She Told Everyone How Painful Her Gender Confirmation Surgery Was. And Then She Died.

On July 20, Saadiya found out that Anannyah Kumari Alex had been found dead in her apartment. Kerala is considered India’s most educated state, and 28-year-old Alex was somewhat of a legend.

She was Kerala’s first transgender radio jockey, a professional makeup artist, a news anchor and, most recently, the state’s first transgender candidate for legislative assembly elections.

Days before her death, Alex told a media outlet called The Cue that she became a victim of “gross medical negligence” during her gender confirmation surgery in June 2020 at a private hospital called Renai Medicity. “My private part looks like a piece of meat,” she said in a video interview. “I want to conduct a resurgery. I want justice.”

The local police told state media that death by suicide is suspected. “More details can be told only after conducting a post-mortem,” a police official told The NewsMinute. 

But Alex’s friends, family and community members call it an “institutional murder.” “We’re waiting for the postmortem report and analysis from the police officials,” said Saadiya. “She had achieved so much and dedicated her life to equality and justice. But her surgery had made her body very weak. She was unable to function properly.”

Saadiya, who is Kerala’s first trans woman TV journalist, added that she herself got her gender confirmation surgery five years ago, but recovered in time. “Anannyah had to change her sanitary napkin at least eight times a day due to fluids and bleeding.” 

Alex had been speaking up about her gender confirmation surgery experience for several months, on social media and news outlets. In one news interview with the regional publication Mathrubhumi, Alex said the Renai Medicity doctors “slashed [her] body here and there”. 

In yet another interview, she said she couldn’t stand, sneeze, laugh, brush her teeth or even breathe properly. “The money for the surgeries are painstakingly made by many through sex work, pooling from here and there, and even begging,” she had said. “Why are marginalised people like us being attacked like this for money?”

India has The Transgender Persons (Protection of Rights) Act in its legal framework, but transgender activists and allied human rights groups say it still fails to protect them. There are nearly 500,000 transgender people among India’s population of 1.3 billion, and they face threats of sexual crimes, assault, blackmail, harassment and even murder. 

There have been past instances of botched gender confirmation surgery in India. Doctors’ malpractice often led to the survivors living with body dysphoria, pain from subsequent infections and side-effects, and extreme trauma. 

The day after Alex’s death, the LGBTQ community staged a protest outside Renai Medicity. The next day, July 22, hundreds gathered for her cremation service. 

The state’s health and social justice ministry ordered a probe into Alex’s death. Kerala’s health minister Veena George said in a press statement that her office is forming an expert committee “to study issues related with sex reassignment surgery.”

On Thursday, an autopsy was conducted by a two-member expert panel. The state’s Human Rights Commission has directed the district police to submit a final report within a month.

The LGBTQ organisation Queerythm told VICE World News that they filed two separate police complaints soon after news of Alex’s death surfaced – one was to stop gender confirmation surgery procedures at Renai Medicity hospital.

Prijith PK, the president of Queerythm, said Alex was the victim of “organised exploitation in the name of sex reassignment surgery.” 

“There are international protocols on treatment of transgender bodies, but cases like Alex’s show serious lapses and negligence in our country. There are financial interests in these surgeries, too,” Prijith told VICE World News. “This is why trans bodies are experiments for doctors.”

Many transgender people don’t speak up about medical negligence out of fear, he added. “But Anannyah did. And she became a martyr for the community. But we will fight to ensure she is the last,” Prijith said. 

Alex’s friends said she had also posted a photo of her vagina on social media to show people what she was talking about. “That was not sex reassignment surgery. That was the most tragic experience a trans person can live with. It’s a criminal offence,” said Prijith. 

Renai Medcity absolved its team of doctors who performed the surgery on Alex of any medical negligence. In an email statement to VICE World News, the private hospital said Alex’s “intestinal obstruction” is “a known sex reassignment surgery complication,” and she underwent the procedure and “weeks-long counselling” with her consent. 

“She was satisfied with the treatment at the time of discharge and complained only 6-7 months later about the surgically implanted body parts and some urinal problems,” the statement continued. 

Prijith said the hospital denied medical records to Alex and her father. “Their public relations officer, in fact, assaulted Alex when she went there to take her medical documents,” he said. 

“But she was always so hopeful and positive. Just a night before her death, she told me her future plans, that she wants to become a great news anchor,” said Saadiya. “The next day, in fact, she was supposed to come over to my place. The news of her death is a big shock. I don’t know what happened.”

Prijith said community members and allies are forming an action council. “We also submitted a series of proposals to issue a state treatment protocol and start sex reassignment surgery units in government hospitals, which can be more secure for trans people,” he said. 

“We will not rest until Anannyah gets justice,” he added. 

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