The truth about gender disparity in organ donations in India

Archana Kamath’s Story: A Window into Gendered Sacrifice

In September 2024, 33-year-old Archana Kamath from Bengaluru donated part of her liver to her husband’s 63-year-old aunt. The surgery itself was successful, but post-surgical complications tragically claimed her life. Her sacrifice devastated her family and community—and highlighted a bigger issue: the gender disparity in organ donation in India.

Archana’s story reflects a pattern seen across the country. Women are far more likely to donate organs, while men are far more likely to receive them.

The Numbers Don’t Lie: Women Give, Men Receive

According to a report by an Indian NGO:

• 80% of all living organ donors in India are women.
• Only 18.9% of recipients are women.
• For every woman who receives an organ, four men undergo transplants.

This imbalance is not a coincidence. It reflects deep-rooted socio-cultural pressures, family dynamics, and healthcare inequalities, pushing women to become donors.

Why Families Pressure Women to Donate

In traditional family structures, men are often seen as breadwinners. When a man falls ill, families rally around him to ensure survival, even if it means a female relative must make the sacrifice. This “breadwinner dilemma” reduces women to the role of protectors of family livelihood—at the cost of their own health.

Historically cast as caregivers, women are also under emotional pressure to donate. Many feel they must risk their lives to save a father, husband, or son. The reverse, however, is rarely true.

As Urologist Dr Jaison Philips observed:

“In all my years of practice, I have never seen a husband step forward to donate a kidney to his wife.”

The Emotional and Psychological Burden

For many women, organ donation is not a free choice. It’s an expectation. In lower socio-economic groups, where women already have limited bodily autonomy, this expectation becomes coercion.

Beyond the surgery, women face long-term health risks—weakened immunity, mental stress, and financial strain. Yet their sacrifice is often overlooked, unrecognised, and unsupported.

Socio-economic Factors Driving the Gap

Gender disparity in organ donation is also tied to economic inequality.

• According to Dr J Amalorpavanathan, former general secretary of the Transplant Authority of Tamil Nadu, organ donors are often younger, poorer, and less empowered than recipients.
• The high cost of a transplant—₹25 lakh or more—means families hesitate to spend on female patients. Many women don’t even make it to the official transplant waitlist.

In patriarchal households, the health of men is prioritised, while women are seen as expendable.

The Health Hazards for Women Donors

Organ donation is especially dangerous for women from lower socio-economic backgrounds, many of whom are malnourished and anaemic.

• The National Family Health Survey (NFHS-2022) revealed that 182.9 million Indians suffer from malnutrition, nearly half of them women and children.
• Poor nutrition reduces women’s ability to recover from surgery, making them vulnerable to life-threatening complications.

This means women are not only pressured into donating but are also at higher risk of poor outcomes afterwards.

Why Men Receive More Organs

Men in India are more likely to suffer from lifestyle-related illnesses such as liver cirrhosis and kidney failure, often caused by excessive drinking and smoking.

As liver transplant surgeon Dr Vivek Shanmugam explains:

“When a man falls ill, it is usually his wife who steps forward to donate. But when the patient is a woman, male relatives rarely volunteer.”

This gender bias ensures that men not only get sick more often but also receive more life-saving transplants.

Solutions: Cadaver Donation and Awareness

Experts suggest that the solution is shifting focus from living donor transplants to cadaver donations in India.

• Cadaver transplants are allocated from a waitlist, free from gender bias.
• Popularising cadaver donation can reduce the exploitation of women as “default donors.”

Dr Amalorpavanathan notes:
“Promoting cadaver donations is essential for making organ transplantation more ethical, balanced, and less exploitative.”

Role of NGOs in Reducing Gender Disparities

Organisations like Transplant India are already working towards this goal. They:

• Create awareness about the ethical issues in live organ donation.
• Encourage cadaver donations to reduce the gender gap.
• Provide financial support for underprivileged patients in need of transplants.

Their efforts highlight that organ donation should be a shared responsibility, not a burden disproportionately placed on women.

A Call for Change

Archana Kamath’s untimely death is a painful reminder of the hidden sacrifices women make in organ donation. Her generosity saved a life, revealing how deeply unequal the system is.

For true change, we need:

• Greater awareness of gender disparity in organ donation.
• Stronger promotion of cadaver transplants.
• A cultural shift towards equal responsibility in families.

Only then can organ donation in India become not just life-saving but also fair and just.