Rajasthan teacher changes gender via surgery, marries student: What is sex reassignment procedure?

Love is love. And it is for this love that a transgender teacher in Rajasthan’s Bharatpur underwent sex reassignment surgery and then married his student.

The school teacher, who now identifies as Aarav Kuntal, said he had his final surgery in December 2021, reports news agency PTI. “I wanted to change my gender because I found it difficult to accept my body. I read a news article about gender change in 2010. Since then, I started searching for ways to change my gender and made up my mind to get surgery,” he told the news agency.

Kalpana, his wife, told ANI that she would have married Aarav, who was earlier known as Meera, even if he had not opted for surgery. “Meera was our physical education teacher at the school. I fell in love then. And three years ago, Meera changed her gender and now is Aarav. We got married after both our families consented to the match,” she told India Today.

What is sex reassignment surgery? What challenges does the transgender community in India face while opting for surgery? Let’s take a closer look.

What is sex reassignment surgery?

Sex reassignment surgery (SRS), also called gender affirmation or confirmation surgery, includes procedures to help people transition to the gender they identify themselves with.

People who opt for sex reassignment surgery experience gender dysphoria. “Gender dysphoria is the distress that occurs when your sex assigned at birth does not match your gender identity,” as per Cleveland Clinic website.

For male-to-female (MTF) transition, the surgeries include reducing Adam’s apple; augmenting breasts; penectomy (removal of the penis) and orchiectomy (removal of testicles); and feminizing genitoplasty (constructing a vagina and labia).

For transgender men– assigned female at birth – they may be required to undergo surgeries such as mastectomy or reduction of breast; oophorectomy (removal of ovaries) and hysterectomy (removal of the uterus); metoidioplasty, phalloplasty and scrotoplasty (construction of a penis and scrotum).

Surgery not the only option

For transgender persons, surgery is only one of the options. Hormone therapy (also known as hormone replacement therapy), puberty blockers and voice therapy are other alternatives that can be considered even if trans people do not go for surgery.

Hormone therapy increases masculine or feminine characteristics; puberty blockers stop people from going through puberty; while voice therapy includes altering your tone or voice or even learning communication skills like introducing oneself with their self-chosen pronouns, as per Cleveland Clinic.

SRS is one of the options for transgender persons. AFP (Representational Image)

After trans people undergo surgery, psychotherapy is recommended to help them in dealing with the changes to their bodies and new lifestyles.

Challenges of sex reassignment surgery in India

Besides stigma, trans people opting for gender affirmation surgery face the obstacle of exorbitant costs.

Depending on the surgery and hormone replacement therapies, the sex reassignment procedure can range anywhere from Rs 2 lakh to Rs 8 lakh. It also varies at different hospitals as well as the nature of surgery – from male to female, or female to male, reports IndiaSpend. 

Moreover, a year of therapy with a psychologist is mandatory before going for the surgery, notes The New Indian Express (TNIE). This comprises two to four sessions per month costing from Rs 1,000 to Rs 1,500 per session, which further enhances the expenditure.

Meanwhile, many avoid government hospitals because of the stigma and “lack of sensitivity”.

Dr Aqsa Shaikh, a medical professional and a transgender activist, said government hospitals need trained and sensitised staff as well as more employees.

“Because of the social stigma attached to the transgender community, there is a fear of not feeling comfortable in crowded places. Hence, it is not surprising that many of them prefer to go to clinics which provide privacy and prioritise their needs. This kind of environment is lacking in government hospitals,” she told TNIE. 

In August, the central government had extended the Ayushman Bharat scheme to transgender persons, making them eligible for annual health insurance of Rs 5 lakh.

To avail the scheme, transgender persons need to get their names included in the social justice ministry database or use their Aadhaar card, mentioning their gender, as per Indian Express.

Those who have a transgender certificate issued by the national portal for transgender persons can also benefit from the scheme.

India has over 4.8 lakh trans people, as per the 2011 Census. AP (Representational Image)

However, a mere two per cent of the 4.8 lakh transgender persons in India (official figure) have been issued the transgender certificate by the social justice ministry, Dr Shaikh told Indian Express.

“Even (if) others are able to get their cards, the challenge is that sex reassignment surgeries are not offered by many institutions, and there are very few trained plastic surgeons in the country,” she added.

Another challenge is that gender affirmation surgeries involve certain risks, warn experts. “Sex Reassignment Surgery in itself is a complicated surgery,” Neelam Singh, a Lucknow-based gynaecologist and director of NGO Vatsalya, was quoted as saying by IndiaSpend.

“When it is performed on a male reproductive organ to transform it into a female, or a female’s to be transformed into a male, a lot of precautions ought to be taken, provided the serious risk factors,” Singh added.

The absence of family support also acts as a deterrent for transgender persons wanting to undergo sex reassignment surgery, an expert told TNIE.

“People like us are abandoned by our families, and even if the lucky ones do have their family’s support, they do not get any financial help,” Rashmi, a transgender person, told IndiaSpend.

With inputs from agencies

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