The Central Industrial Security Force (CISF) has sacked an employee for what they deem gender fraud. Swati (name changed) was training as a constable under the organization. It was during this time that doctors discovered that she did not have a uterus or fully-formed female sex organs. She was sent to the All India Institute of Medical Sciences (AIIMS) where further medical tests failed to prove she was a female.
Yet , Swati was brought up as a girl . The complete absence of menstruation did worry her mother a bit. Still , Swati led a fairly normal life, till now.
"The CISF unfairly sacked her saying she had applied as a "female" while her sex was male, but it was not her fault as she was not aware about her condition," urges a doctor treating Swati in the department of endocrinology, AIIMS. "We get at least a dozen such cases each year," he adds. At the AIIMS , Swati's genetic sex was defined as "46XY" (consistent with males).
"There is a complete absence of sex education in India. It is only when one reaches puberty that one begins to realize the difference in male and female bodies. So how can we expect poor Swati to realize what her problem was? And by the time she consulted a doctor, her sex was established as female, having appeared for higher secondary examinations as a female," says her doctor.
Swati was born to poor parents in Singipur village in the Ganjam district of Orissa. Her family did not realize she had under-developed genitals.
"This situation is not uncommon as we have patients coming to us as late as 13-14 years, but at that age it is difficult for the parents to come to terms with the real gender of the child. A child born to poor parents is often not brought to hospitals because of shame and social taboo," says Dr Yogesh Sarin, professor and head of Paediatric Surgery at the Maulana Azad Medical College.
"Swati is basically a man with genetic chromosome XY, just that the effective testosterone that gives the shape of a penis is not active. It is a matter of multiple surgeries after which she can lead a normal life," says Sarin.
As for Swati , she now wants to adopt a clear gender and undergo the necessary surgeries to become a man, and so get her CISF job back .
"Two years post-surgery, Swati should be given a fair chance to compete as a man at the CISF. Terminating her on grounds of gender ambiguity is completely unfair," says Sarin. "If that does not happen, eunuchs may force her to become part of their community," the doctor treating her , worries.
Swati's story is akin to that of athlete Santhi Soundarajan. Santhi was stripped of her medal at the Asian Games in Qatar after failing the medical test. She now leads a reclusive life and tried to commit suicide in September.
Intersex is a group of conditions where there is no commonality between the external genitals and the internal genitals ( i.e. testes and ovaries).
This group of conditions is also being called disorders of sex development (DSDs). There are four types of intersex. They include 46, XX Intersex , 46, XY Intersex , True Gonadal Intersex and Complex or Undetermined Intersex . In 46, XY Intersex the person has the chromosomes of a man, yet the external genitals are not completely formed, ambiguous, or clearly female. Internally, the testes may be normal, malformed, or absent.