This document discusses several case reports of female-to-male transgenders in India and the challenges they face. It describes families' reluctance to accept their transgender children and the psychological distress it can cause. It also outlines medical transition options for female-to-male transgenders like testosterone therapy, mastectomy, and hysterectomy. Issues at various life stages and concerns about social and legal gender recognition are also summarized.

1. Female to Male Transgenders
Psychosocial and Family issues

3. Case report1
• Ms.D has always dressed in male attire. Now she
is 25.Her family from south side town want her to
get married.
• She has told them that she wants to become
male. They were shocked. They have to take her
to her psychiatrist. The psychiatrist asked the
family to accept the decision of Ms.D.
• They changed the psychiatrist. They found
another psychiatrist who can counsel the patient
to give up her fantasies and stay male.

4. • Ms D s family are stubborn that they cant
allow sex change.
• The patients wants to commit suicide.she is
educated and was working in a software
company before this issue.

6. Case report2
• Ms.A was born as female but always dresssed
like a boy from the city.
• From 17 years she started telling her parents
and wants their consent for sex change.
• Their parents are reluctant but not fully
opposing.
• Slowly Ms.A convinces her parents about her
wish and they finally agreed after several
months of counseling.

8. Case report3
• Ms F is from a small town in north tamilnadu.she
was born as female but believed she was
male.When she expressed this to her family when
he was 18.She was taken to psychiatrist In Kerala
and was given antipsychotics and even ECT was
given.8 years after this the family has left her to
decide her life. But now she developed feeling
like female and gets attracted to males. She is
ashamed about this change and seeks help regain
her masculine feelings

10. Societal aversion

11. Families’Reactions
• Most families do not accept gender-
nonconforming behavior in their children, which
may manifest as early as three to five years of
age. For many parents, the news that their child
is transgender or gender non-conforming can
bring an array of emotions along with it: some
feel sad, fearful and disappointed while others
feel shocked, angry and upset. Very few are
willing to support their loved ones without trying
to make them change.

12. • Parents may threaten, scold or even assault
their female child for behaving like a boy. They
may have several reasons for doing so:
• fear that a gender-nonconforming child will
bring disgrace and shame to the family,
apprehension that their child will not marry,
perpetuate the family line and/or discharge
family responsibilities

14. Differences from mtf

15. Transsexualism
• An obession to belong to opposite sex which is
practically not reversible by psychological or
other medical treatment

16. Hermaphroditism
• Congenital condition of ambiguity of
reproductive structures so that sex of the
individual is not clearly defined such as
exclusively male or female .

18. Transgender
• Those who identify with a gender different
from the one they were born with

19. Transvestism
• The act of dressing in clothing of opposite sex
usually attributed to psychological compulsion

20. Gender Dysphoria
• Gender Dysphoria – This is a fundamental
unease and dissatisfaction with the biological
sex one is born with which results in anxiety,
depression, restlessness, and other
symptoms. The dysphoria often acts as a
catalyst to change one’s body and gender
expression (how one presents to the world) to
be more in keeping with what is felt to be
one’s gender identity (the gender that one
feels oneself to be).

22. Is it really possible to turn a woman
into a man?

23. Testo sterone Therapy
• Height
• Facial hair
• Adams apple
• Body hair
• Androgenic baldness

24. Testosterone and Quality of Life
• Analysis of quality of life health concepts
demonstrated statistically significant (p<0.01)
diminished quality of life among the FTM
transgender participants as compared to the
US male and female population, particularly in
regard to mental health. FTM transgender
participants who received testosterone (67%)
reported statistically significant higher quality
of life scores (p<0.01) than those who had not
received hormone therapy.

25. Sex Reassignment surgery
• Mastectomy
• Hysterectomy

27. Is it possible for F.T.M. transsexuals to
have children?

28. Is FTM a form of mental illness?
• F.T.M." is an abbreviation for "female-to-male"
transsexual, in other words, women who
undergo the medical and legal procedures
necessary to become men. "F.T.M." refers to
people who are female by birth but who have
male or masculine identities or appearances,
which can include tomboys, butches, drag
kings, gender benders, transsexuals,
transgenderists, intersexuals, and other forms
of gender expression.

30. Facebook 56 genders

31. Websites
• www.transguys.com

32. Ngos
• Sahodhari foundation

33. Marriage

34. Name Change

35. Passport
• Gender-sensitivity within the Indian
bureaucracy has taken a small step, with
eunuchs being given the option to enter their
sex as 'E' instead of either 'M' or 'F' in
passport application forms on the Net

37. Decisions
• Making decisions about transitioning, what level to
transition to, or whether to attempt any transition at
all are complicated decisions and require time and
support.
• There are fears of how one will be accepted by family
(parents, partners, children, grandparents and others),
friends, colleges, fellow students, church groups, etc..
• There can be anxiety about ‘passing’ or how convincing
one will be to others as a man or woman (i.e. whether
or not one will be “read” as transgender).

39. Puberty
• This is a particularly hard age, since the body
begins to change and adapt gender specific
features (breasts, changes in genitals, menses,
etc..). Transgender individuals have reported
“I was disgusted by (hair, breasts…etc)”.

41. Early Adulthood –
• With emotional and financial independence
some people feel free to begin to address
transgender issues at this age and look into
transitioning. However, some are not as free
to do so, due to family and other obligations,
or due to lack of information and access to
services.

43. Later Adulthood –
• Some transgender individuals put off
transitioning until later in life when they feel
able to do so. This can be satisfying, but can
also have the disadvantage of producing a
less convincing outcome. In addition there
can be regret about having lived so long in an
unwanted gender. Friends and family may
have a harder time understanding what is
happening since they knew the person for so
long in their natal gender.

45. Transitioning –
• For those transgender individuals who decide to transition (to
present and live in the other sex outwardly), these
emotional/psychological issues may come up:
• Fears about finding a partner
• Impact on family relationships with parents, children, partners and
other relatives
• Impact of relationships at work and with friends.
• Fears about violence and prejudice when one is read as
transgender.
• Feelings about having to experience surgeries, hormones, (and for
MTF transsexuals) facial hair removal and voice changes.
• Frustration of having to change or explain legal documents (drivers
license, passport, titles to property, diplomas, etc)

47. Post transition issues
• – Some issues that may arise include:
• Disappointment that transitioning didn’t solve
all problems.
• Level of satisfaction with appearance
• Level of satisfaction with any surgeries
• Emotional issues that were not addressed
before.
•

49. Contact me
• Thank You
• Dr.V.Jaikumar
• 9841707437
• maildrjai@rediffmail.com
• Jaikumar Velayudham in FB
• 9941241507-whatsapp