Experts stress physical, psychological help for people with gender dysphoria

Patients facing disorders of sex development (DSD) and transgender people are not responsible for their predicament and deserve to be treated with compassion and love, as they are no less of a human being than cisgender people (whose gender identity matches the sex they are assigned at birth).

These statements were made by national and international experts while speaking at an international health conference on Sunday. They said that chromosomal abnormalities, hormonal imbalance and environmental factors sometimes result in DSD.

They also said that there are also the rare conditions in which a baby is born with both male and female reproductive organs, adding that in such cases, it is not always possible to tell right away whether the baby is a boy or a girl. In the past, DSD were given names such as intersex or hermaphroditism.

The experts said that stigma makes the lives of people with DSD miserable, adding that when enabled and not judged, they are capable of doing anything like the cisgender people.

They urged the authorities in Pakistan to establish special treatment centres at major public health facilities to provide physical and psychological treatment to people born with ambiguous genitalia and gender dysphoria.

The national and international experts were addressing the plenary session on ‘Disorders of Sexual Development and Transgender Care’ as part of the 17th Pakistan Endocrine Society Conference (PESCON-19) under way at a local hotel.

International endocrinologists and diabetologists from different countries of Europe, including the United Kingdom, Poland and Germany, as well as those of the Middle East and the Americas attended the conference and discussed the prevailing scenario in the field of endocrinology and diabetology.

Eminent endocrinologist and one of the organisers of PESCON-19, Prof Tasnim Ahsan read out the consensus statement of the Pakistan Endocrine Society: “We recognise that one in approximately 5,000 live births may be an individual with DSD, but determining the prevalence of transgender individuals is difficult in Pakistan, as these people are largely living in the shadows because of societal attitudes and stigmatisation.”

She said the World Health Organisation no longer classifies gender identity disorders as psychiatric disorders and they are now classed under sexual health rather than mental health.

The consensus statement also states: “There is a serious dearth of health care professionals and expertise to help these individuals in leading a fulfilling and happy life. We resolve to develop multidisciplinary teams in all provinces, and raise capacity to optimise the care of these individuals.

“Above all, we as members of a professional society and as individuals will try our best to inform and educate other professionals and lay people so as to remove societal stigma and enable these individuals to seek effective professional treatment with multidisciplinary input without being judged.”

Prof Iqbal Afridi, a renowned psychiatrist associated with the Jinnah Postgraduate Medical Centre, said Islam ensures equal rights and respect for all human beings without any discrimination based on sex, gender, colour, cast or creed. He added that Islam even ensures protection of rights of animals, so it cannot allow disrespect for a human being with confused identity.

“Our Prophet Muhammad (Peace Be Upon Him) treated transgender people with respect. He prohibited their ill-treatment and praised the spiritually-inclined transgender people,” he said, adding that even the Almighty says in the Holy Quran that it is He who “makes them both male and female”.

He informed the gathering that the Government of Pakistan has passed a law titled ‘Transgender Persons (Protection of Rights Act) 2018’ to provide relief, protection and rehabilitation to such people.

He said that society needs to change its opinion about these people, while the authorities should help them assimilate into society.

Distinguished endocrinologist from the UK, Dr Tabinda Dugal spoke about the causes of DSD. She said that endocrinologists should help such people by offering them endocrine or hormonal therapies, options of surgeries and psychological help to live a normal live.

Another psychiatrist from the UK, Dr Qasim Shah deplored the fact that hate crimes against transgender people are on the rise even in educated societies like the UK and other European countries. He called for helping them to live a normal life in society.

Prominent plastic surgeon Dr Sheraz Raza spoke on the surgical treatment of people with ambiguous genitalia. He said that clear laws should be made in Pakistan so that proper treatment can be offered to people facing DSD.

Dr Atif Munir also spoke on the occasion. Later, a memorandum of understanding was signed between the Pakistan Society of Internal Medicine and the Pakistan Endocrine Society for the standardisation of diabetes care and treatment in the country.