Life Changing Operation at Mission Hospital: Boy identified as girl at birth regains male identity at age 17
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Life Changing Operation at Mission Hospital: Boy identified as girl at birth regains male identity at age 17

By N. Niranjan Nikam

He was never happy being a girl. But he was trapped in the girl’s body for seventeen long years. He never sulked or complained as he was getting a lot of attention from everyone because of his prowess in kabaddi. The bubble had to burst one day. The opponent girls’ teams started suspecting his strength and stamina as his kabaddi raiding skills were so good that the girls were hardly able to catch him even once…

Finally, the call came to his father in Mysuru to take him and check him for his sexual identity and see that he gets into the skin of a boy. That is how the boy, who was still identified as a girl, landed in the city all the way from Odisha.

His father Ashish Jena (name changed) luckily knew the right people and he was guided to the Mission Hospital where he met the Director Dr. J. Suguna Shanthi, who referred the patient to Chief of Surgery Department, Dr. Reuben Prakash. He saw the patient and asked the family to see Plastic Surgeon Dr. B. N. Jayaram, who has done a lot of sex change operations.

The tests were done and the ultra sound and MRI scan confirmed that the patient was pseudo-hermaphrodite, said Dr. Jayaram, speaking to Star of Mysore. “When he first came to see me I was surprised that he was so well-built for a 17-year-old, his chest was flat and he hardly had any female features. The only issue was he was squatting like a female to pass urine.” We did the surgical operation but it is not a sex change operation and he is now getting better and better every day responding to all the treatments, said Dr. Jayaram.

Meanwhile, Star of Mysore met the patient Alok Jena (name changed), who recalled his times as a student in a co-education school in Odisha. “I always felt that I was a boy but I was forced to be a girl. My life changed when I was selected to play for the school’s girls’ kabaddi team. I was a very good player. I was even selected for the Odisha Girls Junior Kabaddi team,” said Alok, whose earlier name as a girl was Taarini Jena (name changed).

Taarini was so good that she won 22 raiding awards and the Chief Minister of Odisha was so impressed with her skills that he even offered her a job in the army once she completed 18 years of age, said her father Ashish Jena, who works as a cook in Mysuru.

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His mother Rabani Jena (name changed) said that she never used to dress her daughter in girl’s clothes. Always she would dress Taarini in pant and shirt for some reason.

Taarini was staying with her coach and participating in kabaddi tournaments. As the cry for her ouster from the opponent teams grew louder, the coach called up Ashish Jena and told him to get his daughter checked for her gender identity. Taarini was brought to Mysuru and operated upon at the Mission Hospital.

Asked about the psychological problems he was facing now that he had transformed into a full-fledged boy, the smiling, handsome, Alok said that he was fully aware of the challenges he would be faced with once he goes back to Odisha to continue his eleventh standard.

The challenges start right from changing his name in the birth certificate from a girl to a boy. “Dr. Jayaram and the Director of Mission Hospital are very cooperative and they will give the required certificates for us to present it in Odisha to change the name of my son,” said father Ashish Jena.

Dr. J. Suguna Shanthi, Director, Mission Hospital, Mysuru.

Reconstructive Surgery

The reconstructive surgery done on Taarini (now Alok Jena) is called ‘Reconstruction of Developmental Anomaly of Male Genetalia,’ said Dr. Jayaram, speaking to Star of Mysore.

“The boy was born with undescended testes, a scrotal separation and a small phallus which was mistaken for a clitoris at birth. Hence, the nurse or the ayah who delivered him called him a girl. The parents accepted the baby as a girl and brought her up, until they discovered his developmental features which did not compare to the female features,” he said.

Taarini Jena was enrolled in a co-education school which declared him as a girl. He used to squat for peeing like a girl because his urethra was open behind the scrotum just in front of the anal opening and this was because there was no urinary passage into his penis. In the meantime, both his undescended testes descended. But the penis had not developed to normal size according to age, he said.

Explaining further, Dr. Jayaram said, “Certain hormones and enzymes are secreted at the right time. If they don’t properly secrete at the time of development of baby in the womb, this type of birth defects can happen. That is the reason why though Alok was genetically male, probably due to lack of secretion of hormones, he was identified as a girl.”

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“It was a three-and-a-half-hour operation reconstructing the urethra and I brought the scrotum sacs together and now it resembles that of a male. Now,  the patient is passing urine from the tip of the penis,” he said.

Asked whether the boy will have an erection, Dr. Jayaram said that the erection happens due to certain sponge structure which gets filled with blood and become turgid thereby causing erection of the penis. That tissue is deficient with the patient because of lack of this particular enzyme reductive.

The 5 alpha reductase deficiency is a condition that affects male sexual development before birth and during puberty. People with this condition are genetically male but with this condition it affects phallus development and that is exactly what happened with the patient. But why it happened we don’t know. However, he was trying to get Dihydrotestosterone which will help in the enlargement of penis, he said.

“If correct diagnosis had been done at the early stage of Alok’s life (when he was about five-years-old), proper hormonal and surgical treatment could have been provided to avoid the agony that this patient had to undergo at the teenage period because it is the most important time for sexual differentiation and development. It is the age (10 years to 15 years) when girls become girls and boys become boys. Hence, it is very important for the doctors and also parents to look carefully at a boy or a girl when one is born and identify the problem if there is any in the beginning itself,” he said.

“Unfortunately in my patient’s case he was never seen by a Paediatrician or a Family Physician and because the testes had not descended it looked like female genitalia. This condition is called Perineal Hypospadius Bifid (scrotum with undescended testes which looks like the labia of a woman). But now that we have done the reconstruction surgery, the boy is responding very well and the best thing is that he is one with a very positive attitude. I have asked him to continue playing kabaddi and even enter the Army,” said Dr. Jayaram.

Alok Jena, on his part, said that he is going back to Odisha and try to enter the State men’s kabaddi team and test his mettle as a male.

February 3, 2019

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