Monday, February 22, 2016


I came across a few unusual  cases but as they are just one of a kind, I do not want to put them under cultural pathology. But they are definitely influenced/caused by the culture surrounding them.

Here are 2 which I recall.
One male, with 10th standard level of education was referred to psychiatry for assessment by surgeons of another hospital. He had approached that hospital asking for a sex change surgery and he had been referred to psychiatry to rule out psychiatric issues before they did surgery. I am not sure if the doctors would have gone ahead with the surgery if he had gone back to them. While interviewing this guy  about the reasons  for a sex change, he said he was the son of a farmer, he wanted employment in the police force and if he was a female he had better chances of getting the job as he had the required 'height' and had passed 10th standard! He had two criteria to get the job; now all he needed to do was be a female(because some quota of jobs are reserved for females; the females quota of jobs remain unfilled at times due to few women applying)
I explained to him that the sex change operation was not simple or something he could be done with in a day or a week, that there was a lot of cost involved even if the surgery was free (hormone treatments), that there was no guarantee that he will get the police constable's job if he had the surgery, that he will have to explain to his parents, that he will have to face his village folk, etc.
 He had not thought this whole thing through and had just impulsively hopped on a bus and come to Bangalore, gone to a hospital and landed with us! He left us and did not come again. I hope he has reached his village safely and got a job or is working on his parents farm.
Why do I link this to culture or the society around him? I am not sure if I am right but I think  that: (1) if getting a job for a villager in India was not so difficult,(2) if he had a better quality education,(3) if he had sensible people around him with whom he could have discussed this idea of his, he would not have ended coming to Bangalore for a sex change operation.

The second case is of one where a rural boy had been dressed as a girl by his family since childhood and he also sat in the girls side of the class. Around 7th standard, his family seemed to wake up and wanted him to start acting as a boy and dress like a boy but the boy refused. A similar case which again presented in the department of psychiatry was of a girl who had been dressed as a boy all her life and the parents wanted her to go back to being a girl when she was around 9th grade. What amazed me was that the kids got away in school. I always wondered how they got away while using the toilets in the school? I wondered about the relatives and neighbours who in the early days at least, would know the gender of the child and how could they ALL forget the gender of these kids over time?
In both cases, the parents had no satisfactory answers as to why they brought up the kids as the opposite gender.  I do know of many girls brought up as boys in Afghanistan so as to get education, go out in the city and work, go out to simply shop for vegetables. But these 2 kids were brought up as if they were the  opposite gender, studied alongside the opposite gender kids (a girl sitting with boys in class or a boy sitting with girls  is a very big deal in Indian villages) and were suddenly expected to change gender and behave and dress differently when the parents realized that 'the time had passed' and it was time for them to revert to their right gender. I do not know of what happened to these 2 cases too. Often, many villagers make one or two trips to the city hospitals and cannot afford to come for psychiatric treatment to the city regularly.

Dressing as the opposite gender is something I have seen often in India. I think there are many reasons why we Indians do that but none of the reasons seem very strong. Parents want to see how their baby boy looks in a frock, they dress him in that. and take a few photoes for posterity! They  dress a boy as Krishna and that involves a lot of girlie things like silk clothes, eye-liner, rouge on cheeks, Lip stick, peacock feather in hair, gold jewels for arms, waist, etc. And some parents address a beloved daughter as if she is a son and this continues all through their life. But I have seen this often, with no serious psychological or other consequences.

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