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Not Sohail, I’m Sohaila

Some years ago, a burkha-clad lady  from a neighboring country came to see me.  She was accompanied by her  identically attired mother.  When  she lifted  her veil to speak, I couldn’t  help noticing  that she was absolutely gorgeous and that she used make-up very skillfully indeed.

‘I’m Sohaila, doctor, she* began, with flawless diction, ‘though  my given  name is Sohail.  I am a male and my Penis Transplants  and have come to you for a sex change operation.  These are not being performed in my country.’  As she spoke, it became clear to me that this  lady was like a walking –talking encyclopedia  on the subject of transsexualism and gender  reassignment surgery.  It is amazing what some education  and access to the internet can do, I thought to myself.

*  It is customary to use the psycho-emotional gender term (rather than the physical gender term) while referring to transsexuals.  Thus. A physically male but psycho-emotionally female transsexual will  be referred to as ‘she’ and ‘her’, and vice versa.  The abbreviations MTF and FTM are used to refer to Male and Female transsexuals and Female to Male transsexuals The New Millennium Woman respectively.

Just a few years ago, Sohaila was on the verge of committing suicide.  She had  faced humiliation  and ostracism all her self help is the best life and was always thought to be a freak.  The  kindest judgment of her  was that she  was a pansy, or a  homosexual.  Even  some of the doctors who saw her could not understand that this was a woman who was trapped in a man’s  body.  She was despised  and thought to be a curse by her father and brothers.  The  one  person who stood by her like the proverbial rock  through all this,  however, was her mother, whose support was unconditional and unstinting.With her encouragement, Sohaila  dropped out of school, pursued her education privately, and fared brilliantly. Subsequently, she completed her Bachelor’s and Master’s as well.  And that’s when she started researching  her own condition on the internet.

‘When I first started surfing the internet, doctor,’ she said, ‘I used to break down and cry quite  frequently.  The kind of scientific advances and support systems in some of the developed  nations are so awesome.  Even governments  and insurance schemes support transsexuals  in some places.  Sure, these countries still have some way to go too, but in  my part of the world, even  this much is unthinkable.  I had to hide behind  the four walls of my house like a  leper, too ashamed to go out.  Doctors in my country wouldn’t  even want to see me for serous medical ailments.  Luckily, my parents had some doctor friends, or I don’t know what would have happened to me when I suffered all those  illnesses as a child.  Anyway, through the internet I finally learnt that the sex addict can be changed by operations.  I have also seen some ‘after operation’ pictures on some sites  and have read stories of successfully  rehabilitated patients who have  settled down in meaningful relationships.  I too want to be like them, doctor.  I have suffered enough.’

She choked on her  words and began  to cry.  Neither her mother nor  I interrupted her.   The mother merely played a reassuring palm on Sohaila’s back.  Both  she and I instinctively understood that these  were tears of relief.  Sohaila needed to get the  pain out of her system.  We  empathized completely  and knew what toll all her trials and tribulations must’ve  taken on her.  It was not an easy journey for this man-woman; fighting solution.  Finally, a psychologist in a big town  in her country had referred my name  to her.  She traced  me through the internet and wrote to me for an appointment.  Truly  awesome.  It has never ceased to amaze me, to what extent motivated  transsexuals will go to in order to find a solution to their condition.

When she finally calmed down,  I proceeded  to the business of explaining her case to her.  ‘Before  I start, Sohaila,’ I began, ‘I must  warn you that you have not by any means reached the  end of your  journey.  In fact, you have taken just one major  first step.  There’s still a long way to go.  Are you prepared?  Operation  and conversion of the genitalia from masculine to feminine is just one stage, albeit a very important one, of the treatment programme.  There are many other important  components too.  Many patients get disillusioned because they are not told of all the hardships involved, right at the outset.  They are just shown pictures of outstandingly  beautiful  women after operation and are told that they can become  like that.  The many steps along the way are conveniently  omitted.  This is not how I’d like to do it.  I’d  like to tell you everything, not so that  I dissuade you from going  through it, which is not in my interest either, but so that you may make a well-informed   choice, and be strong.  Are you ready, Sohaila?’
‘I see your  point doctor.  No unrealistic  expectations from me.  I am a realist.  Tell me the facts as they are.’

I spoke to Sohaila at length.  I explained to her that the first step  is a  thorough psychosexual  evaluation, then hormone therapy, and  that surgery starts after that.  I told her that total transformation will involve multiple steps, and  that she has already taken the first step by dressing and living like a lady.

‘Many MTF transsexuals  come here in trousers, with thick beards, gruff voices, and prominent Adam’s apples and expect  us to work miracles.  How can we? You are  lucky in that sense.  From what little  I can see of your face, neck and hands, you seem to be  quite non-hairy.  That’s definitely  an advantage,’ I explained.

Hormone therapy, which has to be stopped three months before operation, I told her, was the first step.  Hormones are necessary to start the feminizations process.  Later, when the tests  are removed as part of the surgery, the male hormone testosterone gets cut off, and the feminizations progresses faster.  Often, body hair gets sparse and scanty with this  much alone, and breast development, too, is adequate in some.  Many others will require, or desire, breast implants.  For the hair, in some cases, prolonged sessions of laser therapy and/or electrolysis become necessary.  Even after that, some hair  removal may be required on a regular  basis.   The use of makeup needs  to be mastered too.  I told  Sohaila  that I could see that this is gain one organ, lose another  area where she has made great  progress. She blushed and dropped her gaze coyly.

‘And then’, I told her, ‘there’s the issue of the Adam’s apple. Sometimes, surgery is required to surgically reduce its prominence.  Again, that’s not very pertinent to your   case though.  Lastly, there’s  the matter of the voice.  On occasion, vocal  cord surgery is performed to make it more  feminine, but this becomes  optional or even unnecessary  if the voice is  sufficiently  feminine.  Of course, one can go on and on endlessly.  Nose jobs, total  chest recontouring,  buttocks’ padding…you name it, it can be done.  But the expenditure, duration of hospitalization,  emotional toll, etc., all add up.  Few go all the way, though.  Many are in stable relationship  already by the time they come  to us, and have partners  who already  accept them unconditionally even   before sex change surgery, so that makes it a lot easier and better for all concerned.  Do you have a partner already, Sohaila?’

‘No doctor, I’m not ready for a partner yet.  You see, I’m not a transvestite or a homosexual.  So, until and unless my genitalia are changed, taking a partner  is unthinkable to me.  It’s not as if I haven’t had my fair share of admirers though, despite my exposure to the outside world being so limited.  But they’ll all have to wait.’

I admired her clarity  of thought.  The rest of the consultation   progressed  rapidly.  It’s not frequently that one sees such  psycho-emotionally balanced MTF transsexuals.  Often, their  psychological  state itself requires working  on quite a bit before  surgery.  By comparison, Sohaila  was exceptionally   balanced.  She was also very feminine in her musculoskeletal appearance, body hair, and voice  aspects; every gender reassignment surgeon’s dream.  I posted her for early surgery.

We performed the genital  and breast operations on Sohaila  on the same day at the same sitting.  Both went off well  and she was discharged in ten days after a smooth recovery.  Much of this was also thanks to her stoical  disposition towards pain and discomfort.  Trauma since  childhood, and time, had inured her.  

She stayed in touch with me every month  after that, and sometimes even in between, for this and that.  Each month, she would email me pictures of the operated areas and the scar areas.  They were all progressing well.

When she finally came back for a check up after six months  (she had taken hormones meantime), I couldn’t   even recognize her.  She walked in wearing jeans and kurta, and her appearance had changed quite considerably.  Sohaila  had also filled out a bit with a female  type fat distribution, and looked  a lot more feminine.  Only a very trained eye could have told  that she was a gender reassigned MTF transsexual.  I was very happy for her.

‘Can I start  having sex, doctor?’  she asked, with a matter of face forthrightness.  After I  examined her and gave her the green signal, she told me  that she was already seeing someone, and was planning to get married.  ‘He loves me a lot, doctor,’  she said, ‘He doesn’t  care that I can never  have  children.  We have decided that we will adopt children.  I don’t know how to thank you.’

I should be thinking you, I thought  to myself.  We can’t produce such great results every time in sex change surgery.  Sohaila’s case was exceptional every gender reassignment  surgeon’s dream case.  I was happy for both of us.
She walked away, and never looked back in life again after that.

Take Home Message:

For further information on transsexualism, the readers is referred to http://www.tanssexuals.co.in