Cost of surgery limits options for child diagnosed with ambiguous genitalia
After Pakeeza Bibi turned 3, it became clear her body had not caught up with her outward appearance of a girl.
“My daughter is in grade five; she behaves like a girl, her friends are girls. She has never complained of any physical problems even with her condition,” said the worried father. PHOTO: FILE
ABBOTABAD:
Ten-year-old Pakeeza Bibi is a grade five student at the government-run girls primary school in Bharwal, Havelian tehsil. However, her father Yastaq Hussain, a grocer from Bharwal, explains his daughter has been diagnosed with ambiguous genitalia by doctors at the Ayub Teaching Hospital.
Hussain told journalists Pakeeza was born a “regular baby girl, but things changed when she turned three.” Around that time, it was discovered Pakeeza’s external genitalia had not developed in congruence with her physical appearance of a girl.
“We overlooked it initially, thinking she would become okay with time,” shared Hussain. When that never happened, Pakeeza started feeling uneasy with what her father explained as the “dual growth” and he took her to a woman doctor who referred the case to Ayub Teaching Hospital. He explained the gynaecologist who examined Pakeeza brought surgeon Dr Irfan Khattak on board – both doctors advised surgery for his minor daughter.
According to Hussain, the doctors told him Pakeeza’s case suggests there is more of a chance for Pakeeza to become a female instead of a male after surgery.
The cost of being a girl
Doctors prescribed five different medical tests before the surgery, rounding off the cost to Rs35,000. The surgery to complete Pakeeza’s physical transformation as a girl would be no less expensive than Rs200,000, they told the grocer.
“My daughter is in grade five; she behaves like a girl, her friends are girls. She has never complained of any physical problems even with her condition,” said the worried father, who is currently making no money as his grocery shop burnt down a few months ago. He was unable to even bear the bus fare from Bharwal to the hospital himself.
With one younger son and surmounting financial troubles, Hussain admits he would not have minded Pakeeza’s sex change to a boy. But this no longer matters to the father after the doctor explained she has a better chance to be a girl.
“I cannot tolerate Pakeeza’s future being compromised because of her physical condition,” which is what will happen without the funds required for her tests and procedures.
Hussain requested Khyber-Pakhtunkhwa’s government and philanthropists to help his daughter.
The doctors who examined Pakeeza were not available for comment. However, Havelian Hospital Medical Officer Dr Sehrish, who had also examined Pakeeza, confirmed the diagnosis of ambiguous genitalia. It is a rare condition, but, as the matter was surgical, Dr Sehrish added it was best to wait on tests to see whether Pakeeza had better chances of becoming a girl or a boy post surgery and treatment.
Ambiguous genitalia
According to MayoClinic.com, ambiguous genitalia is a birth defect which impacts sexual development; it is not a disease. In most cases, the condition is detected at birth or shortly after.
In this condition, it is hard to determine sex from the external appearance of genitalia. There are several possible causes for ambiguous genitalia, explains the US National Institutes of Health:
• Pseudohermaphroditism – where a person has genitals of one sex but physical characteristics of both, or true hermaphrodism – where tissue from both ovaries and testes is present and external genitalia carries markers of both sexes.
• Chromosomal abnormalities such as XXY or XO syndromes
• Intake of steroids during pregnancy
• Lack of testosterone cellular receptors
Published in The Express Tribune, October 15th, 2013.
Ten-year-old Pakeeza Bibi is a grade five student at the government-run girls primary school in Bharwal, Havelian tehsil. However, her father Yastaq Hussain, a grocer from Bharwal, explains his daughter has been diagnosed with ambiguous genitalia by doctors at the Ayub Teaching Hospital.
Hussain told journalists Pakeeza was born a “regular baby girl, but things changed when she turned three.” Around that time, it was discovered Pakeeza’s external genitalia had not developed in congruence with her physical appearance of a girl.
“We overlooked it initially, thinking she would become okay with time,” shared Hussain. When that never happened, Pakeeza started feeling uneasy with what her father explained as the “dual growth” and he took her to a woman doctor who referred the case to Ayub Teaching Hospital. He explained the gynaecologist who examined Pakeeza brought surgeon Dr Irfan Khattak on board – both doctors advised surgery for his minor daughter.
According to Hussain, the doctors told him Pakeeza’s case suggests there is more of a chance for Pakeeza to become a female instead of a male after surgery.
The cost of being a girl
Doctors prescribed five different medical tests before the surgery, rounding off the cost to Rs35,000. The surgery to complete Pakeeza’s physical transformation as a girl would be no less expensive than Rs200,000, they told the grocer.
“My daughter is in grade five; she behaves like a girl, her friends are girls. She has never complained of any physical problems even with her condition,” said the worried father, who is currently making no money as his grocery shop burnt down a few months ago. He was unable to even bear the bus fare from Bharwal to the hospital himself.
With one younger son and surmounting financial troubles, Hussain admits he would not have minded Pakeeza’s sex change to a boy. But this no longer matters to the father after the doctor explained she has a better chance to be a girl.
“I cannot tolerate Pakeeza’s future being compromised because of her physical condition,” which is what will happen without the funds required for her tests and procedures.
Hussain requested Khyber-Pakhtunkhwa’s government and philanthropists to help his daughter.
The doctors who examined Pakeeza were not available for comment. However, Havelian Hospital Medical Officer Dr Sehrish, who had also examined Pakeeza, confirmed the diagnosis of ambiguous genitalia. It is a rare condition, but, as the matter was surgical, Dr Sehrish added it was best to wait on tests to see whether Pakeeza had better chances of becoming a girl or a boy post surgery and treatment.
Ambiguous genitalia
According to MayoClinic.com, ambiguous genitalia is a birth defect which impacts sexual development; it is not a disease. In most cases, the condition is detected at birth or shortly after.
In this condition, it is hard to determine sex from the external appearance of genitalia. There are several possible causes for ambiguous genitalia, explains the US National Institutes of Health:
• Pseudohermaphroditism – where a person has genitals of one sex but physical characteristics of both, or true hermaphrodism – where tissue from both ovaries and testes is present and external genitalia carries markers of both sexes.
• Chromosomal abnormalities such as XXY or XO syndromes
• Intake of steroids during pregnancy
• Lack of testosterone cellular receptors
Published in The Express Tribune, October 15th, 2013.