IMA White Paper on Trans Gender

IMA White Paper on Trans Gender

Dr A Marthanda Pillai National President IMA, Dr K K Aggarwal Honorary Secretary General IMA, Dr Jugal Kishore Professor of Community Medicine Maulana Azad Medical College, D A P Dubey Director Professor of Pediatrics Maulana Azad Medical College, Dr Raeev Sood, Professor and Head Urology RML Hospital, Dr Rashmi Sharma, Gynecologist and Dr Vanga Ashwita Siri, President IMA Students Wing, Delhi Chapter

1.        Transgender is the term used as an umbrella term for persons whose gender identity, gender expression or behavior does not conform to their biological sex.

2.         TG may also takes in persons who do not identify with their sex assigned at birth, which include Hijras/Eunuchs who describe themselves as “third gender” and they do not identify as either male or female. Hijras can be emasculated (castrated, nirvana) men, non-emasculated men (not castrated/akva/akka) and inter-sexed persons (hermaphrodites).

3.         TG also includes persons who intend to undergo Sex Re Assignment Surgery (SRS) or have undergone SRS to align their biological sex with their gender identity in order to become male or female. They are generally called transsexual persons.

4.         TG also includes persons who like to cross-dress in clothing of opposite gender, i.e transvestites.

5.         The gender symbols used should be M/F/TG ( some countries write 0 in place of TG)

6.         Transgender persons have a legal right to decide their self-identified gender. In situations where a TG person wants to choose the gender as male or female then it should be written in bracket ( declared sex)

7.         TG are in the category of socially and educationally backward classes of citizens and will be under reserved category for educational admissions and other government appointments.

8.         Governments should operate separate HIV Sero-survellance Centres since Hijras/ Transgenders face several sexual health issues

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9.         Medical Professionals should seriously address the problems being faced by Hijras/Transgenders such as fear, shame, gender dysphoria, social pressure, depression, suicidal tendencies, social stigma, etc. and any insistence for SRS (Sex ReAssignment Surgery )for declaring one’s gender is immoral and illegal.

10.     Medical establishments should take proper measures to provide medical care to TGs in the hospitals and also provide them separate public toilets and other facilities.

11.     Medical Profession should also take steps for framing various social welfare schemes for their betterment.

12.     Medical Profession should take steps to create public awareness so that TGs will feel that they are also part and parcel of the social life and be not treated as untouchables.

13.      Medical profession should also take measures to regain their respect and place in the society which once they enjoyed in our cultural and social life.

Definitions of some terms used

Hijras: Hijras are biological males who reject their ‘masculine’ identity in due course of time to identify either as women, or “not-men”, or “in-between man and woman”, or “neither man nor woman”.  There are regional variations in the use of terms referred to Hijras. For example, Kinnars (Delhi) and Aravanis (Tamil Nadu).

Eunuch: Eunuch refers to an emasculated male and intersexed to a person whose genitals are ambiguously male-like at birth, but this is discovered the child previously assigned to the male sex, would be recategorized as intesexexd – as a Hijra.

“Aravanis and ‘Thirunangi’ – Hijras in Tamil Nadu identify as “Aravani”.

Tamil Nadu Aravanigal Welfare Board, a state government’s initiative under the Department of Social Welfare defines Aravanis as biological males who self-identify themselves as a woman trapped in a male’s body.
Some Aravani activists want the public and media to use the term ‘Thirunangi’ to refer to Aravanis.

 Kothi
Kothis are a heterogeneous group. ‘Kothis’ can be described as biological males who show varying degrees of ‘femininity’ – which may be situational.
Some proportion of Kothis have bisexual behavior and get married to a woman. Some proportion of Hijra-identified people may also identify themselves as ‘Kothis’. But not all Kothi identified people identify themselves as transgender or Hijras.

Jogtas/Jogappas
Jogtas or Jogappas are those persons who are dedicated to and serve as a servant of goddess Renukha Devi (Yellamma) whose temples are present in Maharashtra and Karnataka.
‘Jogta’ refers to male servant of that Goddess and ‘Jogti’ refers to female servant (who is also sometimes referred to as ‘Devadasi’).

Sometimes, the term ‘Jogti Hijras’ is used to denote those male-to-female transgender persons who are devotees/servants of Goddess Renukha Devi and who are also in the Hijra communities. This term is used to differentiate them from ‘Jogtas’ who are heterosexuals and who may or may not dress in woman’s attire when they worship the Goddess. Also, that term differentiates them from ‘Jogtis’ who are biological females dedicated to the Goddess. However, ‘Jogti Hijras’ may refer to themselves as ‘Jogti’ (female pronoun) or Hijras, and even sometimes as ‘Jogtas’.

 Shiv-Shakthis
Shiv-Shakthis are considered as males who are possessed by or particularly close to a goddess and who have feminine gender expression. Occasionally, Shiv-Shakthis crossdress and use accessories and ornaments that are generally/socially meant for women. Most people in this community belong to lower socio-economic status and earn for their living as astrologers, soothsayers, and spiritual healers; some also seek alms.” (See Serena Nanda, Wadsworth Publishing Company, Second Edition (1999)