February 01, 2026

-

Premium

A Voice for Change

Growing up in Chamarajapet, Bengaluru, Akkai Padmashali learnt Gfear early. At eight, her father beat her in public. She was locked inside the house for months--punished for a `crime' she barely understood. She only knew this: though she was born male, she was certain that she was a woman. And except for her brother, her family could not accept this. "I didn't know why I was being punished," she has said. "I only knew who I was." It was a truth she carried alone for many years, in a family and society that did not yet have the language, or the willingness, to understand her. By the time she was 12, Padmashali was expelled from home and lived on the streets, facing hunger, sexual violence, and constant danger. One day, overwhelmed by isolation and despair, Padmashali reached a breaking point and found herself staring at a rope, ready to end it all. But in that moment, a powerful instinct surfaced instead: I want to liveThat moment, she would later write, became her turning pointIn her memoir A Small Step in a Long Journey (Zubaan, 2022), Padmashali describes the loneliness of those years with devastating clarity. "In those two seconds," she writes, "the rope became my family, my friends, teachers, society--all of them flawed." Little did she know then that this one resolve would change not just the course of her future, but would also rewrite India's laws, giving voice to countless transgender people who live their lives on the marginsToday, she's a prominent trans rights activist, a former politician, whose voice has echoed through national laws and court judgements. Padmashali began her work at Sangama, a Bengalurubased LGBTQ rights collective. In 2014, she founded Ondede--meaning `convergence'--a human-rights organization advocating for women, children, and sexual minorities. True to its name, Ondede chose engagement over confrontation, working with government systems

RECENT YEARS HAVE SEEN GREAT PROGRESS IN NEUROINTERVENTIONAL APPROACHES.

"They thought that it was stressing her body, her health, too much. She was suffering a lot," Ms. Nafees recalls, tears dripping down her cheek. "It would be better if we allow nature to take its course." Three weeks after she was born, Maryam was moved into a private hospital room as a palliative patient. Her doctors couldn't say how long she might survive, or even whether her remaining time could be measured in hours, days or weeksThey laid out one possible scenario: When Maryam's nasogastric feeding tube was removed, her oxygen levels would drop, her heart rate would slow. She would get sleepy and sluggish and eventually dieMaryam was disconnected from her medical supports. All they could do now was waithad Maryam been bigger, older and less fragile, there was an option for controlling her seizures. Before their daughter was moved to palliative care, her parents asked about functional hemispherectomy, which Mr. Beg had come across in his own research. It involves surgically disconnecting the dysfunctional side of the brain from the healthy side. But a baby should weigh at least seven kilograms before under- going a hemispherectomy, says Dr. James Rutka, neurosurgeon at SickKids; Maryam was barely a month old and weighed less than three kilogramsWhen Maryam was disconnected from her medical supports, her seizures continued, as everyone expected. But then something remarkable happened. She started drinking from a bottle. Her temperature stayed normal, as did her vital signs. She was breathing, moving, looking alertMs. Nafees could tell that some hospital staff were surprised, but she was not. Since giving birth to Maryam, she had come to understand something fundamental about her daughter: She was strong. "Maryam proved to everyone, against all odds, that she was going to fight for her life," says Ivanna Yau, a nurse practitioner with SickKids' epilepsy team. "This was not the end for her." Clearly, not intervening was no longer an option, Ms. Yau says; a new plan was formed. Maryam's parents would manage her seizures at home until she was big and strong enough for brain surgery. Ms. Yau--who Ms. Nafees calls a "sister, life changer, saviour"--joined Maryam's medical team and stayed in constant communication with her parents, helping them manage her seizures and medications.