Asmaa and Samar were known by residents of their hometown in the southern Saudi town of Al-Nimas as two sisters, Al-Watan reported. Their lives were changed forever when they learnt they had in fact been born male. They had to undergo gender reassignment surgery to correct the problem. Asmaa and Samar who later became Walid and Yaser respectively were born with both male and female organs. Dr. Bassam Bin Abbas, Consultant Endocrinologist at KFSH said about one in every 5,000 children are born with adrenal gland difficulties, which require the patient to undergo a gender reassignment or sex change operation. Official statistics are unavailable due to social taboos about the topic in the Kingdom. Asmaa, 24 and her sister Samar, 14, noticed obstetric and congenital irregularities. Their father, Mohammad Sa'id Al-Shehri, took them to the Specialist and the Military Hospitals in Riyadh, explaining that he had doubts about their gender. Asmaa, who later became Walid after sex change surgery, was referred to the Urinary Tract Diseases Department at King Faisal Specialist Hospital where the six-hour surgery was performed. According to Walid's father, Walid exhibited male characteristics from an early age and avoided communication with members of the community for two decades. The father blamed the delay in performing the surgeries on the hospitals rescheduling from one year to the next. “I was studying at a school for girls and lived in a female environment at home and at school. I was certain I was suffering a congenital deformity and therefore segregated myself from females and started playing and mixing with males. In junior high school, I became even more reclusive and I preferred the company of my sister. Deep down, I knew I was male, particularly because my voice was hoarse and that I acted more like a tomboy,” he said. Yaser, formerly Samar, went through the same ordeal. He said that he preferred to play with boys since childhood and never felt like a girl. Their father said that boy's mother suffered emotionally for more than 15 years due to the condition of her children. What Yaser is describing is known as gender dysphoria which occurs when an individual feels emotionally different from their physical gender characteristics. Many people who experience gender dysphoria undergo surgery to change their gender like Walid and Yaser did. Over the last 5 years Dr. Abbas said more than 600 people have undergone gender reassignment surgeries in the Kingdom. “These individuals have transgender problems. In the case of females, some do not have sex organs and are unable to conceive despite having a uterus. As for men who have changed into women, social taboos may doom them to a life of spinsterhood,” he said. Abbas said many people who have gender reassignment surgeries have difficulty in adjusting to their new lives because their families do not approve. In 2007 Brazil began providing free gender reassignment surgery, according to the New York Times. Brazilian judges ruled that the surgery should be covered as part of a constitutional clause guaranteeing medical care as a basic right. Brazil's public health system offers free care to all Brazilians.
