Tracing the evolution of male to female medical practices and their impact on Indian transwomen healthcare

The medicalisation of transgender identities has evolved from the pathologisation of gender identity disorder in earlier psychiatric manuals to the contemporary recognition of Gender Dysphoria. The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), played a pivotal role in defining Standards of Care (SOC) for male-to-female (MtoF) transition procedures. This paper examines the historical trajectory of MtoF medical transitions, tracing their influence on Indian transwomen’s healthcare policies, legal frameworks, and medical practices. By analysing global advancements in sex reassignment surgery (SRS) and their subsequent adoption within India, this study highlights how international medical and legal precedents have shaped Indian policies, including the NALSA (National Legal Services Authority) Judgment (2014) and ‘The Transgender Persons’ (Protection of Rights) Act (2019). The paper further explores the trajectory from Nirvana (ritualistic castration) to gender reassignment surgery and the role of organisations such as the Association for Transgender Health in India (ATHI) and events like IPATHCON 2019, and from SOC to ISOC in aligning Indian medical practices with global standards, thus creating a bridge between international developments and localised healthcare reforms.