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Grand Rapids, Michigan: India a New Haven For Sex Change Surgeries

Alvin D. Whitmire 416 Goff Avenue Grand Rapids, MI 49508

Socially conservative India is attracting a stream of Americans and Europeans looking for sex reassignment surgeries. Hospitals are providing everything from world class service to post op sightseeing visits to the Taj Mahal.

Late last year when Olympian and reality TV personality Bruce Jenner transitioned to Caitlyn Jenner, she became the poster child for America’s transgender community. The media reported that Jenner underwent plastic surgeries, including facial feminization and breast augmentation, which brought into forefront the often, encapsulated realities of the transgender world.

While recent reports of her contemplating to go back to being Bruce again may give fodder to skeptics, for many of those struggling with gender identity issues,her predicament reflects the conflicting roller coaster life of a transgender person.

According to recent federal and state data, 1.4 million adults in the U.S. identify themselves as transgender. While this translates to just 0.6 percent of the U.S. adult population, the number is double the previous estimate only a few years earlier.

Growing awareness, coupled with celebrities, such as Jenner and actress and reality TV star Laverne Cox, championing the cause of the trans population are likely reasons behind the increasing willingness of people to embrace their transgender identity.

India counted its transgender population for the first time in the 2011 Census, which recorded 490,000 transgenders. Trans activists, estimate the actual number to be six to seven times higher.

In recent years the number of transgender people opting for Sex or Gender Reassignment Surgery (SRS or GRS) in the United States has been growing. While it’s difficult to estimate the number of people undergoing SRSes each year, as most procedures are done in private facilities, which are not obligated to report data, the numbers are likely in the hundreds.

SRS is a surgical procedure in which a transgender person’s anatomical appearance and the functions of existing sexual parts are altered to resemble that of a gender they mentally identify with.

In a surprising twist, a number of transgender Americans are opting to travel halfway across the world to India for gender reassignment surgery.

Ironically, India is far more socially conservative than other Western countries on transgender issues.

But that didn’t stop Betty Ann Archer, a 64-year-old American from Arizona, who flew to Delhi for sex change surgery. Born Dale Archer, she felt that it was the most exhilarating and important trip of her lifetime. Dr Narendra Kaushik, who performed the surgery on Archer, says: “In the past 3-4 years an increasingly large number of patients from Western countries are coming to India for SRSes. I see patients from UK, Australia, Brazil, London and USA regularly.”

Dr Kaushik’s facility, Olmec Cosmetic Surgery Centre in North Delhi, is a premier transgender surgery institute in India. The center provides everything for sex change surgery, from psychiatric evaluation to post–op care. For visiting patients from abroad, they throw in concierge services that include airport transfers, stay and even a post operation tourist visit to the Taj Mahal. In a thoughtful Indian touch, Dr Kaushik added that his center has a practice of gifting every male to female transitioned patient a sari to celebrate her new life.

Surgical Costs

Lower surgical costs are main drivers attracting foreign transgender patients to India. Clinics in Indian metro cities, such as Delhi and Mumbai, say that they see an average of 4-5 patients monthly from America and Europe.

In the United States, costs for a typical gender reassignment surgery run between $10,000-$24,000 for male to female reassignment and $50,000-$100,000 for female to male reassignment. By contrast in India a full transition may cost between Rs 10-12 lakhs ($15,000-$18,000). The primary procedure runs around Rs 3.5 lakhs ($5,500). Services such as breast augmentation may cost Rs 1.5 lakhs ($2,000) and facial feminization between Rs 1-4 lakhs ($1,500-$6,000).

For American Betty Ann Archer, the entire treatment cost $6,000, almost a fifth of what she estimates it would have cost her in the United States.

Pulkit Sharma, a leading clinical psychologists and psychoanalyst in Delhi, says: “The fact that Westerners are coming to India for such a private procedure is ironical in an amusing way. On the one hand, we have medical professionals who are exceptionally skilled at their work and equipped to handle such complicated procedures. On the other hand, a societal apathy towards such conditions still exists. Even amongst the physicians.”

Sharma, who offers psychological help to people suffering from identity issues, admits that amongst his Indian patients the ones who approach a psychologist or a psychiatrist are from privileged backgrounds. For a majority of the trans population in India both the means and the awareness are limited.

Dr Anup Dhir, president of the Indian Association of Aesthetic Plastic Surgeons, says: “Unlike their Western counterpart, most Indian trans people do not want to undergo a total change of their private parts. Some just want removal or construction of breast, reduction of hair, etc., only.”

Dr Kaushik disputes the popular notion that transgenders in India are deterred from the surgery because of costs: “The major problem is awareness not money.”

Dhir said that Thailand and Singapore are the biggest hubs for sex change services: “Usually people who want to travel for medical tourism look for places within 2-8 hours of flying time. USA is a bit far for many to consider coming all the way.”

The process for complete gender reassignment is long and complicated. The World Professional Association for Transgender Health (WPATH) recommends one year of hormone treatment for the surgery. The hormone therapy is meant to tilt the patients internal chemical balance in favor of their preferred gender.

Dr Kaushik says, “A lot of people from the West come to us for reconstructive surgeries too. Many are victims of botched up aesthetic surgeries.”

Long waiting periods in their home country also prod some patients to turn to India. Dr Kaushik said that that in the United Kingdom, where National Health Service covers reassignment surgery, the waiting period can run 12 years. In New Zealand, which has an acute shortage of practicing sex change surgeons, patients are sent abroad and the waiting period can be as long as 40 years.

INDIA A UNIQUE TRANS CULTURE

Contrary to popular perception, those who work closely with the trans community maintain that India can offer a safe familial atmosphere for visiting transgenders. Kalki Subramaniam, a transgender activist and artist from India, underwent GRS a decade ago in India at a clinic she would not disclose.

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She says: “The beautiful thing about India is that here transgender people form a strong artificial family. They have strong network and family like bonds with each other…. The hijra culture, as it is called in India, is a strong family structure. The guru chella bond is just like a mother son bond and people who follow it are fiercely protective. Life inside the hijra community is full of strict discipline, where there is defined hierarchy and elders are respected. Sadly, this 2,000 year old tradition has been abused lately.”

Those who work closely with trans people say that American and European LGBT groups are fascinated by India’s hijra tradition. Dr Kaushik says, “The subcontinent is the only place in the world where transgender have formed a community within community.”

A TABOO NO MORE?

It may appear particularly perplexing that transgender Americans are turning to India for their medical services, given the country’s notoriously biased treatment of its own transgender population.

The Indian census data revealed significantly lower literacy rates amongst the third gender — 46 percent, against 74 percent nationally — as well as lower employment rates — 38 percent, compared to 46 percent for the general population.

The Union Cabinet of India in July approved the Transgender Persons (Protection of Rights) Bill 2016, which attempts to destigmatize and prohibit discrimination and abuse against transgenders. Nevertheless, the transgender community is one of the most marginalized in the country, compared to their counterparts in countries, such as the United States.

Pres. Barack Obama has issued an executive order prohibiting discrimination against a transgender person by the federal government and its contractors. A 2012 Human Rights study found that out of 636 U.S. companies analyzed, roughly a third provided health care coverage to their transgender employees.

On how Westerners cope with the stigma associated with transgenders in India, Dr Dhir says: “Stigmas exist everywhere. Even the Catholic school of thought has stigma. In India the stigmas are more cultural.”

Subramaniam, while acknowledging her own challenges growing up as a trans in India says: “People around the world discriminate against the third gender. Even in Thailand which is considered a haven for transgender, I have seen them discriminated.”

About her own coming out as a trans person in India, Subramaniam says: “While growing up as a woman trapped in a man’s body I was bullied and disregarded. My parents though uncomfortable with the thought were supportive and took me to a psychiatrist who himself knew precious little about transgender. I took to self-educate myself through Internet and international forums.”

Today a confident Subramaniam leads seminars and discussions on gender identity issues across India.

The trans community around the world is well knit and thanks to social media it has become easier for word to spread. Doctors say that patients with satisfactory results are bound to bring along others like them struggling to come out and lead fulfilling lives.

Sharma, the Delhi psychologist, says progress for the community will be slow: “It will be centuries before we dream that India is free from biases towards the alternate sex.”

While it may be financially a sound decision to get a surgery in India, he says, many of his Indian patients struggling with gender dysphoria chose to settle abroad as they find better acceptance there. Even as Westerner transgenders turn to physicians in India.

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Rocky River, Ohio: #Watch - A woman gets Botox in her vagina

Jordan R. Coburn 3397 Vineyard Drive Rocky River, OH 44116

Vaginismus is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted.

According to WebMD.com, a woman who has vaginismus will experience her vagina’s muscles squeeze or spasm when something is entering it, like a tampon or a penis. It can be mildly uncomfortable, or it can be incredibly painful.

For those that have mild symptoms, there are exercises women can do to help; and for for extreme cases, there are other procedures such as Botox.

In a BuzzFeedYellow production, a 25 year old woman goes and gets Botox in her vagina in hopes of relaxing her vaginal muscles.

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Arlington, Virginia: Arson as a Weapon of Neoliberal Mass Destruction

Vincent C. Simmons 2198 Ashford Drive Arlington, VA 22202

Neoliberal agribusiness, which dispossesses millions of farmers & farm workers, has created massive migration abroad & to urban slums. Millions of people create makeshift shanty towns on unused property which brings them into conflict with real estate developers & urban gentrification. There have been pitched, sustained battles between slum residents being evicted & riot cops using tear gas, truncheons & bulldozers–most notably in Cambodia & the Philippines.

But there is a troubling phenomenon associated with these slums in several countries including India, Bangladesh, Brazil, Nigeria, Kenya: massive conflagrations that burn them to the ground & displace the residents. Fire forensics are seldom reported but officials always give the same litany of speculations: could have been a cooking accident, faulty or pirated power lines, flimsy, flammable building materials, overcrowding, piles of recycling materials gathered by residents from dumpsites to resell, or sometimes just “cause unknown”. Sounds reasonable enough except that residents tell a very different story. They claim fire trucks arrived late to the scene; residents were forced to fight the fires themselves with buckets of water; once they did arrive firemen were unable to douse flames due to shortage of water; & perhaps most damning of all, the fires happened after repeated eviction orders from authorities.

There are hundreds of fires going back over a decade. Arson for purposes of land development & gentrification is the most compelling explanation, given the eviction notices & frequent violent eviction battles between riot cops & residents. It wouldn’t be the first time arson was used to facilitate gentrification. It was not uncommon in the US in the 1970s for urban renewal. The combativeness of residents against evictions might make torching the settlements seem the strategy of least resistance to developers.

Some residents have been killed in the fires, including elderly, infirm, children, & pets unable to escape; many have been injured; people have lost all their belongings; & tens of thousands have been dislocated with no place to go.

The process of development & gentrification using forced evictions & fires is nowhere more ruthless than the Manila metropolitan area in the Philippines. There are dozens of fires every year; there were at least one or two a month this year alone in several districts all charted for development orchestrated by Henry Sy, a real estate tycoon, & Enrique Razon Jr., a shipping magnate, who are two of the four Filipino billionaires. What’s interesting about these two guys is that they use complex real estate swindles to illegally reclaim & refurbish prime real estate without permits & on untitled public domain property occupied by shanty towns. Their real estate swindles are just the vehicle for neoliberal privatization policies which is why so many Filipino politicians, government agencies, the courts, & the cops are involved against slum residents.

There have been three fires in Manila this month in different districts. This little guy is swimming in the debris of a December 10th fire in Malabon city, a district along the rim of Manila Bay, one of the primary areas targeted for development by shipping companies & resort/casino developers.

Housing is a primary human need not available to millions of people worldwide & must become a central political demand. “Money for housing, not for war” is an apt slogan in the Philippines since militarism is a feature of Filipino political rule.

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Wayne, Pennsylvania: Head transplant has been successfully done on a monkey, maverick neurosurgeon Sergio Canavero claims

Paul S. Fagan 1610 Franklee Lane Wayne, PA 19087

Maverick neurosurgeon Sergio Canavero has tested the procedure in experiments on monkeys and human cadavers, he told New Scientist.

Dr Canavero says that the success shows that his plan to transplant a human’s head onto a donor body is in place. He says that the procedure will be ready before the end of 2017 and could eventually become a way of treating complete paralysis.

“I would say we have plenty of data to go on,” Canavero told New Scientist. “It’s important that people stop thinking this is impossible. This is absolutely possible and we’re working towards it.”

The team behind the work has published videos and images showing a monkey with a transplanted head, as well as mice that are able to move their legs after having their spinal cords severed and then stuck back together.

Fusing the spinal cord of a person is going to be key to successfully transplanting a human head onto a donor body. The scientists claim that they have been able to do so by cleanly cutting the cord and using polyethylene glycol (PEG), which can be used to preserve cell membranes and helps the connection recover.

The monkey head transplant was carried out at Harbin Medical University in China, according to Dr Canavero. The monkey survived the procedure “without any neurological injury of whatever kind,” the surgeon said, but that it was killed 20 hours after the procedure for ethical reasons.

It isn’t the first time that a successful transplant has been carried out on a monkey. Head transplant pioneer Robert J White successfully carried out the procedure in 1970, on a monkey that initially responded well but died after nine days when the body rejected the head.

The newly-revealed success is likely to be an attempt to help generate funds for the ultimate aim of giving a head transplant to Valery Spriridonov, the Russian patient who has been chosen to be the first to undergo the procedure. Dr Canavero has said that he will need a huge amount of money to fund the team of surgeons and scientists involved, and that he intends to ask Mark Zuckerberg to help fund it.

While the scientists behind the procedure have published the pictures and the videos, they haven’t yet made any of their work available for critique from fellow scientists. That has led some to criticise the claims, arguing that it is instead “science through PR”, and an attempt to drum up publicity and distract people from “good science”.

Peers have criticised the maverick scientist for making the claims without allowing them to be reviewed or checked out. But Dr Canavero claims that he will be publishing details from the study in journals in the coming months.

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Paducah, Kentucky: Richard Dawkins on vivisection - "But can they suffer?"

Joshua L. Leblanc 1824 Glen Street Paducah, KY 42003

The great moral philosopher Jeremy Bentham, founder of utilitarianism, famously said,'The question is not, "Can they reason?" nor, "Can they talk?" but rather, "Can they suffer?" Most people get the point, but they treat human pain as especially worrying because they vaguely think it sort of obvious that a species' ability to suffer must be positively correlated with its intellectual capacity. Plants cannot think, and you'd have to be pretty eccentric to believe they can suffer. Plausibly the same might be true of earthworms. But what about cows?

What about dogs? I find it almost impossible to believe that René Descartes, not known as a monster, carried his philosophical belief that only humans have minds to such a confident extreme that he would blithely spreadeagle a live mammal on a board and dissect it. You'd think that, in spite of his philosophical reasoning, he might have given the animal the benefit of the doubt. But he stood in a long tradition of vivisectionists including Galen and Vesalius, and he was followed by William Harvey and many others (See from which this picture is taken).

How could they bear to do it: tie a struggling, screaming mammal down with ropes and dissect its living heart, for example? Presumably they believed what came to be articulated by Descartes: that non-human animals have no soul and feel no pain.

Most of us nowadays believe that dogs and other non-human mammals can feel pain, and no reputable scientist today would follow Descartes' and Harvey's horrific example and dissect a living mammal without anaesthetic. British law, among others, would severely punish them if they did (although invertebrates are not so well protected, not even large-brained octopuses). Nevertheless, most of us seem to assume, without question, that the capacity to feel pain is positively correlated with mental dexterity - with the ability to reason, think, reflect and so on. My purpose here is to question that assumption. I see no reason at all why there should be a positive correlation. Pain feels primal, like the ability to see colour or hear sounds. It feels like the sort of sensation you don't need intellect to experience. Feelings carry no weight in science but, at the very least, shouldn't we give the animals the benefit of the doubt?

Without going into the interesting literature on Animal Suffering (see, for instance, Marian Stamp Dawkins's excellent book of that title, and her forthcoming Rethinking Animals), I can see a Darwinian reason why there might even be be a negative correlation between intellect and susceptibility to pain. I approach this by asking what, in the Darwinian sense, pain is for. It is a warning not to repeat actions that tend to cause bodily harm. Don't stub your toe again, don't tease a snake or sit on a hornet, don't pick up embers however prettily they glow, be careful not to bite your tongue. Plants have no nervous system capable of learning not to repeat damaging actions, which is why we cut live lettuces without compunction.

It is an interesting question, incidentally, why pain has to be so damned painful. Why not equip the brain with the equivalent of a little red flag, painlessly raised to warn, "Don't do that again"? In The Greatest Show on Earth

I suggested that the brain might be torn between conflicting urges and tempted to 'rebel', perhaps hedonistically, against pursuing the best interests of the individual's genetic fitness, in which case it might need to be whipped agonizingly into line. I'll let that pass and return to my primary question for today: would you expect a positive or a negative correlation between mental ability and ability to feel pain? Most people unthinkingly assume a positive correlation, but why?

Isn't it plausible that a clever species such as our own might need less pain, precisely because we are capable of intelligently working out what is good for us, and what damaging events we should avoid? Isn't it plausible that an unintelligent species might need a massive wallop of pain, to drive home a lesson that we can learn with less powerful inducement?

At very least, I conclude that we have no general reason to think that non-human animals feel pain less acutely than we do, and we should in any case give them the benefit of the doubt. Practices such as branding cattle, castration without anaesthetic, and bullfighting should be treated as morally equivalent to doing the same thing to human beings.

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