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