The latest data on organ donation in India has revealed two striking trends that merit reflection. First, living organ donations vastly outnumber deceased organ donations; and second, there is a stark gender imbalance in actual donation and transplantation outcomes. Transplants from deceased donors have been fewer than 24,000 in the last decade. In 2023, over 60% of donors were women, while nearly 65% of organ recipients were men. In the case of liver transplants, men accounted for a staggering 70% of recipients in 2023. This can be attributed to the fact that men are generally greater consumers of alcohol than women. Interestingly, the analysis is based on data collected from driving license applications submitted in 2024, where more women applicants than men answered ‘yes’ when asked if they were willing to donate their organs or tissue in the event of death in 17 out of 21 states. A similar disparity is noticeable when the lens is widened: while India ranks a respectable 20th globally when it comes to living donors, it plummets to 67th for deceased donors among 77 countries. These two findings suggest a dual narrative. On the one hand, there is a notable altruism among women, reflected in higher pledges for posthumous donation and participation in living donation. But this altruism is not immune to social conditions. Since families and physicians often depend on living donors to save lives, the pressure of identifying a viable donor shifts to the patient’s immediate circle. Here, women frequently become the default donors. Societal norms evidently play a role in this choice. Deep-rooted gender expectations around caregiving, minimal bodily autonomy, and familial duty condition — force? — many women to step forward as donors.
India’s deceased donation infrastructure and public acceptance of the act are still evolving. Critical elements such as intensive care unit beds, ventilators to maintain potential brain-stem dead donors, and organ preservation facilities are in short supply. Data from the health ministry’s Rural Health Statistics report indicate a shortfall of nearly 80% of specialists at community health centres as of March 2022. According to the National Organ & Tissue Transplant Organisation, 9.8% women applicants pledged to donate their organs in case of death. The number for men is 8.9%. If even a fraction of these pledges gets translated into reality, it would transform India’s donation landscape. But that should not entail women shouldering the burden of donations.