Sex change a big, expensive business in Kenya

By Gatonye Gathura

The demand for gender change in Kenya is much higher than the public may imagine as recently explained by top medical doctors at Kenyatta National Hospital.

In the first documented scientific narrative of people born of undefined gender in Kenya, the experts tell of 30 cases within a decade at the referral facility alone.

But this they say may only be half the story since many children in Kenya are born outside of health facilities.

But because of increasing attention on LGBT issues the experts says doctors in the country are under pressure to provide answers and legal opinions to patients, activists and the public.

Telling of the ordeal of being born of undefined gender in Kenya ten experts, mainly university lecturers and surgeons, say the condition is a nightmare for patients, doctors and even families.

In the first place medical workers at Kenya National Hospital (KNH) do not even know what to call the condition.

“Proper terminology has not fully picked up at KNH and this creates difficulties in managing the individual conditions that make up the syndrome,” they write in the current issue of the East African Medical Journal.

But the medical fraternity has settled on the mouthful definition of Disorders of Sexual Differentiation or DSD.

In the first place gender change and even identification is an expensive process and most of the tests are not available in the country.

Even when the proper gender is identified a reassignment may be many years later as experts advise the patient be of mature age to contribute in the decision.

Of the 30 cases the team had studied, who have been treated for undefined gender at KNH from January 2003 to December 2013, three are still waiting for sex reassignment.

The experts say the problem is magnified by family and community demand that a child be assigned gender immediately after birth even where there are doubts.

The team now recommends that the allocation of a gender in a child born with indeterminate sex be withheld until investigations are concluded.

“This should be done as an emergency, and ideally the infant should be kept in hospital for the whole duration,” wrote the team led by K. D. Kihiko a lecturer and paediatric surgeon.

But the team agrees that the country lacks necessary legal framework to guide issues of undetermined gender conditions. The current trend in Kenya is to withhold any major reconstruction until much later when the patient can have a say.

“The paradigm is to do early diagnosis in the neonatal period, allocate a gender, but withhold any surgical procedures for later, especially those ones that drastically alter appearance.”

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