As I sat impatiently outside the waiting room to see the doctor who would finally do my top surgery, I took a look around. The doctor’s clinic was behind a post office in Borivali West, Bombay. Dr Neeta Patel had a showcase full of honours for plastic surgery. I tried to focus on them to get my mind off a disturbing sight – a picture of Sai Baba that she had garlanded and in front of which rested a lit lamp.

I was accompanied by my mother and Annakutty, my partner at the time. It was a big moment for me. my mother, who had raised me and my brother singlehandedly, was with me as I prepared for a second birth of sorts, in a body closer to what I felt like I should have. When my mother left her marriage and walked out with her two young children, she had a job and some property that was handed down to her from a dominant shudra caste ancestry.

In hindsight, I wonder if it was the endogamous caste control over my body along with internalised transphobia that made me vacillate between whether or not I should medically transition to become a man. I went back and forth in my head for several years until the choice really became one between life and death. It took me more than two decades of loneliness to find other trans men. This was of course, before the internet.

When I started living with my brothers, I realised that though a lot of us wanted to transition medically, we had absolutely no idea about surgery, hormones or health care.

So, I began a search along with Annakutty, going to all the doctors who I had heard would do the surgery or prescribe hormones. We went to Gujarat, Delhi, Bombay and Tamil Nadu. Once, during this journey, the general compartment was so full, we decided to travel in the ladies’ compartment. I sat on the overhead luggage rack. Soon, men started getting into the compartment and taking over most of the space. A policeman came into the compartment and chased them all away. One man pointed up to me and said, “What about him?” The policeman grabbed me by the hair and dragged me down from the luggage rack.

Annakutty screamed that I was a woman to make him stop. I understood in hindsight that there was nothing else that Annakutty could have done in that moment of panic to protect me. But at the time, I didn’t know what was more humiliating, to be dragged down the way I was, or to be called a woman.

This experience, along with many others, made it clear that even without surgery and hormones, there were some public spaces i could not occupy without being at the receiving end of violence. So, for a lot of us, who have socially lived as men before we even knew of the possibility of gender affirming surgeries, it is more about the intense discomfort we feel in our own bodies than the idea of how you see us. And because these surgeries are performed by plastic surgeons, it makes others believe that these surgeries are optional when in fact they are an integral part of the right to life of trans people.

For those of us who desire surgery, it is not a brave choice, it is, most often, the only choice.

At the end of our trip, we had seen some non committal surgeons who wanted to make money, one sleazy surgeon, an experienced surgeon, one good endocrinologist and one good psychiatrist. Among them, there was only one woman. The rates quoted by all surgeons were on the higher side of Rs 50,000. My experience of having been sexually abused when I was 16 years old by a doctor during a minor surgery made me pick the woman surgeon. It was at her office that I was waiting.

The secretary, Meena, called me in. Dr Neeta smiled as we walked in. She slipped between “she” and “he” as she talked about me during the consultation. In my desperation to get the surgery done, I smiled weakly through a conversation that would have, in any other circumstances made me bare my fangs. She explained how the surgery would be done. “Each patient is a signature for me. You will have minimal scarring and be able to live as a man after this. Don’t worry,” she assured me.

For accessing hormone treatment, they require your mental health to be “assessed” and for two psychiatrists to certify you as having gender identity dysphoria (a lot of psychiatrists still write “gender identity disorder”). Depending on your psychiatrist, this could take any amount of time, in some cases, even years. We are left at the mercy of doctors who know very little about us.

In most cases, they try to convince us that we should continue to live in the same bodies, they warn us about the consequences of “sex change”. Among trans friends, I have heard of instances of electro shock therapies, house arrests, being chained to their bed posts, trans men being forcefully administered female hormones and marriage being prescribed as a “cure”. With no way to opt out of this oppressive medical system, I let them certify me as having a disorder. In fact, I pleaded with them to certify me, in order to become who I am today.

One of my major anxieties when I got onto hormones was how my mother would react to my physical changes.

I started looking more like the man she disliked from her past. Would she begin to see him in me more? I realised over time that she didn’t hate him as much as I thought she did. It was an impossible relationship due to many reasons, some within their control and some, outside of it.

As I masculinise over the years, I have come to realise that I have also become the child who cannot be “explained” to many. When you medically transition, the joke is over. The child can no longer be indulged as a tomboy, the “daughter’ will never get married and give you chubby grandchildren, you stumble when you say your kid’s name, when you use pronouns, slowly you avoid conversations about that child with friends and family, you panic when someone rings the bell when your child is at home, you cannot ask extended circles to open a few doors of opportunity for your kid.

Your erasure is written into family histories as blank spaces where your photograph once was. As someone who is convinced about the need to destroy caste networks, this erasure came as a relief to me. I have begun to understand the erasure as something that is propelled by caste respectability and shame. It must also be said that it is natural for people close to us to feel a sense of loss, to not know how to transition themselves.

Once, when I went home, I found my school uniform neatly folded up in my mother’s cupboard. I realised then, that even as she struggled to embrace the son I had become to her, she still mourned the loss of the daughter she once thought she had given birth to. I acknowledge the incredible support I have received over time from my loved ones in this journey.

My surgery date was given. November 23. The surgery was to happen in a tiny operation theatre behind Dr Neeta’s clinic. I arrived in the morning around 9 am and was made to change into a medical gown. I waited for two hours, trembling with fear and excitement before the anaesthetist came. The doctor came and did markings on my chest for the surgery. I was on the operation table. The last thing I remember was the colour of the nail polish on the anaesthetist’s fingers. A dirty shade of green. And the glass beads on the surgeon’s cap. Anaesthetised dreams I cannot recall now, followed for about 6 hours.

When I woke up it was late evening. I saw my mother through a haze. I badly wanted to pee but when I tried, I couldn’t. I was taken back in an auto to a place we had rented for 15 days. There were two plastic cans with fluids and blood on both sides of my chest. Drainage pipes. They would be removed after five days. The surgery was practically pain free and I was on the other side! I was happy. Well, almost.

I went back to remove the drains and dressings in five days. Dr Neeta removed the dressing on the left nipple and said, “Everything looks good”. Then she removed the one on the right side and said, “Oh! Oh!”

Alarm bells started ringing.

My heart was pounding against my newly operated chest. “The nipple graft doesn’t seem to be taking fully, but don’t worry. You will be fine,” she said. I looked in the mirror. There was only blood and flesh where my nipple and areola complex should have been. She told us not to panic and sent us back. Over the next few weeks, I watched in horror as both sides of my chest opened up and became craters of flesh and blood.

Dr Neeta said, ‘One other patient had the same issue. He was allergic to the sutures. We did a skin graft and he is fine.’ I knew the guy she was talking about. He came with his parents to visit me and showed me his chest. She seemed to have just about fixed it with a second operation, a skin graft (recently, I spoke to him again and learnt that he has undergone four surgeries with her since and his results are still not satisfactory!). I left Bombay on her advice that I should be back in a month for a second operation. I changed my dressings every day and waited for a month to pass.

Right before I went for the second surgery, I saw an angel kneel before Mother Mary and pray for me. It gave me hope at a time when i most needed it. That image is etched in my memory as one of unconditional love and faith.

After exactly a month, I went back for the second surgery. Same routine. Except this time I was not excited. She took skin from my thigh to reconstruct my chest. I left Bombay the next day on her advice. “This is not a major procedure. You will be fine. You can go home,” she said.

In a week, I saw my chest disintegrating again to form the same craters of flesh and blood. I lost all desire to live. All my life I had waited for that moment. Even before I knew it was possible to transition medically, I had waited for it. Years of self-hatred and bodily shame led me to this place. Years of binding so tight I could hardly breathe. I had finally convinced myself, a psychiatrist, taken hormones, looked for doctors, got my mother this far with me on my journey and I looked down at the body I had always wanted to see and saw nothing but broken dreams. Broken dreams inside a broken chest. How I wished during those times that I had a god I could believe in, complain to, blame, be angry with!

The next few months, as I plunged into the depths of despair, defeated by my body, Dr Neeta stopped taking my calls.

She stopped responding to my messages and mails. I realised that I had been taken for a ride by a doctor who had no idea what she was doing. A doctor who was propelled more by her greed to make money than providing health care. Over the next few months, I got in touch with all the men who had gone to her for surgery and learnt that many had complications. They do not want to tell their story. And understandably so.

Soon after my experience, I put out a warning for trans men about this doctor. Let this story also be one such warning to more men who come after me. I do not for a second regret the decision to undergo the surgery, I only regret the surgeon I went to. Since then, better and cheaper resources for trans men have been located.

Last month, I am happy to say, the sixth man from our close circle in Bangalore successfully underwent an affordable operation at Victoria Hospital. All men except for one out of the six are from historically oppressed castes. All are working class men who left their families when they were young. I am convinced that before we leave this world, things will be better for younger men who come after us. We will work hard to make sure they are.

Gee Imaan Semmalar is a theatre actor, writer, filmmaker and co-founder of Panmai Theatre, Chennai.

Excerpted with permission from ‘Emperor Penguins’ by Gee Imaan Semmalar, from A Life In Trans Activism, A Revathi, as told in the original Tamil and translated by Nandini Murali, Zubaan Books.