Living With Pride: Under The Third Gender And Their Struggles

The world understands that there are only two gender identities - male and female. When we speak about the third gender, ‘different’, ‘unnatural’, ‘not normal’, and such terms follow. With the little understanding of humans that even science has, we follow a rule that if someone does not fit into the definition of our ‘normal’, they cannot be a part of our society.

With our Living With Pride campaign, we bring to you stories from the LGBTQ+ community. This article is a small effort to talk about the third gender, break the stigma around it, and present readers with facts.

To provide you with credible information, we connected with Dr Chetna Jain, Director, Department of Obstetrics and Gynaecology, Cloudnine Group of Hospitals, Gurgaon.

In 2014, the Supreme Court of India recognised transgender people under the third gender. Apart from this, the broad classification of the third gender includes: True Hermaphrodites, Female Pseudohermaphrodites, Male Pseudohermaphrodites, and Klinefelter. Intersex is an interchangeable term for hermaphrodites.

Let’s learn about their anatomy

True Hermaphrodites

A person is referred to as a true hermaphrodite if they have both ovaries and testes. When a baby is born and a doctor’s examination points towards genital ambiguity, experts can run blood tests, MRIs, and other scans to verify the genital organs (gonads).

This can help parents to identify the sex of the baby. Dr Jain said that in most cases it is easier to remove testicles and perform surgery on male genitalia to convert it into a vagina (What Is Vaginismus) with clitoris.

If the baby has XX chromosomes, and they grow up to identify as female, they can consult a doctor, get the surgery done, and even bear kids if they wish to.

Dr Jain shared that there have been 11-12 cases where true intersex have given birth, but interestingly, all babies they birthed were males.

Female Pseudohermaphrodites

Female Pseudohermaphrodites are the ones whose internal reproductive organs are ovaries while the genitalia looks like a pseudo penis. Their chromosome composition is XX. Hence, if they want to get the surgery done in future and live as women, doctors can operate. In these cases, they will not require hormonal pills to do away with facial hair or other features that we associate with men.

Male Pseudohermaphrodites

Male Pseudohermaphrodites are the ones who have testes as reproductive organs, but their genitalia would like an enlarged clitoris. In such cases, if an adult wishes to go through with surgery, they would need the doctor to build a male genitalia. They will also not require hormonal therapy because their chromosome composition is XY.

Klinefelter

In the native language, Klinefelter is referred to as the hijra or kinnar community. During their birth, they have XXY chromosome composition. In ancient times when an attendant helped a mother to deliver the baby, they used to inform the community about the birth of the baby, and the child would grow up within the community never knowing the truth about their family.

However, if a baby is born in a hospital and the doctor notices ambiguity in genitalia, they will inform the parents. In such cases, experts will run scans to verify the internal reproductive organs. Depending on the results, parents can learn about the inclination of sex. When the kid grows up, they can decide whether they would like to go through with the surgery or not depending on their gender identity.

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Health Concerns Of Third Gender

In the case of female or male pseudohermaphrodites, they will have to consult a doctor first before indulging in intercourse. In many cases, a doctor also confirms if a baby has testes in the abdomen or if they have descended.

Dr Jain said since the temperature of the abdomen is high, it can leave the testes infertile if they remain there for more than a year or two. It also increases the chances of developing cancer. In such cases, most experts would perform the surgery to bring down the testes.

As we discussed in our previous article about Understanding Transgender People, Dr Jain said it is easier to remove testes and create a vagina than to create a fully-functioning penis. When a person undergoes surgery to become a female, they can bear a baby. If they do not have a uterus, a person can choose to go IVF and give birth to a child via surrogacy.

One of the major health concerns associated with genital ambiguity or sometimes defects are cardiac and spine problems. Therefore, it is crucial to get a baby checked thoroughly in case a doctor suspects ambiguity in genitalia.

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