KOZHIKODE: For years, the path to gender-affirming surgery in Kerala has been fraught with insurmountable hurdles, including exorbitant costs and lack of specialised, accessible medical care. However, a new dawn is breaking for the transgender community and those who nurture dreams of transition.
In a historic move, the state government is establishing a dedicated Gender Reassignment Surgery (GRS) Unit at Kottayam Medical College Hospital (MCH). The pioneering initiative aims to offer a lifeline of hope, providing safe, affordable and compassionate care through the public healthcare system for the very first time in the state’s history.
“This is not just a medical project, it’s a social and ethical commitment,” said R Bindu, Higher Education and Social Justice Minister. “For far too long, our transgender citizens have been marginalised and denied the fundamental right to quality healthcare. The trauma faced by those seeking to align their physical bodies with their gender identity is immense, and it is our duty to alleviate that suffering. The new unit will be a beacon of hope, providing a safe space where they can receive care with dignity, respect and without the fear of judgment. We are not just building a hospital unit, we are building a more inclusive and empathetic society,” she said.
The initiative comes as a crucial response to the glaring gaps in transgender healthcare. Arjun P C, an executive board member of Queer Malabaris, hailed the move.
“Gender reassignment surgeries in private hospitals, which cost anywhere from Rs 2-Rs 5 lakh for male-to-female transition and Rs 4-Rs 8 lakh for female-to-male transition, can lead to crippling financial burden. The money doesn’t even include the extensive and essential costs of mandatory pre-surgery therapy and ongoing hormone treatments, which can add tens of thousands of rupees to the total. The new public unit will help remove the financial barriers and ensure none is left behind,” Arjun said.
There have been reports of botched gender reassignment surgeries leading to immense hardships to the transitioned individuals, and in some cases, prompting them to take extreme steps. Ananya Kumari Alex, Kerala’s first transgender radio jockey, ended her life in July 2021 due to an alleged botched surgery.
In January 2017, Sagar, 41, who underwent female-to-male transition at Thiruvananthapuram MCH and initially celebrated the procedure as a significant step forward, later claimed the procedure endangered his health, forcing him to sell his house and borrow money to cover the mounting expenses. He also alleged the doctors performed 13 surgeries on him, far exceeding the three typically required for sex change, causing immense physical and mental hardship.
To avoid such complications and guarantee the highest standard of care, the government plans to send a team of doctors from medical colleges across the state abroad for specialised training. This will equip them with the latest techniques in gender-affirming surgery and holistic transgender care, enabling them to build a multidisciplinary team capable of delivering world-class services within a government setting.
The GRS unit will be a cornerstone of a larger, more comprehensive approach to transgender healthcare. The project aligns with the work of a newly formed group of medical professionals, the ‘Pride in Practice Society,’ which is developing a detailed protocol for gender-affirming care. This protocol, created with inputs from both medical experts and members of the transgender community, will provide much-needed guidelines for healthcare providers, who currently operate without a standardised framework.
This holistic approach, which includes not only surgery but also pre-operative counseling and post-operative follow-up care, is crucial. As Arjun noted, a significant issue in the past has been a lack of proper post-operative care, leading to complications and infections. He believes a dedicated team of trained doctors will be better equipped to manage the issues, providing a sense of security and trust that has been missing for years.