John (identify modified), a 28-year-old transman, felt a wave of nervousness as he walked into the gender guidance clinic for transgender persons at Chennai’s Rajiv Gandhi Authorities Common Hospital (RGGGH). However that anxiousness quickly gave technique to reduction. On the clinic, he underwent a collection of counselling periods and medical consultations with a crew of medical doctors earlier than continuing with gender affirmation surgical procedure.
“The medical doctors at RGGGH have been very pleasant. They made me really feel snug all through the surgical procedure and restoration,” says Mr. John, who acquired a mastectomy. “I can’t even really feel the stitches now. Extra importantly, I really feel extra like myself.”
In 2019, Tamil Nadu grew to become the second State within the nation, after Kerala, to arrange a clinic exclusively for transgender people at RGGGH, and later, at Government Rajaji Hospital in Madurai, providing free gender affirmation surgical procedures. In reality, RGGGH had been performing free surgical procedures for transpersons since 2009, however they have been performed as a part of basic outpatient providers. “The gender clinic ensures that every one providers can be found underneath one roof, so transpersons don’t should go from one place to a different to obtain gender-affirming care,” says M. Sugumar, head of the cosmetic surgery division at RGGGH, who can be answerable for the gender clinic. His crew contains Senthil Kumaran, assistant professor within the division of plastic Surgical procedure at RGGGH, and a postgraduate resident.
The doorway to the gender clinic at RGGGH is marked by colors of the trans delight flag
| Photograph Credit score:
Meenakshy S.
As of 2024, the hospital has carried out 171 gender affirmation surgical procedures for transmen and girls, which embrace penectomies, breast implants, and mastectomies, amongst different procedures. Greater than 1,500 trans individuals have sought care on the clinic, as of 2024. There was a drop within the variety of surgical procedures through the COVID-19 pandemic, as most outpatient providers have been shut. Nonetheless, since then, the variety of surgical procedures has elevated, says Dr. Sugumar. He attributes this rise to the progressive insurance policies of the State authorities, in addition to rising consciousness and schooling inside the transgender neighborhood.
What does the clinic provide?
The clinic, which operates on Fridays from 9 a.m. to 1 p.m., homes a psychiatrist, an endocrinologist, a venereologist, a doctor, and plastic surgeons. “A transperson who visits the clinic is first referred to the psychiatrist. After a number of rounds of counselling, the endocrinologist evaluates the hormonal features, and the doctor, the bodily features. The venereologist ensures the individual’s sexual well being, and the cosmetic surgery division performs the surgical procedure,” explains Dr. Sugumar. Every surgical procedure might price between ₹1.5 lakh to three lakh in personal hospitals.
Trans individuals aged 18 and above are eligible for surgical procedure, however medical doctors work with them for a few yr to make sure they’re sure about continuing, because the surgical procedure is tough to reverse. “It’s a time-consuming course of, but it surely’s obligatory. Docs want to make sure we’re totally ready for surgical procedure,” factors out Mr. John, an accountant.
Nonetheless, Jaya, a transgender activist and basic supervisor of Sahodaran — an NGO that works for the welfare of the LGBTQIA+ neighborhood — says the size of the method could be a barrier for a lot of in the neighborhood, particularly those that have left their natal households with the intention to bear surgical procedure. “Some transpersons might have left their properties with little or no financial savings to help themselves through the course of. Whereas due diligence is vital, there needs to be higher mechanisms in place to help transpersons throughout this era of transition,” she provides.
The clinic, which operates on Fridays from 9 a.m. to 1 p.m., employs a psychiatrist, an endocrinologist, a venereologist, a doctor, and plastic surgeons
| Photograph Credit score:
Meenakshy S.
Surgical procedures additionally include sure danger components. As an illustration, Kamali, a transwoman, underwent gender affirmation surgical procedure in 2015 (earlier than the gender clinic was established) at RGGGH, and skilled problems a couple of months later. “I developed an an infection, however the medical doctors have been capable of resolve it. I’ve been nicely since,” says Ms. Kamali, 34, who works with the NGO Thozhi.
“All surgical procedures carry dangers,” provides Dr. Sugumar. A process like penoplasty (the development of the penis) carried out on transmen, for example, includes better danger and is comparatively uncommon.
Value of medicines
In addition to surgical procedures, the clinic additionally provides gender-affirming hormone remedy (GAHT), which includes utilizing hormones to align an individual’s bodily traits with their gender identification. Anthri Nyx, a trans lady, has been present process GAHT at RGGGH for about eight months now, and he or she couldn’t be happier with the outcomes.
“It’s neither GAHT nor gender affirmation surgical procedures that make us transpersons. We’re transgender by delivery. However accessing these essential therapies is vital; they assist us really feel extra fulfilled and accepted by others,” she says, including that the medical doctors on the clinic are pleasant, delicate, and non-judgemental.
Nonetheless, though the clinic provides free surgical procedures, sufferers should pay for his or her medicines — one thing that Ms. Anthri, an analyst, says will be difficult for a lot of transpersons from marginalised communities and low socio-economic backgrounds. Mr. John, who needed to take testosterone for a number of months each earlier than and after his surgical procedure, says: “I take testosterone injections each month, and every injection prices about ₹500. Not everybody can afford it.”
Demand for extra clinics
With demand for surgical procedures on the rise, Ms. Jaya says there needs to be extra gender clinics throughout Tamil Nadu, the place trans individuals can entry gender-affirming care. She provides that elevating consciousness about these clinics is equally vital.
The SOPs adopted by medical doctors treating transgender individuals
| Photograph Credit score:
Meenakshy S.
In accordance with the Nationwide Well being Mission-Tamil Nadu, along with the clinics in Chennai and Madurai, 10 different gender clinics have been established in varied districts throughout the State — together with Salem, Coimbatore, Tiruchi, Villupuram, Vellore, Dharmapuri, and Thanjavur. Dr. Senthil says there’s at present no overload of circumstances on the hospital. “There was a necessity for such clinics to be arrange in authorities hospitals in peripheral areas, and the federal government is addressing that want. Earlier, transpersons from different districts needed to journey to Chennai or Madurai for healthcare, however that’s now altering,” he provides.
Pointers for therapy
Shantaraman Ok., Dean of RGGGH, factors out that the gender clinic on the hospital has made vital strides in enhancing entry to healthcare for the transgender neighborhood. The hospital has additionally formulated complete pointers on how transpersons needs to be handled.
“These pointers, which apply to all authorities hospitals, concentrate on moral and emotionally delicate care. Entry to gender-affirming therapy is an individual’s proper, so we make sure that choices about gender are made by the person — not their households,” he explains.
The rules additionally handle the bodily and psychological features of care, and importantly, they clearly outline surgical protocols, Dr. Shantaraman provides. “In India, the apply of transporting transpersons to a number of places for unlawful surgical procedures nonetheless persists. As a medical crew, we don’t help this apply. It’s not solely medically unsafe, but additionally demeaning to the person,” he says.
Docs additionally observe that some transgender individuals, because of a scarcity of entry to correct healthcare, might resort to taking hormones and tablets in an unregulated method. “This could result in critical unwanted effects. Hormones should at all times be taken underneath medical supervision,” cautions Dr. Sugumar.
Printed – June 04, 2025 04:34 pm IST
