KOCHI: God created Adam and for his companionship Eve was created. Thus there were only two sexes in the universe. During the great floods, as described in the Old Testament, Noah was asked by God to select a male and a female from each species to enter the ‘Ark’. We now know that sex differentiation is on the basis of chromosomes in the cell. There are altogether 23 pairs where 22 pairs are called autosomal chromosomes and the 23rd pair called sex chromosomes are labelled as XX/XY. In females, the sex chromosomes are XX, and in males XY. Sometimes due to abnormalities in certain foetal enzymes responsible for the synthesis of male/female hormones, development of ambiguous genitalia occur, which make the differentiation of sex at birth difficult.
Rarely the presence of both testes and ovaries (ovotestis) may be detected in the same child (‘inter sex’ or true hermaphrodite). Sexual attraction towards the opposite sex is natural, but attraction towards the same sex is rare. Sexual attraction towards the same sex was considered as a mental disorder in previous years.
The Holy Bible
Old testament states that ‘God destroyed a town Sodom (Genesis 19.4) because of the sodomic attitude of the people living there. People with unnatural sexual attractions are called gays, lesbians or bisexuals. Males sexually attracted to males are called gays, females attracted to females are called lesbians. Individuals (males/females) attracted to same and opposite sex are called bisexuals. Same sex couples can now marry legally in 23 countries.
Discrimination
Discrimination and disparities are particularly acute for low TG people. In India, there are 4.8 lakhs tansgenders and in Kerala 25,000, Kerala is ranked 20th in the number of TGs among Indian states. In the US, there are approx. 1.4 million TG adults (2017) and TG teens amount to 150,000 (13 – 17 age group).
To help the LGBT group, a group of social activists, human rights people, politicians and doctors from all over the world assembled in Indonesia on Nov 6, 2006 and prepared a document ‘The Yogyakarta Principles’ and these principles are ratified by the UN Human Rights Commission. In India, the Indian Supreme Court judgment on April 14 2014 which gave them equal rights in voting, employment, education and representation in legislature. But the Transgender Protection Rights bills, 2016 is still pending in Parliament. This particular Bill guarantees the rights to self perceived gender identity and also proposed to establish a National Council for TGs.Now there are TG representatives in local bodies, legislative assemblies and human rights organizations.
Transgender sports competitions, beauty competitions and get togethers are being conducted under the auspicious of several TG organisations like Navodaya, Querela etc. Public and private companies are employing transgender people (Cochin Metro has employed 23 TGs). The Kerala Church Bishop’sCouncil in a meeting held in Trivandrum recently has promised to to initiate ‘welfare measures for TGs. The Kerala Govt. has recently issued identity cards to TGs in Trivandrum, and granted education scholarships to TG students.
Now transgenders have access to therapies depending on their gender identity. TGs can take hormone therapies for developing female or male physical characteristic – or surgery to correct their birth gender. These surgically corrected people are called ‘trans-sex’ individuals. Surgical methods include breast reconstruction, hysterectomy, vaginoplasty or phalloplasty and orchidectomy. The current treatment for gender dysphoria also include counseling.
The Diagnostic and Statistical Manual of Mental disorders (DSMM) uses the term ‘gender dysphoria’ (gender discontent) to describe the clinically significant stress that accompanies for the profound misalignment between gender identity and assigned sex at birth in TGs.
Although not universally accepted by the scientific community.
Possibilities of gene mutations in chromosomes 1 and 10 and biological changes in the cortex and subcortical regions of the brain at birth are attributed to this behavior.
The author is principal consultant in Medicine,S U T Hospital, Pattom, Trivandrum