Irshad, Usama, Ali Madeeh Hashmi, and Irum Aamer. "Between a Rock and a Hard Place–Gender Dysphoria and Comorbid Depression in a Young, Low-Income, Pakistani Transgender Man." Cureus 12.9 (2020).
Abstract
Gender dysphoria (GD) describes an incongruence between a person's assigned and expressed gender and the distress associated with it. The management of GD ideally involves a team of healthcare professionals, including psychiatrists, endocrinologists, and surgeons, and may include one or more of the following - psychotherapy, hormone therapy, and gender reassignment surgeries. While Pakistan still has a sizeable population of the traditional 'khwaja siras' or 'hijras,' many young transgender Pakistanis are now adopting global transgender identities and seeking sex-reassignment procedures from a state-run healthcare system, which still heavily discriminates against them. In spite of the passage of a new law protecting the fundamental human rights of transgendered Pakistanis, they continue to be oppressed and deprived of education, employment, and healthcare. This case report describes one such young transman from a low-income Pakistani household, who, owing to the legal red tape, family pressure, religious disapproval, and hefty hospital expenses, is left with only two options - to undergo unsafe, unstandardized procedures at the hands of quacks or live the rest of his life trapped in the wrong body. There is a dire need for a wide-scale awareness campaign to educate and sensitize the general public about transgender rights. Medical students must also be exposed to transgender patients during their medical school training in order to familiarize them with the special medical needs of transgender individuals.
Conclusions
It is imperative to expose medical students to transgender individuals during the course of their education and to teach them about the unique physical and mental health needs of transgendered bodies. At the same time, serious discourse must also begin among Pakistani medical and legal experts, as well as human rights activists, about court requisitions for sex-reassignment surgeries and whether such a prerequisite negates the fundamental right of a capable, adult human being to be able to make decisions about their own body. There is a dire need for a wide-scale social awareness campaign on national television and print and social media in order to educate the general public about the discrimination, hatred, and violence traditionally faced by transgender individuals. At the same time, parents of transgender children must be educated about the importance of providing their children unconditional love and emotional support to help them grow into strong, independent individuals.
Keywords: gender dysphoria, transgender health, lgbtq health, gender identity disorder, pakistan, sex reassignment surgery