A fact-finding report by the Justice for Anannyah State Action Council has recommended that a precise protocol based on international guidelines be framed for gender affirmative procedures in the State.

The fact-finding report is an attempt to get clarity on circumstances related to the death of Anannyah Kumari Alex, a transwoman, last year allegedly owing to post-gender affirmation surgery (commonly known as sex reassignment surgery) complications.

The report also recommends that the conditions of transgender community in the State be taken into account while drawing up the protocols. Special licence or certificate should be issued for surgeries based on the protocol. The government should also set the standard of care and ensure it is monitored.

Treatment methods

A proper framework will ensure that proper training, pre-and post-operative care, financial costs are regulated and monitored, say transgender persons. Those undergoing surgery will get a clear idea on the treatment methods available, what complications they can expect during surgery, what changes lie ahead post-surgery, and prepare for surgery accordingly.

As there are very few people with expertise in gender affirmation surgeries and gender affirmative procedures such as hormone therapy and counselling in the State, doctors, psychiatrists, psychologists, other health workers, and social workers should be trained in medical colleges outside the State that have expertise in such areas.

Interdisciplinary courses should be started for gaining more experience in transgender medicine. A team of different wings in transgender medicine such as psychiatry, endocrinology, and psychiatry should be formed at the district-level, and training be provided to them at the State level so they can provide comprehensive treatment.

Documenting experiences

Studies and research on gender assignment procedures should be taken up, and on its basis experiences at the transgender community level should be analysed. Experiences of those who have performed surgeries in private hospitals should be documented so that corrections can be made where needed.

Community resource centres and resource persons should be created within the transgender community to create awareness of gender assignment procedures among transgender persons, their families, government departments and the public and provide support to those who require it, say the recommendations.

‘No treatment records’

The report calls for a reinvestigation into the death of Anannyah, a transgender radio jockey and the State’s first transgender candidate to enter the Assembly poll fray, alleging lapses on the part of the police. Anannyah had undergone sex reassignment surgery and subsequently developed complications. She had spoken about her experience in detail.

As if the complications faced during surgery are not enough, treatment records are not provided by hospitals post-surgery. If not satisfied, transgender persons are unable to seek treatment in other facilities in the absence of records, the report points out. If an appellate authority is set up, such instances can be avoided.

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