Tuesday, July 08, 2008

Oh Men! Don't compete with women for motherhood!

The world is not any the less equal only because men and women are made differently, - the ways their biological differences make them think, look and behave. These differences themselves have assigned to them dissimilar roles to play in the society. So long as the physical prowess helped men dictate the primacy of their actions, they could claim superiority. But men are challenged in every field, in studies, in professional skills, in the study of science, in expressions through arts and what have you. However, men have always held their own in the arena of sports; women in the pride of bearing children. They never contested each other in these fields alongside but see now, a man has challenged womanhood even in the act of creation. Not just novelty this, but scary!

Thomas Beatie was born female, underwent surgery and took hormone treatment to become a male; kept her reproductive organs, got artificially inseminated by a donor sperm, became pregnant and has delivered of a baby on 29th July at Los Angeles. The baby is a girl, we are told, but wait till a decision is made if the child will remain as a girl or whether there will be a sex change. In reality, no one undergoes sex change for the fun of it. Cases of infants born with ambiguous genitalia are not common but nor are they rare. Ambiguous genitalia are physical anomalies in which the genitalia are not clearly identifiable as male or female. They are often detected at birth and are a sign of intersex. Of the 3 to 4 million children born annually in the United States, approximately 1 in 2000 are reportedly born with ambiguous external genitalia (thus approximately 1,500 to 2,000 such children yearly). Estimated 100-200 pediatric surgical sex reassignments are performed in the United States annually, mostly during infanthood. Official statistics are not available for India but it is believed, there are at least 10 lakh people in this category.

The case presents strange ethical questions. It just does not stop with what a man/woman wants to do with his/her body. (S)he lets his/her decision impinge on the psychological upbringing of the child, who has no scope for any form of participation in the decisional process. The child will have to grapple with the enigma whether the person who gave birth to her is her mother by the fact that she was delivered through her loins or a father because, he looks and carries his identity in the society only as a male. There is no clear cut medical opinion whether physicians should perform sex re-assignment surgery (SRS) on Infants with ambiguous genitalia. The American Academy of Pediatrics published guidelines supporting the view that such a child could be raised either as a male or a female depending on the nature of surgery to be performed in infanthood. This has also been strongly challenged by many academicians and even the consent obtained from parents for performing surgeries on children are contested on the grounds that practitioners obtain consent on 1) the false aura of urgency; 2) the failure to impart complete and accurate information; 3) the oppressive secrecy in which parents are advised to not discuss the situation with others and to particularly withhold all information from the child; 4)the failure of physicians to reveal the uncertainty of the outcome; and 5)the failure to account for the child's "right to an open future" in the decisional calculation.

Beatie made a conscious choice to live like a man, underwent a surgery and married a woman. He asked the surgeon to retain the ovaries and uterus. The doctor obliged. There are no laws to regulate this practice. Patient autonomy in India is never predominant and medical paternalism, leaving the doctor to decide what is best, gains normative acceptance. Perhaps, what Beatie did in USA will not be replicated among the Indian male or female, at least not in the near future and doctors in India would not have done what an American doctor chose to do or not to do. But follow the winds of change. There have been odd instances of transgender persons occupying positions of political power – Shabnam Mausi became Member of Parliament from Sohagpur in Madhya Pradesh in 2000 and Kamla Jaan was elected Mayor of Katni in Madhya Pradesh in 2000. In fact, in the case of Kamla Jaan, in August 2002 the Madhya Pradesh High Court invalidated her election on the grounds that a eunuch is “essentially male” and therefore cannot contest from a seat reserved for women. The court, in effect, did not recognise a person’s right to choose his or her gender identity. But traditional Hindu law and Muslim law accorded to them status to inherit the property and be a propositus to form a fresh stock of descent. The MP High Court might have committed an egregious error. The case is pending before the Supreme Court. In 2005, the Central government introduced a category ‘E’ in passport application forms where ‘E’ stands for eunuch. But transgender people are not satisfied with this. The better option would have been a ‘T’. They are sensitive to the stigma that words such as eunuch bear and do not want to be addressed thus.

In the past 10 years concern about the transgender community has become widespread owing to the fear of the spread of HIV/AIDS. Since the hijra/kothi community has been found to engage in sex work, numerous NGOs have mapped them as “vulnerable population” for HIV/AIDS intervention projects. In its 172nd report, the Law Commission, chaired by retired Justice Jeevan Reddy, recommended that Section 377 of the IPC be repealed. The recommendation, however, was made in the context of a redefined law on sexual assault to replace the old law on rape. The Department of Social Welfare in Tamil Nadu has passed a G.O. in December 2006 with recommendations to improve the living conditions of aravanis. The G.O. strongly favours counselling as a means to deter families from disowning a transgender child. It also recommends counselling for children with behaviour changes in schools, for which teachers need to be specially trained. The G.O. clarifies that there is no ban in admitting transgender persons in schools and colleges and that no discrimination should be shown against such persons on account of their sexual identity. The G.O., however, is yet to be implemented but the welfare board set up by the State promises an opportunity to put these steps into practice. An important recommendation made by the jury following the December 17 public hearing was that cases against transgender women must be handled by women police alone to avoid sexual harassment in police custody. The jury also recommended that transgender women be protected under the Tamil Nadu Prohibition of Eve-Teasing Act, 1998. It is also suggested that the Board of Film Certification should curb derogatory portrayal of the transgender community in movies and television serials.

All these initiatives, important as they are, shall not take the Indian community to tread the adventurism of their US counter-parts and doctors that spells disaster to off-springs’ psychological upbringing. Gillette blade tempts a man in an ad with ogling bevy of girls to signify what a smooth shave could help achieve. Don’t give in yet! Children will least doubt in whose laps they would want to be cradled. A man is just no competition to a woman for motherhood.

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