In Pakistan, a historic bill was passed in 2018 which allowed the perpetually marginalized community of Transgenders in Pakistan to list their chosen gender in official documents, be able to vote and even run an office. It is sad though that many popular media shows keep on using transgender attire as means of amusement and continue to make silly humiliating remarks for the Transgender community.
Traditionally, gender assignment at birth used to be done into either masculine or feminine based on the appearance of external genital organs. This classification can be deceptive at times. Sometimes the external appearance does not match with the internal genetic makeup and the internal organs can be other than the gender assigned at birth. This is true in the case of individuals who were unique in their development and find it difficult in later life to adjust with their perceived role as the true nature of their genetics unfolds in the form of delayed puberty.
Read more: Netflix sees backlash over Chappelle special’s transphobia
Unfortunately, nobody in our society empathises with such individuals who actually are different by birth from the masculine and feminine categories. This group of individuals was previously categorised as Intersex in medical terminologies but moving forward in an era of acceptance for varied sexual orientations we can include them broadly in the transgender population to avoid any hurtful feelings. The 2018 Pakistani Act with regards to the protection of rights also confirms the difference between Intersex and Transgender.
Interestingly, there is a new terminology known as Cis -gender
If you happen to fill out an application form to get a role in an international agency, they might ask you if you consider yourself, Cisor would you not like to mention your chosen gender? It also goes further to include or exclude your sexual orientation as LGBT( Lesbian, Gay, bisexual or transgender). The option of non-disclosure is always open!
A Cis male or female is a person who was assigned either male or female gender at birth in conformity with the traditional binary classification and that person is well adjusted in his or her role. There is an increasing number of individuals in the developed world who despite having spent some time of their lives as Cis decide to reverse their roles. They must go through a series of evaluations. The first step is to get the diagnosis of “Gender Dysphoria” from a Psychiatrist, which means that the individual is not happy with his or her assigned gender. Then they follow appointments at Gender identification clinics for ongoing discussions with Psychologists.
An Endocrinologist (A Doctor who deals with hormonal imbalance), manipulates their hormonal status by suppressing the natural and augmenting the desired cross hormones. Last step in their transformation can be the surgery to help them achieve their desired gender, although some may decide not to have surgery. As a result of all these interventions and complex surgeries to alter the outlook a Cis woman gets converted into a Trans male and a Cis male acquires the status of a Trans woman. They have the right to get a new medical file in accordance with their new role and it is their free will if they wish to mention their transformation process in it, otherwise, they can take a fresh start.
Read more: Rights of the transgender community: A need to do more?
I also came across a Trans woman at a clinic in North America
I called out the name of the next patient on the list which was Mary but instead, I saw a white male rising up from his chair in the waiting room and walking toward me. Initially, I thought he might be representing Mary on her behalf today, but when I asked him, “how may I help you today”? he started narrating his symptoms. He was seeking relief for his anxiety and mood disorders. He told me that he used to be Cis Male and fathered three kids. Then he had a bad divorce and he got depressed. He then reflected on his life events and realized that it was a time for a change, so he acquired a passive role, changed his name to Mary and considered himself the wife of John, his new Cis Male partner.
There are a variety of solutions to help such members of society to experience parenthood. They can get their sperms or eggs frozen before getting their gonads removed and use those eggs and sperms later if they wish to have kids. Same-sex couples can contribute either with sperms or eggs from one partner and get into a legal contract with a surrogate woman to host their baby in her womb.
In Pakistan, the scene is totally different. Almost all Transgenders are basically Intersex. Somehow all minors born as non-binary end up on roads for begging. In continuation of the Government’s efforts to uplift the status of this vulnerable segment of society, A national registry should be maintained. Birth of all babies with ambiguous genitalia should be reported, care and counseling provided to the parents and special clinics established for the follow-up of such cases. Those who get identified later in adolescence should receive Psychological support in addition to the medical appointments, corrective surgeries and the hormonal support needed to sustain them in the role most suited as per their unique genetic makeup.
Read more: Rights of Transgenders in Pakistan
The aim to include them as useful and respected members of society requires education and guidance. Institutions like hospitals, schools and factories owned by Government can provide jobs to these individuals where they can wear uniforms and maintain an attire in confirmation with their chosen role. This might help in getting acceptance in society. An effort should be made to erase the memory of a ‘Khawaja Sara ‘wearing shocking and bright makeup and ornaments. Media can play a role by providing a platform to Pakistani transgender society. They should be given opportunities to share how they struggled for recognition and respect. Such shows might be thought-provoking for other members of society who are yet to accept Intersex as a disability or medical disorder rather than a curse or stigma!
The author has done MBBS, MCPS, FCPS, MCCEE, and is a consultant Obstetrician & Gynecologist at Mega Medical Complex. The views expressed in the article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.