Whe he gently taps on the glass jar, the goldfish leap toward him and then move away. He is careful with them. He points to a small motor to pump in oxygen.
“They would die otherwise,” he says.
“Mine died one night. Just like that,” I say.
“Only the goldfish understand,” he says.
He is a person in a half-half body, assigned a gender at birth that didn’t match with his soul. He was born a girl and over the years realised he didn’t feel like a woman at all. He is now 26 years old, and has reclaimed some of his gender through surgeries and hormone pills, gradually making the journey to becoming a man. There is still some way to go, and money is needed to reach the destination. His job as a real estate agent isn’t his best bet. By his calculations, if he were to save two-thirds of his salary, it would be another ten years before he would be able to get his body ‘fixed’.
He is without a past. He was born with another name, a girl’s name, but now has a male name. He does not want it revealed; we shall call him D. D is from Model Town in Delhi. Everything that indicated he was born a girl—old photos, the little pieces of jewellery his mother gifted him, the clothes—has been annihilated. “I was reborn the day I went to the hospital to get my breasts removed,” he says.
Besides the goldfish, he shares his tiny two-room flat with his mother, younger brother, an aunt and a cousin. They moved here a few years ago. He has no friends from the past. He likes to live in anonymity. We agree to meet somewhere in the city because he is careful about the truth.
He walks awkwardly, his feet parted, with a swagger. He is still trying to make order out of the chaos of his own body. He doesn’t like asking for help, he says. But at the last mile, he can’t give up.
“Can you help?” he asks me.
D struggled with his female organs for years; the scars that crisscross his back are proof of that. When he had been a girl, he had cut up his denims and sewed the cloth together to wrap around his chest and make the swell of his breasts invisible. The coarse fabric cut through his skin but he refused to remove it. He would rather suffer it than acknowledge the breasts. Three years ago, he decided to get a mastectomy done. The family advised him to think it through. They didn’t accompany him to hospital. He didn’t want them to.
That he was born a girl is not unusual. Many like him are trying to cross over, but access to sex reassignment surgeries (SRS) in India is limited. In 2008, Tamil Nadu became a pioneer, announcing that it would sponsor sex change surgeries—but only for males to become females. Female-to-male is a more difficult procedure. Doctors say the reconstruction of male organs is usually far from perfect, and the hormones have side-effects. Each time he injects himself with testosterone, D experiences mood swings.
Sex change comes at a great cost. In India, private hospitals charge up to Rs 2.5 lakh for it. But that’s if you find a genuine specialist. In India, only two integrated centres—Sitaram Bhartia Institute in Delhi and Kokilaben Dhirubhai Ambani Hospital in Mumbai—perform this procedure. They have a team of experts, including surgeons and a psychiatrist. But even this is no guarantee.
For instance, a man who approached Dr (Col) SV Kotwal of Sitaram Bhartia Hospital demanding a sex change was refused because he wasn’t suffering from Gender Identity Dysphoria (GID), a medical condition where a person experiences a mismatch between biological sex and gender identity. People often view GID as a birth defect, or as a lifestyle change. In developed countries, there are support groups to help friends and family members become aware of the condition. In India, there is nothing.
D worked odd jobs to collect money for his double mastectomy. He now needs to undergo a phalloplasty to reconstruct an artificial penis at the site of the vagina. With a monthly income of Rs 7,000, it will be many years before he can get a male organ. He has tried approaching NGOs for help but nothing has worked out. His mother understands, or so she pretends. She wants him to be happy. But with her job as a staff nurse at a private hospital, she can’t rescue him. “There is never enough money for anything,” she says.
Early in the morning at their house, she is busy cooking for her sons before leaving for work. At 8.30 am, she will report at the private clinic for an almost 12-hour-long shift. Overtime is important in their lives. She works seven days a week. In the last three years, she has only taken three days off when she was ill. “That’s no way to live,” says D.
“I was very happy when my daughter was born. I was 22 years old at the time. Her head was small, and she was so fair. She was fragile,” D’s mother says.
D’s father left them when the children were young. He was an abusive alcohol ic. He doesn’t know that his daughter has crossed over. He loved her long hair and combed it often when D was a teenager.
D announced he was a boy as he entered his teens. He started wearing pants, though that wasn’t so unusual. But when he came home after his Class 12 examinations, his mother was shocked—he had chopped off his hair.
“She said she wanted to be a boy,” D’s mother says. “I blame nobody but myself for this. I was always away. I would lock the house and go to work leaving her inside. While they were growing up, their father wasn’t around. I thought maybe that had something to do with his desire to be the man, to take care [of us].”
Sometimes, she has a slip of tongue and addresses her son by the name he was given at birth. All hell breaks loose. “Even I don’t recognise my son sometimes. If I were to see him in the market, I would not be so sure,” she says.
Apart from her family in Kerala, not many know she has a daughter who became a man. She is afraid of intolerance and ridicule. Some remember she had a daughter; others know she has two sons. She can’t help matters. “I tell God that he should take him away before I die. I don’t know what will happen to him after I am gone,” she says. D was born in Kerala, but his family moved to Delhi when he was still young. He has grown up a quintessential city person, battling crowds, making space for himself to live, to breathe, and to express. In his family’s small apartment, one room is shared by D, his younger brother, and their mother. In the other room, his aunt lives with her children. He went through the motions—playing cricket, hanging out with boys, all the while biding his time. “I thought when I turned 18, I would break free,” he says.
He waited a long time before he started to negotiate his freedom. It came in spurts. First, he cut his hair. Then, he decided to forgo college. Someone had told him about surgeries that could fix his body, and he took up a job at McDonald’s to start earning. At Rs 22 per hour, it was going to take a long while to save up enough to transform himself. A girl who became his confidante brought him a newspaper cutting with details of sex reassignment surgeries.
“I have been struggling. I can’t see myself in the mirror. It is like looking at a freak,” he says. “Who wants to be a freak?”
We are in a car. He is quiet for some time, then asks what if it had happened to me. “What if everyone called you Rahul or something? What if your reflection in the mirror was something you didn’t identify with?” He looks out of the window. We don’t talk for a few minutes. The long term effects of the hormones that D has been prescribed are unknown. The drugs make him irritable. He has a tendency to slip into depression and it often takes days for him to crawl out and live normally again. His mother is afraid of him. Her two sons don’t talk to each other.
She understood that her daughter was slowly turning into a man in 2009.
“I noticed she wasn’t menstruating.
She had never told us she was taking the pills but we could see the changes,” she says. Before his birthday in 2010, D took the definitive step of doing away with his breasts.
In 2012, in the classifieds section of a newspaper, tucked between matrimonials and old car sales, were the words: ‘…after sex reassignment surgery and this shall be valid for all legal and judicial purposes…’ It was the announcement of his name change. “I planned the surgery in a way that my rebirth happens around the time of my birthday,” he says. He has to take hormone injections every two weeks. The dosage will decrease, but it is a lifelong thing.
He is in love. He checks his phone frequently, showing me the photo of the girl. While he had been employed in a call centre, she had called for some work and they had started talking. They then met and liked each other. He even thought they could get married.
On his last birthday, she got him flowers, a watch, and candies. He shows off the watch. It is large on his wrist but he loves it, and wears it every day.
“That was my best birthday,” he says. “We went to a club. We danced. We had dinner.”
Not long after, he told her he used to be a woman. She stopped taking his calls. He is still wondering why it had to be this way. He had been honest. He could satisfy her sexually. He would not be able to help her conceive, but there were options for that—sperm donors, etcetera. He is still hoping she will come back.
“I love her,” he says. “I know she liked me. I didn’t want to feel anything, because that would mean more suffering. I wasn’t capable of love. My heart was.
My body wasn’t. I told her everything. She was crying. We met. I held her hand. But I knew it was going to end. That feeling when you know you can’t help anything.”
In the photo he shows me, she has her head on his shoulder—an attractive girl, with long hair and dark eyes. “I said I would need time,” he says. “I showed her videos of sex change operations. I kept saying it would be alright. But while I said all this, I was a two-body person. It is like I have lost control. Like I have lost the plot. By this age, people are settled. They think about a career. Here I am, fixing my basics. I am still trying to find myself.”
Dr Kotwal, who has performed more than 80 SRS, says science can help correct gender mismatch, but never erase it. Before every intervention, he tells his patients that they shouldn’t look for miracles. He will try his best, but perfection is an illusion. Those who come to him are also not looking for perfection, he says. They are looking to cross over.
He remembers one patient who wanted everything done in a single sitting. The operation, in 2007, lasted for 14 hours. When he regained consciousness, the patient was relieved. His girlfriend was standing next to him and they knew they had run the last mile.
I got in touch with that patient. He told me over the phone that his girlfriend’s family had tried forcing her to marry someone else. They were appalled by the idea that their daughter wanted to marry him. They had both dropped out of college and started working to collect money to get his SRS done. He came from a middle class family. His father had passed away, and he lived in his grandmother’s house with his aunts. He is estranged from his family now, having told them about his decision to change sex. His mother moved away and they didn’t talk for years.
He took up a small room, and started the process of reclamation. His mother passed away last year. He wishes he could have reconciled with her and seen her one last time, but he couldn’t. He says he is happy with his wife, who stood by him throughout. When they eloped, the girl’s family lodged a complaint and sent men to look for them. Now the couple have returned to live in Delhi. He has started a business and his wife has taken up a job at an NGO.
“I have hope that I will be able to produce a child, too,” he says.
Such happy endings are rare.
Dr Kotwal speaks of many instances where gay men, in an impulsive state of mind, have approached quacks and been operated upon. And such changes are irreversible. Many countries, such as Israel, Cuba, Brazil, and even Iran, provide SRS as part of the government’s health policy. In the United States, some insurance companies cover it and 36 universities have introduced SRS as part of their student insurance programs. In Iran, it is a way to address the problem of homosexuality. By assigning the other gender to gay men, the country is eliminating its gay population. There are many cases of gays transitioning in order to escape the government’s ire.
In India, it is still viewed as a lifestyle change. Dr Kotwal speaks of a recent instance when two women approached him. They were in the paramilitary forces and wrote to the authorities seeking permission for a sex change. Permission was granted—they are now undergoing training as male commandos.
Gender reassignment therapy is legal here, unlike in Pakistan where there are still cases of people who desire a sex change being imprisoned. However, India suffers from a lack of information. Even in medical institutions, there are no courses that teach surgeons SRS.
Dr Kotwal educated himself, following up with training and conferences abroad.
A petition on Change.org claims almost 40 per cent of transgender people in the US have attempted suicide. This figure was arrived at through a poll surveying over 7,000 transgenders. In India, there is a reluctance to even admit these issues exist.
“I don’t feel like killing myself anymore,” says a woman in a video that Dr Kotwal plays for me. She says earlier that she would wonder every morning whether she should be alive. In a pink blouse, with kohl-lined eyes, the woman narrates her journey from male to female. The video’s next sequence features a Muslim male who was born a woman. A smile stretches wide on his face. “I was reborn,” he says.
D says he is in that state before birth and death. “Ten years I have been trying to change,” he says. Every morning and evening, he goes to a temple and prays. Faith is an anchor, but it doesn’t always help. “I have cried a lot. Even now, when I bathe, I don’t look down. It scares me. I don’t remove my underwear while I shower. I am tired of controlling everything—emotions, desires. Surgery is my only hope,” he says.
We are quietly sipping our iced teas. Except for when he smiles while speaking about his lover, he is always sad. “I want to be myself. I have my own imagination. I want to be manly, masculine, complete,” he says. “I don’t want to live this hybrid life.”
That he wants to be in love, I understand. That he wants to be done with the trauma, I understand. In fact, I try and understand all of it. There are those that say people like D want to show only a certain side of themselves because they need money. I think I understand that as well.