Dr Aqsa Shaikh
Islam has been sent down as a blessing for the entire humanity. Islam is for everyone – not just for human beings but for all entities. Islam not just tells us to fulfill duties and mind rights of other human beings – be they Muslims or non-Muslims but also of plants, animals, and the environment. Islam tells us that a man is not superior to a woman, a white is not superior to black or an Arab is not superior to a non-Arab.
Muslims believe that we have been given this worldly life as a preparation for the hereafter; that this life is a test. Islam has also taught us how to lead our lives during our stay on this earth. From the Azaan recited in the ears of a newborn to the last prayer for a deceased person everything including marriage, sexual life, birth, death has been explained.
All forms of human lives are created by Allah in all variations of sex, gender, ethnicity, ability, color, etc. Allah says in Quran
“To Allah belongs the dominion of the heavens and the earth; He creates what he wills. He gives to whom He wills female [children], and He gives to whom He wills males. Or He makes them [both] males and females, and He renders whom He wills barren. Indeed, He is Knowing and Competent.” [Quran: 42:49-50]
While there is a difference of opinion if these verses refer to the intersex and transgender children, there is no denying the fact that Allah creates some people as intersex and transgender.
What is Gender Incongruence
Gender Incongruence is a condition when the gender affirmed by a person is different from the sex assigned to them. So, if someone was assigned male at birth and then identifies themselves as a woman then they are Transgender women. If someone was assigned female at birth and then identifies themselves as a man then they are Transgender men. Many transgender people feel intense discomfort in their body to the extent that some end up hating it or doing self-harm. This is known as Gender dysphoria.
What does Islam say about Gender Incongruence?
Islam is mostly silent on gender incongruence. The understanding of gender has only progressed in the last 100 years or so. Many Muslims while recognizing transgender persons strictly oppose allowing any form of gender-affirmation procedure. They say that any form of change in the body to match the identified gender is not allowed as it is within the ambit of changing the creation of Allah. They quote this Ayat of Quran in defence –
“And I will mislead them, and I will arouse in them [sinful] desires, and I will command them so they will slit the ears of cattle, and I will command them so they will change the creation of Allah. And whoever takes Satan as an ally instead of Allah has certainly sustained a clear loss.” [Quran: Surah An-Nisa:119]
Changing the creation of Allah?
When Islam talks about changing the creation of Allah, we need to understand the concept and the thought behind it. Using this phrase ‘changing the creation’ for everything won’t be helpful. Man, since ancient times has been changing the creation of Allah. Starting from carving out weapons out of stones, pulling down mountains to create paths, modifying the course of rivers, agricultural techniques for creating new breeds or hybrid varieties, and better breeds of animals – including emasculating animals, making them wear a leash or nailing shoes into their soles -these are all examples of changing the creations of Allah. Islam encourages men and women to look beautiful – and coloring hair by women and applying henna on hair by men are all acceptable. Piercing ear lobes and noses; is that changing the creation of Allah? It may be noted that all these activities are done without any medical indication.
When there is a medical indication – then ‘changing the creation’ is very much allowed. For Congenital anomalies – whether life-threatening or not – corrective surgeries are allowed. Corrective surgeries for Intersex persons are allowed by all schools of Fiqh in Islam to help them assimilate into society. Isn’t that going against the decision of Allah?
When we say Allah makes no mistake – we should not consider congenital anomalies as mistakes by Allah; they are His willful act. So, no – by making someone intersex, transgender, gay or lesbian – Allah has not made that person like that by mistake. Also, it is not due to some sins committed by that person in the past life or sins committed by their parents. It’s all a part of the act by Allah.
Sex and Gender – Mind, Body, and Soul
Before we discuss gender-affirmation procedures (also called Sex-change surgery, though it’s a misnomer) we need to understand what is Gender Incongruence (previously called Gender Identity Disorder or Transgenderism). And to do that we need to understand who is a male or a female. Is male or female decided based on external genitalia at birth? The doctor declaring – congrats you have a boy! Some developed countries like the U.K. do not declare the sex of the baby at birth, because they know that sex cannot be determined by simply looking at the genitalia. Is male or female decided by the X and Y chromosomes? What about those with chromosomal aberrations? Or is it decided by the brain structure? Or is it decided by the brain function? What is more important – body, brain, or mind?
In Islam, there is a concept of body and brain (sometimes confused with heart) and Soul or Rooh and it gives most importance to Soul – which is eternal and immutable. And our modern concept of mind is the closest we can get to understand the Soul. So, do we decide the gender of a person based on the body, brain, or soul? If there is an apparent body of male and brain and soul of female- so is the person more male or more female? Is it really necessary to have a binary classification? Can there be a third or even fourth category? When we say that God created someone in the male body, why are we ignoring that the same God created the female brain and the female soul in that male body? Philosophy aside – though very little research is done on transpersons, the available data suggests that in transpersons the brain structure is similar to that of their identified gender, which means that transwomen have male body and female brain and vice versa.
Also, we need to understand that people are not trans by choice. One can try changing their orientation and see if they succeed, they won’t. Secondly, we need to understand that it is not hormonally-influenced. So, giving someone high levels of hormone won’t make them start thinking like particular sex. So, no, the sexual orientation or gender identity cannot be changed by hormones, drugs, seeing pornography, having sexual activity with the opposite sex, or electric shocks (conversion therapy) – all these are examples of things done in the past to try and change people’s sexual orientation and gender identity. Not just have they been proven unsuccessful and harmful they are also banned and illegal. The brain and soul are more powerful influencers than the body. Both Homosexuality and Gender Incongruence are no longer considered a disease by the World Health Organisation or Associations of Psychiatry across the world.
So, since we cannot change the mind and the soul, changing the body is the only option for those who have gender dysphoria or want a body that matches their mind and soul. And in current social norms and medical standards, it is very challenging to change the body but still, transpersons want to do it because without that there is a lot of distress (Gender Dysphoria). And changing the body relives that distress. Many studies have shown that even minimal forms of gender affirmation services immensely help in improving mental health, reducing suicidal ideation, and improving quality of life.
Fatawa on Gender Affirmation Procedures
Coming to Fatawa (religious opinions) on this issue, please remember that gender-affirmation procedures are recent phenomena – 50 years old as against Islamic history of 1400+ years. So, there is very little discussion on this topic even amongst contemporary Islamic scholars. Also, most Islamic scholars have limited knowledge of modern medical sciences and Psychiatry. In such a scenario, it is expected that they reject any drastic solution for the apparent no-problem of gender incongruence. The first major reform came in the Shia school of Islam- when a transwoman met Ayatollah Khomeini and explained her plight. And then Ayatollah gave a Fatwa allowing sex-change surgery for transpersons. Iran today is the center of gender affirmation procedures in the Islamic world. Then the next big momentum was at Al-Azhar University, Cairo, Egypt – the biggest Sunni Islamic university of the world. Here a transwoman student’s case came to light and then a Fatwa committee discussed the matter at great length and finally allowed her to undergo surgery. In recent years, more and more Muslim countries have started allowing it. In Lebanon, it got permitted recently. In UAE, it was allowed a few years back. Also, in Saudi Arabia, it is allowed as sex-correction surgery. A few years back, a group of some 50 Pakistani Muftis issued a fatwa, allowing transpersons to marry the persons of the sex opposite to their perceived gender, to have rights of inheritance as per their identified gender besides, that they should be treated with their perceived gender after death for funeral purpose and that they should not be humiliated. Many schools of Islamic jurisprudence, now not only allow but recommend sex correction procedures for intersex persons and allow it for transpersons with dysphoria (intense discomfort) especially if it is life-threatening, certified by health professionals and affirming the gender is likely to relieve this dysphoria. These conditions are more or less the same as the conditions laid down by the World Professional Association for Transgender Health.
Having said all this, I am sure you will find plenty of Fatawa saying that it is not allowed. In the event of contrasting opinions by religious experts, what to follow, and what not is an individual’s choice based on their understanding.
Practicing Islam as Transgender persons
The Muslim Society is based on the binary of the sexes. We have the infrastructure, facilities, and rules for men and women. There is nothing concrete for transgender or intersex persons. In such a scenario logically they should be allowed entry and assimilation into any place as they feel comfortable. But is that easy or devoid of trouble? Imagine someone with the male body and female soul, going to the male section of the Mosque. Such a person will not just be uncomfortable for being in the wrong space but will also be constantly attracted to men. Can such a person find entry into the female places of worship? Now, even if this person may be at ease there what about the cisgender women in these places? Will they be comfortable, will they be attracted to the male body amongst them? We have seen that even in the most-developed and open-societies like Europe and the United States there has been a raging and furious opposition by cisgender women to the use of female toilets by Transwomen citing security concerns.
We have seen an example of this during the Prophet’s (ﷺ) life too- wherein a gender-incongruent person was allowed access to both the male and the female spaces. Things went on smoothly for some time till one day it was found that this person was describing the body of a lady to a man in a seductive manner, post which he was denied access. Ask any transgender woman and she will tell you how difficult it is to be amongst men, behave like a man, get attracted to them and then show that they have no feelings for them, to keep killing those feelings every moment, to feel guilty for having those feelings especially in the most sacred places like a mosque or even a pilgrimage to Makkah and Madina and at the end of it to feel helpless and depressed. No doubt the rates of Suicide amongst Transgender persons are multiple times higher than other persons. And then there is pressure from the family to get married. Many Transgender persons have been forcefully married to people they are not sexually attracted to. Such marriages happen because of intense blackmail and fear of being a social outcast or sometimes in the hope that this will ‘cure’ the condition. Some of these forced transgender marriages are consummated and some are not. Some even end up having kids. But almost none of them are happy or are able to fulfill the conjugal rights. Those who oppose getting married are asked to adopt celibacy and devote their life to prayers and fasting. They end up living a life of lies and frustration.
While we understand that the issue is very complex with no simple solution which is in sync with the traditional understanding of Islam or modern understanding of sex, sexuality, and gender, we need to find a more humane, scientific, and socially acceptable solution. And such a solution has to center around the well-being of the transgender person. A Transgender person can be a good member of society and a good Muslim only when they are themselves at ease and accepting of themselves.
Dr Aqsa Shaikh is a medical doctor and Community Medicine Specialist. She is an Associate Professor of Community Medicine at HIMSR, Jamia Hamdard, Delhi. She is a Proud Transgender Woman and works on LGBTQIA+ rights, rights of Persons with Disability, and Mental Health. She has authored many medical books and blogs with Times of India, Women’s Web and Youth ki Awaaz, etc.