People suffering from disorders of sexual development should be treated with compassion and sensitivity-Tasnim Ahsan


DSD session during PES annual conference 2019
People suffering from disorders of
sexual development should be treated with 
compassion and sensitivity-Tasnim Ahsan
Experts ask for multi-disciplinary teams to raise 
capacity and optimize the care of these individuals

By Dr. Musarrat Riaz

KARACHI: Pakistan Endocrine Society arranged a special session specially focusing on the Disorders of Sexual development (DSD) and transgender care during the recently organized 17th Annual Conference in Karachi which was attended by a large number of Health care professionals. Emeritus Prof. Tasnim Ahsan, an eminent Endocrinologist and former Director of Jinnah Postgraduate Medical Centre (JPMC) who was the main person organizing this session shared her experiences and real-life cases of people suffering from these disorders and the plight of these individuals who suffer in silence as health care professionals are not properly trained to deal with these conditions.

She said that World Health Organization (WHO) no longer classifies gender identity disorders as psychiatric disorders. It is re classified as “Gender Incongruence” and is now classified under sexual health rather than Mental Disorders. It is our duty as health care providers to treat these people with compassion and sensitivity as they are no less of a human being than cisgender people. These are rare conditions in which a baby is born with both male and female reproductive organs and it is not always possible to assign the gender to the child at the time of birth. Stigma attached to these individuals with DSDs make their life miserable. Given equal opportunities these people are capable of leading a healthy and productive life just like cisgender people.

Pakistan Endocrine Society arranged a special session focusing on the Disorders of
Sexual Development (DSD) and transgender care during the recently organized 17th
Annual Conference in Karachi. It was addressed by Prof. Tasnim Ahsan, Dr. Tabinda
Dugal Prof. Iqbal Afridi Dr. Qasim Shah Dr. Shiraz Raza Dr. Atif Munir who 
photographed here with the mementoes which were presented to them at the
end of the session.

Dr. Tabinda Dugal, consultant endocrinologist from United Kingdom elaborated various causes of DSD and shared her experiences of treating these people in the setting of UK. She stated that endocrinologists can make a significant difference in the lives of these people by offering hormonal treatment, referring them for surgical procedures as well as providing psychological counselling with the help of a multidisciplinary team so that these people can lead a normal life.

Prof. Iqbal Afridi, a renowned Psychiatrist from JPMC in his presentation showed a recorded interview of a transgender person emphasizing the plight of these people and the problems they face in getting jobs, renting a house or availing health care facilities. Taking reference from Holy Quran and teachings of Islam, Dr. Afridi pointed out that Islam gives equal rights to every human being irrespective of cast, color creed or gender. These people need love and compassion as a human being as they are not responsible for the way they are born. He informed the gathering that Government of Pakistan has passed a law titled “Transgender persons (Protection of rights Act) 2018” to provide protection and rehabilitation to such people.

Dr. Qasim Shah, consultant Psychiatrist from UK shared his experiences of dealing with these individuals from UK perspective. He said that that people with DSDs and transgender people face similar problems in developing countries as well. Crimes against transgender people are on the rise in European countries also and they are not generally accepted in the society. Laws have now been passed in 2010 to protect the rights of these people.

Eminent Plastic surgeon Dr. Shiraz Raza from Lahore informed about the various surgical options available for the treatment of ambiguous genitalia and showed pictures of corrective surgeries that has been successfully performed in Pakistan. He said that still the law in Pakistan is not very clear about certain aspects of the management of DSDs and transgender people and is one of the reasons that surgeons are reluctant to operate on such people.

Dr. Atif Munir, consultant endocrinologist from Fatima Memorial Hospital Lahore elaborated the details of “Transgender persons (Protection of rights Act) 2018”. The Law clearly states that these people have equal rights of employment, health care facilities and should be considered equal to cisgender people in every way.

All the experts urged the authorities in Pakistan to establish special treatment centers at major public sector hospitals to provide physical and psychological treatment to people born with ambiguous genitalia and gender dysphoria.

To conclude Prof. Tasnim Ahsan read out the consensus statement of the “Pakistan Endocrine Society” which states that “We recognize that one in approximately 5,000 live births maybe an individual with DSD, but determining the prevalence of transgender individuals is difficult in Pakistan as these people are already living in the shadows because of societal attitudes and stigmatization”. The consensus statement further states that “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 multi-disciplinary teams in all provinces and raise capacity to optimize the care of these individuals.” “Doctors treating such patients, cannot be culpable for any untoward outcome, as long as guidelines for managing such individuals are followed” the consensus document further states.

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