Mumbai: What is holding back people from coming out before 18-20 years age?

The five years data given by Sion Hospital under an RTI points out that the cases of sex change operations majorly involve patients with psychiatric and gender identity dysphoria above 18 years of age.

According to the psychiatry doctor attached with Sion Hospital, many cases which come for diagnosis and treatment have gender identity issues since many years.

Dr Nilesh Shah, head of psychiatry department at Sion Hospital, said: "Due to social pressure and norms, not being independent since childhood, they tend to speak out only after they start getting independent after 18 to 20 years of age. We do get cases for a male to female and vice-versa surgeries, but most of them come for diagnosis. We cannot say that male to female sex-change operation is more in comparison to female to male sex change operation. Majority of them are from urban population, while few from rural parts. Social norms become an issue for them to open up about the problems at an earlier stage."

The recent case of Lalita Salve is one such example where Salve was raised as a woman by the family due to the gender confusion created by her medical condition. Salve will be undergoing a sex-reassignment surgery on Friday at St George Hospital in Fort.

In sex-reassignment surgery (SRS), the person's physical appearance and function of their existing sexual characteristics are altered to that of a similarly identified gender. It involves reshaping the genital parts of the body.