MUMBAI: After a long Covid-induced pause, Mumbai’s St George Hospital has resumed free sex reassignment surgeries, offering renewed hope to individuals seeking gender-affirming care. In the last six months alone, three patients have benefited, and more are now enrolling for the procedure.
“This isn’t just about surgery. It’s about restoring dignity, giving people the right to live as who they are,” said Dr Sagar Gundewar, head of the plastic surgery department, who revived the service post-pandemic. The department had remained non-functional during Covid-19 but is now actively treating patients from across Maharashtra.
The push for such services gained public momentum after the 2018 case of Lalita Salve, a police constable from Beed district, who received official permission for gender reassignment. Since then, awareness around gender-affirming care has grown, but access has remained largely unaffordable. Private hospitals charge anywhere between ₹15,00,000 and ₹20,00,000 for such procedures. At St George, however, they are provided free of cost. “We’ve seen a surge in demand. The need is real, and we’re proud to meet it,” said JJ Hospital dean Dr Ajay Bhandarwar.
Among those who have recently undergone surgery is Rakesh (name changed), who began identifying as a woman at the age of 16. “I used to cry seeing myself in the mirror. I didn’t feel like myself,” she said. After completing all psychological and hormonal evaluations in November 2024, she underwent surgery at St George. “Now, I feel complete. I can live as who I truly am,” said Rakesh, who now works in the private sector in Mumbai.
Another patient, Shreya (name changed), a 40-year-old woman from Nanded, was born with underdeveloped reproductive organs due to hormonal imbalances. Though married, she struggled with physical intimacy. Doctors at St George successfully developed the missing organs. “I never thought I’d live a normal married life. This changed everything,” she said.
The third case is Anamika (name changed) from Solapur, who has identified as male since childhood. “I’ve dressed and lived like a boy since I was nine,” she said. Despite family opposition, she proceeded with gender reassignment. Her breasts and uterus have now been removed, and she is preparing for the final phase—construction of male genitalia. “It’s not easy. But this is who I am. I’ve waited all my life for this,” she said.
Explaining the medical framework behind the surgeries, Dr Gundewar said, “We begin with a psychiatric evaluation. Once cleared, patients undergo hormone therapy—estrogen for male-to-female, testosterone for female-to-male transitions. After at least four months, they become eligible for surgery.”
He added, “In recent years, there has been a two-thirds increase in the number of people assigned male at birth transitioning to female, compared to a one-third increase in female-to-male transitions.”
The procedures are performed in multiple stages. “We remove the original sex organs, then reconstruct new ones. Facial, voice, and structural changes follow if required,” he said. Female-to-male transitions are especially complex, taking up to 16 hours of surgical time in total.
The science behind these transitions often stems from intersex conditions or gender dysphoria. While most males are born with XY chromosomes and females with XX ones, hormonal imbalances during foetal development can result in a mismatch between one’s biological sex and gender identity.
Dr Vinayak Sawardekar, medical superintendent, credited institutional support with reviving the service. “This facility was dormant for years. Today, we are giving people new lives,” he said.