by Vaishnavi Sundar
Narendra Kaushik – a plastic surgeon who has made worldwide headlines for stating his intent to transplant a uterus into a trans-identified male – might just be the Indian Victor Frankenstein. Dr. Kaushik has several academic degrees to his name, all of which he undertook at Indian institutions between 1991 and 2014. Several websites advertise his medical experience to be somewhere between 16 – 20 years, but the exact duration isn’t clear. His purported affiliation with the Medical Council of India returns no result, but the Delhi Medical Council (which offers paid registration of Rs.2000) has his credentials certified until 2024. He founded his own Delhi-based practice ‘Olmec Healthcare centre’ in 2010. Along with his wife, he has two registered LLPs (Limited Liability Partnership), Olmec Healthcare and Olmec Pharmaceuticals. While his first LLP is active, the current status of Olmec Pharmaceuticals LLP is ‘Under Process Of Strike Off.’
In April 2019, he inaugurated a multi-storied hospital complex in the capital city. The building appears to have state of the art interiors, facilities and strangely the name (and designation) of Dr. Kaushik displayed on the building’s walls. Dr. Kaushik claims to offer a dizzying array of services. He calls ‘Olmec Healthcare’ a “premiere transgender surgery institute… the foremost supporting platform for transgender community for [the] last 14 years… the most trusted healthcare centre in India.” Unsurprisingly, he uses terminologies such as ‘assigned sex at birth’ across all platforms.
His popularity amongst transgender clientele seems to date back about 7-8 years based on social media posts. Several of these clients are foreigners, including a British man, Graham Pascoe, whose quest to ‘transform into Sue’ caught the attention of Indian media in 2015. In 2015 alone, Dr. Kaushik claims to have operated on 15 foreigners. The main reasons why foreigners pick India for their SRS are lower costs and a markedly reduced waiting time. Pascoe, for example, was given a waiting time of four years by the NHS, and he said financing it privately in the U.K. would have cost him £40,000. A 2015 article cited that “the procedure costs between Rs 7.5 lakh and 11 lakh in Thailand whereas in India you can get a new sexual identity starting Rs 3.5 lakh without compromising on the quality of treatment.” Since the demand for such procedures has risen exponentially in recent years, I imagine the cost has since gone up significantly.
India is turning into a ‘trans surgery’ hub, a reputation that was once unique to Thailand in Asia. Men and women from the US, Europe and even several African countries head over to India solely for sex change tourism. Ceasing upon the opportunity, several clinics have popped up in relatively small towns where (you’d think) there is little awareness about gender ideology. Dr. Kaushik is quite active on social media sites including Quora and Reddit, where he responds to questions posed by youngsters, elevating his status, and leading followers to his practice. Olmec also has a YouTube channel filled with saccharine testimonials about how amazing Dr. Kaushik is. When I made Dysphoric (a four-part documentary series available to watch for free), I used Dr. Kaushik’s social media posts to illustrate how several Indian surgeons actively promote surgical interventions by offering ‘packages’.
As previously mentioned, both his firms are partnerships with his wife Sunanda Kaushik. There is very little information about other colleagues on their website. There is him, and all other links leading to the ‘team’ or ‘staff’ are deadlinks. There is no mention of Ms. Kaushik anywhere either. However, after some digging online, I found that both Dr. and Ms. Kaushik are registered as WPATH (World Professional Association Of Transgender Health) members. Against Ms. Kaushik’s name on the site, other credentials include: “Counselling, Education, Electrolysis/Laser, Hospital/Practice Administration, LGBTQ Therapy, Social Work” and her educational qualification is listed as BA, MS.
Incidentally, Olmec Healthcare’s website contains a section called ‘required documents’ detailing a list of documents needed in order to proceed with any surgical intervention. These include basic information directed at foreigners to confirm identity, arrival information, letters from an endocrinologist as proof of being on HRT etc. Then there is this point (note: for a clinic of international repute, the accessibility of the website in terms of language and interface is below par. Clarifications within parenthesis are mine):
“Psychiatrist/ psychologist referral letter. In accordance with WPATH guidelines, we require one referral letter from your psychiatrist or psychologist from your home country, confirming that any form of GCS (Gender Confirmation Surgery) is the recommended form of treatment in your case. Should you have 2 referral letters from two different experts you are welcome to use them here in India, please just make sure that they are written in English. In case you have 1 referral letter from your home country, the 2. referral letter will be arranged for here in [the second referral letter will be arranged here in] Delhi, by our local experienced psychologist.”
It doesn’t say if the “local experienced psychologist” is Ms. Kaushik given that she is a WPATH member after all. If that is the case, Olmec has a great system in place! Membership of WPATH comes in a few categories; both husband and wife seem to have signed up for ‘Least Developed Country – full membership’ which costs $70 (US) per year. I rang the number given on their website pretending to enquire about a service. After a few tries, they started disconnecting my call. I needed someone to speak with me in English, and it seems, no one was available (I will update the piece if I establish further contact).
Uterus transplant as a procedure
About five years ago, a procedure, widely discussed in the media was that of a 26-year-old woman who underwent a uterine transplant by doctors at Galaxy Care Hospital in Pune. The process was to harvest the uterus from a donor and immediately transplant it into her body. It was considered the first such surgery of this kind to be performed in India. The patient was reported to have suffered from ‘Asherman syndrome’, a condition where the uterus becomes prone to damage due to curettage and other infections, affecting both menstruation and pregnancy. This woman not only had a successful organ transplant (of her mother’s uterus), about a year and a half into the surgery, she gave birth to a girl child through IVF.
A media report states:
“Fewer than 20 uterus transplants have been attempted around the world. In April , doctors in Saudi Arabia attempted the first uterus transplant on a 26-year-old woman. However, the uterus infarcted – that is, a part of the tissue went dead because of an obstruction in blood supply – and the uterus had to be removed. Almost a decade later, doctors in Turkey managed to successfully transplant a uterus harvested from a cadaver into a patient. However, despite several embryo transfers after the uterus transplant, the woman was unable to conceive a child. In 2013, a team of doctors headed by Dr Mats Brannstrom in Sweden conducted the first successful uterus transplant that led to a viable pregnancy. On September 4, 2014, the recipient of the uterus gave birth to a healthy child. Brannstrom and his team have performed nine uterine transplants of which two were not successful.”
How does this work in a male body when even a female body could be infected by such transplants? Furthermore, how does one successfully fit a uterus into a male body when even on a skeletal level it is not designed to accommodate one? WPATH lays out a ‘Standards of Care’ document, which is periodically updated (currently SOC8). The website states that SOC is a
“clinical guidance for health professionals to assist transgender and gender diverse people with safe and effective pathways to achieve lasting personal comfort with their gendered selves, and to maximize their overall health, psychological well-being, and self-fulfillment. This assistance may include primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services (e.g., counselling, psychotherapy), hormonal or surgical treatments among others.”
Unless implicitly tied to ‘reproductive options’, nowhere does it speak of organ transplant. In any case , there is the huge question of scientific efficacy, and the ethical quagmire to navigate while conducting such an experimental procedure. It is therefore imperative that policymakers lay down some ground rules, as opposed to letting someone attempt an impossibly dangerous, and no doubt unsuccessful surgery just because there is a willing participant. Isn’t the phrase ‘first, do no harm’ applicable across medical commitments of all kinds?
In an article, Dr. Kaushik said “Every transgender woman wants to be as female as possible,” And that includes being a mother. The way towards this is with a uterine transplant, the same as a kidney or any other transplant. This is the future. We cannot predict exactly when this will happen but it will happen very soon. We have our plans and we are very very optimistic about this.”
Only, it is not the same as any other transplant. According to Indian regulations, organ transplants fall under the Transplantation of Human Organs and Tissues Act 1994, and is limited to transplants for “therapeutic purposes.” For example, replacing a critical organ if it fails to function properly, or when an organ may have to be removed due to life threatening diseases such as cancer. Based on Dr. Kaushik’s proclamation, it is unclear whether this can be justified as ‘therapeutic purposes’.
Another way to look at this – since it is an organ concerning reproductive capabilities – is through the lens of assisted reproductive technologies (ARTs). And the two legal Acts that cover the procedures of such a transplant would be the Assisted Reproductive Technology (Regulation) Act 2021 and the Surrogacy (Regulation) Act 2021. While it is unclear if Dr. Kaushik plans to do IVF or gestational surrogacy (the only two permissible ARTs in India), neither of which includes ‘male masquerading as a woman’ as its recipient. The ART Act defines itself as “all techniques that attempt to obtain a pregnancy by handling the sperm or the oocyte outside the human body and transferring the gamete or the embryo into the reproductive system of a woman.”
Wombs for sale
The dire economic status of women in India is a well-known fact. I have written and spoken extensively about the ways in which women are exploited in this country. There seem to be players on either side of the victims. One, an all-powerful industry that profits from women’s bodies (including dead ones), second, a group of regular people (sometimes family members) who see her body as their only means of survival, and therefore push her towards the industry to realize it. This is true for child labour, prostitution, other forms of slavery, surrogacy etc.
Last year, discussion around commercial surrogacy hit the mainstream as lawmakers chose to prohibit it entirely. Previously, on several occasions, husbands have threatened wives to go through with it despite risks to her life, just so she can make some money. Though the legalities of surrogacy have been altered to eliminate monetary exchanges, experts believe the industry has merely gone underground. As with ‘woke’ attitudes towards surrogacy and prostitution, harvesting a woman’s uterus to be donated to a ‘man masquerading as a woman’ would soon fall within ‘choice’ feminism’s gambit. Women, even those who aren’t trans-identifying, will soon be coerced into donating their uteri. There isn’t an endpoint to how acutely women in this country can be exploited, and I speculate the worst with this new ‘womb transplant’ offshoot.
There is a steep rise in the number of women ‘transitioning’ in India, several of whom get a double mastectomy at the very least. There are online forums where discussions around finding an affordable doctor to do “bottom surgery” are normal. Given that testosterone causes atrophy, many trans-identifying females will require hysterectomies at some point. Others will elect to have a hysterectomy and salpingo-oophorectomy as part of their affirmation treatment. There is no record of how the removed organs are preserved/discarded. Knowing the levels of Indian bureaucracy, there won’t be explicit papers to clarify such information and you’ll have no choice but to just take the hospital’s word for it. What happens to all the uteri removed from young women who are transitioning? In their rush to get rid, surely, they aren’t going to worry about the careful disposal of what they consider a burden?
Though Dr. Kaushik claims he will attempt his impossible surgery using a dead donor or a female patient who has transitioned and had a hysterectomy; is there a way to really find out such details? Several states have made it entirely free for the trans-identifying population to get affirmation surgeries done at government hospitals. Private parties could potentially purchase removed organs from said hospitals because niche industries like cosmetic surgery have boomed with privatization. In 2017, the former head of the Indian Council of Medical Research said that the country doesn’t “have a committee to look into this specific form of transplants” – referring to transplants of the uterus within two females. Therefore, given that womb transplants – women to women – remain unregulated, who is to say that the boundaries for such surgeries cannot be expanded to include men? Furthermore, if such a procedure is deemed essential for a male’s ‘gender affirmation treatment’, will government hospitals expand their remit for free trans healthcare to include it?
In a 2021 paper titled ‘The Montreal Criteria and uterine transplants in transgender women’, Dr. Jacques Balayla, an obstetrician-gynecologist and clinician scientist at McGill University (and the lead author of the paper) said:
“A woman who is born without a uterus and a man who transitions into a woman because of gender dysphoria have a similar claim to maternity if we consider them to have equivalent rights to fulfill the reproductive potential of their gender (sic). And I think that we should… the time has arrived to advance a rights-based ethical framework for transgender women due to successes the medical community has achieved in recent years developing pregnancies, achieving safe births, and preventing graft rejection among uterus transplant recipients.”
If such a market is established in India, the demand will be not just from Indian men, but also from men abroad. As discussed before, the market will not be limited to trans-identifying females, and will expand to the rest of the female population. Men could essentially shop for wombs in India, and industries would have a field day at the expense of vulnerable women – while the woke ideologues continue championing the donors.
After my brief foray into all of this, I’m not sure how I feel about the industry of organ transplants in general. Much like several women online, I too have decided against organ donation when my time comes. This ideology has single-handedly wreaked havoc in women’s lives worldwide. It haunts me. And now it feels like the depths of Victor Frankenstein’s depravity is unravelling in our living rooms. Whether Dr. Kaushik will perform the surgery or not, the lives of women have never been more under threat.
I will leave you with one last caveat which sent a shockwave down my spine. I looked up ‘Olmec’ to find out if it was medical jargon. I can’t be sure of his intent behind the name. But, according to Wikipedia, the name ‘Olmec’ comes from the Nahuatl or Aztec word for the Olmecs. This word can be broken into two parts ōlli meaning natural rubber, and mēcatl meaning people.
Vaishnavi Sundar is a filmmaker, writer and women's rights activist. She has been advocating for women's sex-based rights through her films, her vlog channel and many of her published work. Vaishnavi is passionate about bringing to light the extent to which gender ideology has infiltrated India.
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