The case for a third gender

The Star
by LOH FOON FONG and RASHVINJEET S. BEDI

Is there a need for a third category of gender for transsexuals?

ALL Win wants is to live a normal life.

From childhood to adulthood, he has had to endure countless taunts because of how he looks and acts.

“When I played with other kids in the park, they would call me bapuk or pondan,” says the 44-year-old transsexual, recalling the torment he went through, even at pre-school age.

Later, in an all-boys secondary school, Win avoided the canteen and toilets. “I was scared of being the butt of jokes. It was torture for me.”

Having experienced the discrimination, the health product executive says he understands why Mohd Ashraf Hafiz Abdul Aziz, who died on July 31 after a heart attack, had wanted to legally change his name.

After undergoing sex change in Thailand two years ago, Ashraf, 25, had applied to change his name to Aleesha Farhana but his application was rejected by the Terengganu High Court on July 18.

A day after his death, 17 NGOs called on the Government to have consultation with the transgender community who faces stigmatisation and discrimination.

Landmark case

Win, whose real name is Zaidi Zakaria, was legally recognised as Zareena Zakaria in Canada while studying there 20 years ago. Following a traumatic experience (he was raped at knifepoint), he was referred to a gender identity clinic in Toronto.

Two psychiatrists, a psychometrist, a psychologist, an endocrinologist and an internist carried out physical examinations and psychological tests on him and concluded that he suffered “gender dysphoria and appears to be transsexual”. (The American Psychological Association defines transgender as people whose gender identity or gender expression differs from birth sex. Transsexuals are transgendered people who live or wish to live full time as members of the gender opposite to their birth sex.)

Zaidi was told that if he wanted to pursue surgery through their clinic, he would need to live, study or obtain employment in the female role for a period of two years and change his documents to an unambiguous female name.

Win did not go through it due to legal and technical complications. But when he returned home, he was unable to find a proper job, despite having a degree, because of discrimination, he says. He ended up working either as a waitress or cashier for many years.

Win admits he has had relationships with men in the past but all left him when they got married or because he chose not to practise premarital sex, he says.

In April this year, the Pakistan Supreme Court made a landmark decision to allow an unspecified third category of gender for transsexuals. It also recommended that they be given opportunities in government jobs.

Sisters in Islam has described the court decision as a pragmatic one, made on the basis of social realities, compassion and humanitarian principles. However, it notes that concern may arise for transgendered persons who prefer to be identified as solely male or female.

Buddhist Research Society president Datuk Ang Choo Hong says that a third gender is in line with the early Buddhist scriptures that describe four types of gender male, female, male and female sex organs (upathobhajanaka) and no sex organs/sexless/eunuch (pandaka).

Nisha Ayub, coordinator of the Pink Triangle Foundation's Mak Nyah programme, highlights the problem transsexuals face at the Customs or airport.

“The passport says male' but the person looks female. The official will ask if the passport is fake,” says Nisha, who underwent sex change surgery a few years ago.

Kairos Research Centre director Dr Ng Kam Weng says the Pakistan court decision acknowledges a reality.

“If the purpose of the decision is to prevent discrimination in employment simply because they do not fit into male or female identity as traditionally understood, then I think it is a right decision,” he says.

Sexuality rights trainer Angela Kuga Thas says that while it is important to allow a change in the identity card because transsexuals look different from the gender stated on their identity cards, there is a need to indicate if a person has undergone sex change.

This is because transgender women have different health issues from women because of their different biological make-up.

Win, however, is not in favour of a third gender, saying he does not think it would remove discrimination.

Another transsexual, Hani, 27, hopes the government will allow male or female gender change in the identity card.

“I feel like a woman. I can't explain why I feel this way,” says Hani, who is in two minds on whether to pursue sex change if his gender cannot be changed in the identity card.

Universiti Pertahanan Nasional Professor of sociology and criminology Dr Teh Yik Koon, who has conducted research on Mak Nyah, says trangenders should be reassigned either as male or female. She too is not in favour of a third gender as she believes discrimination would still occur.

Win hopes the Government will set up a sexual change assessment centre. A person may want to undergo surgery not necessarily for sexual intercourse but to have the “right body” and to live a normal life, he says.

Dr Ng is in favour of a professional assessment mechanism.

“The Government should look at transsexuals sympathetically,” he says. “If the board says no' to the person assessed, then it should propose counselling. If the board says yes', then the Government should approve the change in the identity card.”

However, he draws the line at marriage for transgenders as the state must maintain heterosexual relationships for the perpetuation of society.

Association of Ulama secretary-general Dr Mohd Roslan Mohd Nor agrees that such a mechanism should be set up but stresses that sex change must be based on genetic or biological reasons.

He says that currently, only hermaphrodites (khunsa) are allowed sex change. In Malaysia, the National Fatwa Council allows sex change for khunsa wadhih (those with clear male and female sex organs at birth) and khunsa mushkil (those without clear male or female sex organs at birth).

With advice from the Health Ministry, the council has agreed to include ambiguous genitalia and testicular feminisation syndrome in the khunsa mushkil category, he adds.

UKM Medical Centre Department of Psychiatry head Prof Dr Hatta Sidi is calling on the government to have grants for studies in this area.

“We need religious and other relevant authorities to come out with some standard operating procedure. But a lot of insight research work must be done first,” he adds.

Dr Teh says that before a fatwa was issued in 1983, transsexuals could opt for sex-change operations and there was a panel that would interview and provide pre- and post-operation counselling for them.

“This should be brought back,” she suggests.

Society to be blamed?

Is transsexual orientation psychological, genetic or biological?

Universiti Kebangsaan Malaysia's health psychology unit head Assoc Prof Dr Alvin Ng Lai Oon says it is psychological, has some evidence of being biological but not necessarily genetic.

He adds that biological research points to the likelihood of sexual hormone levels before birth.

If society accepts a whole spectrum of femininity and masculinity for men and women as they are, will transgenders be less rejecting of the sex they are made?

Dr Alvin says he sees more guilt than confusion.

“Children come up with all kinds of defence mechanisms. Sometimes, making up a certain safe' identity may help but in the long run, the internal conflict eats them up inside. For many children, adults are always right, and guilt puts them at risk of depression.”

He says there is no harm accepting men who are feminine or women who are masculine for they pose no threat to society. In fact, there is more harm in rejecting them.

“As for need of sex change, it depends on the individual. Not all want to go for a sex change. Some are happy enough with partial change, some are just happy being transvestites,” he says.

Dr Alvin believes that discrimination will likely reduce if transgenders are allowed sex change but not completely, because for some, masculine features may still be present.

Dr Hatta says society is partly to blame for labelling and reinforcing the confusion in a child.

A transgender's behaviour, he believes, is acquired and multi-factorial, not innate. Research in the area of genetics and biology is inconclusive or cannot be replicated.

Dr Hatta, one of the experts consulted by the Department of Islamic Affairs in the Prime Minister's Department, says that as a psychiatrist, he does not judge trangenders or change them but counsels them for the problem presented.

Most transgenders who consulted him, he shares, do not want sex change.

“We also do not approach it as a sin because that can lead them into depression and suicide.”

Since Malaysians from various ethnicity and faiths emphasise compassion towards transgenders and believe that they must not be bullied or discriminated against, greater efforts must be made to stop the stigmatisation and discrimination.