Transgender people in South Africa enjoy equal treatment thanks to the country’s liberal constitution – I thought so too

In a country with some of the most progressive laws that protect the rights of the LGBT community, why does transphobia continue to plague South Africa, and where is it prevalent?

A conservative country with progressive laws?

Yes, you read that correctly. Although it sounds rather strange, and a little contradictory too, this seems to be what South Africa has become. South Africa seems to be at a standstill, with the harsh acts of discrimination the transgender community continues to face, despite its’ liberal constitutional laws. The perpetual cycle of the discrimination and social injustice the transgender community faces has only continued. I will be addressing the areas in which transphobia is prevalent such as hospitals and universities, identifying where reforms need to take place, as well as briefly analyzing the potential causes and effects of select social injustice issues affecting transgender people. I will then analyze what the cause of the discrimination transgender people face, whether it’s a result of transphobia or a matter of people being ignorant and uninformed

My project advocates for the transgender people in South Africa to receive the respect and equal treatment they both deserve and are entitled to. By aspiring for South African citizens to treat one another with respect irrespective of one’s sex, race, religion, sexual orientation or gender identity my project will be working towards making Gender equality of the UN’s SDG a reality. Through raising awareness and encouraging others to strike conversations about the struggles of the transgender community my project will be challenging transgender based discrimination and stigma, because in order to achieve gender equality for all people need to be educated and socially aware of the realities of the transgender community.

Terminology: Definition:
Assigned sexThe sex an infant is assigned based on their reproductive organs/genitalia.
Gender expressionExternal appearance of one’s gender identity, usually expressed through behavior, clothing, haircut or voice, and which may or may not conform to socially defined behaviors and characteristics typically associated with being either masculine or feminine (Campaign).
Sexual orientationAn inherent or immutable enduring emotional, romantic or sexual attraction to other people (Campaign).
Gender identityOne’s innermost concept of self as male, female, a blend of both or neither – how individuals perceive themselves and what they call themselves. One’s gender identity can be the same or different from their sex assigned at birth (Campaign).
TransphobiaThe dislike and prejudiced attitude towards a transgender person.
TransitioningThe process by which some people strive to more closely align their internal knowledge of gender with its outward appearance. Some people socially transition, whereby they might begin dressing, using names and pronouns and/or be socially recognized as another gender. Others undergo physical transitions in which they modify their bodies through medical interventions (Campaign).
GatekeeperA person who controls who or who does not have access to certain things.
Gender affirmingThe type of healthcare, surgeries, and therapy transgender patients receive in order for them to conform to their own inherent gender (Beemyn).
MisgenderingTo incorrectly assume or name one’s gender by either using the incorrect pronouns or using the incorrect gender terms.
DeadnameThe birth name someone had before having it changed.

Local resources

After watching the documentary “Growing up Trans” I was really surprised to see just how complex and difficult the lives of transgender people can be. Considering the documentary was filmed in the U.S.A, I had become more aware of the obstacles transgender’s people face, but it then led me to question whether the experiences for transgender people in South Africa differ that much from that of an American transgender person. I learned that South Africa is not as progressive as I had assumed it was, despite its’ laws and legislations. When I got the chance to get in touch with local resources in my community, the first thing I did was research LGBT advocacy organizations and LGBT activists. One of the organizations I was fortunate enough to get in contact with was Iranti, they advocate for LGBT rights in South Africa. As a reputable organization, they aim to inform and educate people about the struggles the transgender community endures from hate crimes and violence to inaccessible, quality healthcare. They inform people about transgender issues in South Africa in many forms and mediums such as events, videos, etc.

Author and LGBT activist Dr. Anastacia Tomson, whom I had the pleasure of getting into contact with and interviewing said, “There is an interplay between the lack of access to healthcare, the difficulty in obtaining accurate ID documents, the challenge in finding or retaining employment or shelter, violence and abuse in the streets – these are all symptomatic of a fundamental failing of the system to look after the vulnerable, and it’s important to keep this integrated comprehensive perspective in mind when highlighting issues that face the community.”

Laws and location

In South Africa, discrimination on the basis of gender identity, sex, sexual orientation, race or religion is illegal, along with other many laws that protect members of the LGBT community. In addition to this South Africa was the fifth country in the world to legalize same-sex marriage as apart of its constitutional law in 2006, and was the first African country to do so. Along with its’ multiple constitutional laws that protect the human rights of the LGBT community, any forms of discrimination on the basis of sex, race, religion, sexual orientation, and gender identity are illegal. South Africa was also the first African nation and fifth country worldwide to legalize same-sex marriage in the constitution in 2006 (“Gay And Lesbian Rights”). Take a look at this website to find out what laws your own country has that support LGBT rights, and to compare your country South Africa follow this link

Out of South Africa’s 9 provinces, the Western Cape and Gauteng are known to be the safest spaces for the people to be open with their sexual orientation, gender identity, and gender expression. Urban regions and cities such as Cape Town and Johannesburg are more accepting and open for the LGBT community, providing them with a relatively secure environment. Statistically speaking, the likelihood of someone being open with their sexual orientation and gender identity in the Western Cape is 70%, in Gauteng it’s 60%, in Limpopo 35% and Eastern Cape with the lowest figure of 15%. This is where hate crimes and violence against the LGBT community is most prevalent (Morris, Michael 2017).

(van Heerden, Gerbrandt 2017)

The root of stigma & issues in medical spaces

A study was conducted in Limpopo at a rural-based university which analyzed the experiences and lifestyle for the LGBT community in rural South Africa. The findings from the study showed that in most cases the reason behind the discrimination and stigma LGBT students faced was related to people’s religious beliefs and the negative misconceptions they held about LGBT people (Mavhandu-Mudzusi and Sandy 1049-1056). The results from this study also showed that the people in the rural area against the LGBT students were not only fellow students but also university professors, lecturers, staff and even healthcare providers who refused to provide healthcare to LGBT patients.

Having said that transgender-related issues in medical spaces are not exclusive to rural areas. According to Kellyn Botha, a representative, and writer for Iranti: In government hospitals and clinics, the biggest issue at hand is the treatment of transgender patients from service providers and professionals, including the quality of gender-affirming care that’s being offered. Additionally, hospital policies often require transgender patients to be placed in hospital wards according to their assigned sex, and for their deadnames to be used on documentation. Whereas in the private sector of healthcare many doctors are reluctant to treat transgender patients because the very concept of gender-affirming care is something so foreign and alien to them. At Groote Schuur hospital mental health professionals have been known to act as gatekeepers to transition services and procedures for transgender patients, such as the provision of hormone replacement therapy. In South Africa, the lack of adequate training of mental health professionals only creates an additional barrier to both access and quality of healthcare (Wilson, D et al.).

Do you think South African medical aids cover the costs for transgender clients procedures?
Yes of course!
Yes, but only for the ones necessary
No, probably not
Created with SurveyMaker

Accessibility to adequate healthcare for transgender patients is a luxury due to associated costs. Most medical aids in South Africa refuse to cover the costs of some procedures because according to their policies these surgeries fall under cosmetic procedures and not medically necessary, including hormone replacement therapy (HRT). Hormone replacement therapy, also known as cross-sex therapy, is a treatment transgender people use to produce certain hormones associated to their desired gender those being either testosterone or estrogen, taking these drugs is a crucial part of the transitioning process for patients (“Definition Of HORMONE REPLACEMENT THERAPY”). For procedures such as this many medical aids’ policies categorize them as a lifestyle choice for their transgender clients, as opposed to a necessity to the benefit of their health.

Should medical aid cover the costs of procedures for transgender clients?
Yes, but only longterm ones like HRT
No, because they aren’ t all necessary
Created with Poll Maker

The problems and shortcomings in the field of medicine and healthcare are only the tip of the iceberg. Every social injustice issue the transgender community endures are all interconnected and affect one another in different ways. In many cases most of the problems that arise only continue as a result of preexisting issues. For example, university-level curricula in the study of Health Sciences and field of medicine entirely need to be remodeled to be more inclusive of LGBT related issues and specific healthcare needs. At present, UCTs health sciences curricula do not adequately address LGBT specific health issues. Where LGBT health-related content is taught in the MBChB curriculum, it is largely discretionary, unsystematic and not incorporated into the overarching structure (Müller, Alexandra 2013). To ensure that healthcare professionals in the future are properly equipped with sufficient knowledge about their potential LGBT patients, and to avoid instances of misgendering patients. Several experts in the study of medicine and health, propose that hospitals implement sensitization training with doctors, nurses, and other healthcare service providers or professionals. They would be trained as to how they can offer quality care and treat their transgender patients in a manner that is respectful and sensitive about their gender identity and experiences. It appears that the driving force of all these issues is people’s ignorance, their lack of knowledge fuels the perpetual cycle of injustices and discrimination for the transgender community.

Moving forward…

To look at the bigger picture, we’re really just scraping the surface here, the transgender community faces far too many issues from the rest of South Africa. As representatives of the Iranti organization and Dr. Anastacia Tomson have said the best way to eliminate ignorance is to empower people with the relevant and necessary knowledge. That alone is a solution, however, prevention methods seem to be the way moving forward. By educating and informing people early on from university level to even primary schools, we are minimizing the chances of transphobia to continue to plague South Africa. Ignorance is a choice. In this day and age with the wealth of information we have at our fingertips, there is no excuse. It’s simple, make the right choice.

What we need to do is prevent any such problems for the transgender community to continue, not just in South Africa, but anywhere and everywhere in the world through raising awareness in families, schools or communities. Educating and informing people only rids them of their ignorance, which consequently eliminates any possibility of discrimination and prejudiced attitudes to persist. Simply making these issues that the transgender community face a topic of discussion is an achievement alone and lays a foundation for allyship to grow. No matter how small it may seem, talking about the realities of the transgender community forces people to acknowledge that they exist. I urge you to help to destroy the prejudices held against the transgender community one conversation at a time, this we can all work towards making gender equality a reality sooner rather than later.

Through the exchanges and conversations I had with members from my community a few inspiring people such as Dr. Anastacia Tomson redefined for me how to proactively approach activism in South Africa. I learnt that when it comes to educating people, ignorance brings forth many complexities with it since it is a choice. After engaging with multiple people with very different viewpoints and opinions when it comes to tackling social injustice, I found that there doesn’t have to be a ‘right’ way to approach activism when trying to change other’s mindsets. Prevention methods can go hand in hand with efforts to find solutions. 

Below you will find a few South African based LGBTQ+ advocacy organizations and activists to follow or support:

  • Iranti – a non-profit organization that advocates for equality and justice for lesbian, transgender and intersex people, particularly in South Africa, through a variety of themes and sectors in society from Violence to Healthcare and Education, which is carried out and achieved by means of approaching these injustices from a human rights framework and plan of action. Iranti is a reputable organization that was founded in the January of 2012 that is also a part of national, regional and global advocacy platforms, with numerous achievements and successful projects under their belt. Website link
  • Gender Dynamix – ‘Having been established in 2005, Gender DynamiX (GDX) is the first registered Africa-based public benefit organization to focus solely on trans and gender diverse communities. What started as a mere vision, slowly grew into a grassroots organization. GDX has since become an institutionalized non-profit organization (NPO) that is fundamental to the development of the trans and gender diverse movement(s) in South Africa and across southern Africa. Website link
  • OUT – ‘OUT has been in existence for over 21 years. OUT is a professional service organization focusing on Lesbian/Gay/Bisexual/Transgender (LGBT) people. Based in Tshwane (Pretoria), OUT’s work takes place on local, provincial, national, continental and international levels. OUT’s focus areas of work are direct health and mental health services, research, mainstreaming and advocacy.’ Website link
  • Dr. Anastacia Tomson – She is an author, activist, and medical doctor. Along with her very own gender-affirming and inclusive medical practice, she holds educational workshops, sensitisation and diversity training and more. She has an award winning memoir published, as well as her own blog. Website link

Here’s a link to the works cited

Share this project
  1. April 26, 2019 by Sara.Mirani

    Hi Pabi! Something super powerful about the video you showed was that it was mostly transwomen, and they often don’t get a lot of recognition or representation!

    • April 27, 2019 by Pabi Nchoba

      Hey Sara! There are a lot of struggles with being a transwoman, especially being in public and people stigmatizing them because of their appearance. For many transmen society simply labels them as a ‘tomboy’ without any further invasive questions coming their way.

  2. April 27, 2019 by Tess Blake

    Hey Pabi! Before coming across your project, I knew about South Africa’s liberal constitution and conservative government; however, I was completely unaware at how severe the discrimination against LGBTQ+ people still was. I also find it so interesting how levels of discrimination can differ based on where one is situated (even within such a small country such as South Africa). Thank you for sharing this new information & giving insight into the problems that continue to exist even within such a “progressive” nation!

  3. April 28, 2019 by Rebecca.Urato

    Pabi, Great work! I’m really impressed by your project, and I learned a lot. Thank you for shedding light on this topic, and also providing definitions/terminology to help me better understand.

  4. April 28, 2019 by Ellie Pearson

    Pabi, this is wonderful! Your passion for this topic really shines through. The world definitely needs to be talking about transphobia more and realizing that it does exist in countries like South Africa, even if it seems progressive. Thank you for starting a conversation about this in the Catalyst Conference!

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