK	$24,000 (₹18,37,680)
Australia	$30,000 (₹22,97,100)

History of Sex Reassignment Surgery

The first know sex reassignment surgery was performed in 1930 Germany on the danish painter Lili Elbe, She had 4 surgeries done on her

But, She died 3 months after the surgeries

Magnus Hirschfeld is considered the father of transgender health, In 1918 he coined the term “transvestite” which meant a person who likes cross-gender dressing

Hirschfeld was probably the first physician to offer means of sex change to his patients,

He established the first gender reassignment institute and was the first to perform castration for sex change in 1922,

but unfortunately in 2nd world war, he was exiled by Nazi Germans

The institute was shut down and most of his work got lost.

Later, Henry Benjamin became the face of modern transgender healthcare, Henry had been studying transgender issues since the 1950s,

In 1966 he wrote the book  The Transsexual Phenomenon

He formed the standards of sex reassignment surgery and made the Henry Benjamin International Gender Dysphoria Association

which today is known as the World Professional Association for Transgender Health (WPATH)

which still defines the standard of care for the health of Transsexual, Transgender, and Gender Nonconforming People

In India, sex reassignment surgery has been around for quite a long time now

J J Group of Hospitals’ St George in Maharashtra became the first government hospital in the country to start a dedicated outpatient department for sex reassignment procedures.

Ethical issues concerning Sex Reassignment Surgery

“Above all do no harm”

Many people and healthcare professionals argue that tissues are removed from our body in case of infection, to restore the disturbed body functioning,

or in case of aesthetics surgeries to enhance certain body features to improve self-image

Sex Reassignment Surgery does not fall into any of this category

How ethical is it to remove body tissues for treating gender dystrophy?

Many people who are in favor of Sex Reassignment Surgery argue back that gender dystrophy causes a great deal of psychological distress

Denying access to these procedures can potentially cause harm to individuals with gender dystrophy

let me know what you think about this argument in the comment section

Final Thoughts

It’s a person’s right to select his gender identity, While many people can treat their gender dystrophy without the procedure,

Sex Reassignment Surgery can help patients feel more at ease, It’s all about a person’s choice.

In transsexual health in India is really poor and more effort is needed to improve the lives of over 4,50,000 transgender individuals.

More education and awareness is needed so that people can know about trans health in India.