Nandana Suresh was numb when she heard about the suspected suicide of the transgender activist Ananya Kumari Alex, reportedly following a failed gender-affirmation surgery. Suresh told us she immediately thought back about her own botched gender-affirmation surgery, and how many others like her would have had to suffer the pain and other post-surgery complications that had plagued her for the past 20 months.
In 2019, Suresh underwent the surgery at Saravana hospital in Tamil Nadu’s Madurai city. For the next year, she struggled to urinate. We met Suresh at her partner’s residence in Mararikkulam village, in Kerala’s Alappuzha district, on the afternoon of 22 September. She had already changed her clothes twice that day due to bleeding, as she had to insert a catheter tube for urination a day before. “I had barley boiled in water to make urination smooth but still the quantity of urine was tiny,” Suresh said.
Suresh’s experience is common for transgender people in Kerala who underwent gender affirmation surgery in the state. While the state claims to help fund such surgeries, the transgender people are only reimbursed after the surgery, barely reducing the struggle for a community that has been economically marginalised. Trans-rights activist told us that the state does not offer such surgeries in government facilities and medical staff at government hospitals can be hostile to the needs of the community. The lack of guidelines or clear protocol has also meant that private hospitals can conduct such surgeries without the transgender person being prepared for the procedure or giving informed consent. This has led to several transgender people suffering severe medical complications following the surgery. Trans-rights activists argue that the issue is exacerbated by the Transgender Persons Act, 2019, because it makes surgeries a necessity to access welfare schemes meant for them, forcing many reluctant transgender people to undergo unsafe surgeries.