feminism

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Lack of access to transgender healthcare in South Africa. What funders should know……

Published December 9, 2013 by transfeminists

Friends,

I am honoured to have been invited to a funding dialogue in Berlin, December 2013 and I am happy to share this presentation with you.

Though South Africa is classified as a developing country, the political, economic and social conditions for South Africans are still very much in line with third worlds standards. The brunt of South Africa’s previous apartheid regime can still be felt today. The regime, based on racial segregation played a huge role in the inequalities that South African’s still feel today. Those inequalities are no more visible than in the LGBTI community. Some members of the LGBTI community have managed to create a fairly good existence for themselves in a post apartheid South Africa. Sadly, this is not the reality for most transgender people in South Africa. When hate crimes are perpetrated, in most cases they are committed against those who express visible gender diversity. The black transgender women from impoverished communities almost always serve as the primary target in this regard.

What does this have to do with transgender health? The inequalities that play itself out, especially in the transgender movement of South Africa, are based on the inequalities that were created through the apartheid regime. A system whose mission was not just to racially segregate South Africans, but also further entrench gender inequalities. This is to say that in the hierarchy of power, it is the white cis-gender man who, at the top of the hierarchy assumes a self-imposed position of power, while it is the black, illiterate trans woman from the so-called homelands, that is positioned at the bottom of this hierarchy. This is a population of women that come through our programs on a daily basis, and we continue to work hard at addressing this dynamic.

There is no doubt in my mind that this unhealthy power dynamic still plays itself out, even 20 years later in South Africa’s ever maturing democracy. These are dynamics that influence the ways in which transgender folks access mainstream health and well-being services. Needless to say that those services are non-existent to black trans folks in rural areas. Most trans people of colour in South Africa does not have the privilege of boarding a flight to Bangkok in order to access gender reassignment procedures. The ways in which trans persons of colour in South Africa access gender affirming treatments is unequal in relation to the ways that trans folks with privilege access the same treatments. Our organisational efforts at creating safer spaces, including access to gender affirming care, are located within this context. After all, the high HIV infection rates are amongst trans women of colour. The same can be said for the intolerable levels of violence, the lack of development opportunities and a number of other obstacles.

On access to health care in South Africa

  • Most trans persons access health through the public health care system.
  • Trans specific services exist only in two centres in South Africa, one in Cape Town, and the other in Pretoria. Needless to say, it is difficult for rural trans people to access these services.
  • At both centres there exists a 26 year waiting list
  • Very little theatre time is dedicated to gender reassignment surgery since it is not as seen as urgent in relation to other surgeries.
  • Hormone treatment is available but difficult to access even for those in the urban centres. This is because there is no streamlined service and cases are handled on an individual basis, rather than as being part of a standard service package
  • More FTM patients are helped since some of the surgical procedures are offered as general surgeries like hysterectomies and mastectomies are offered within the gynaecology departments of both these centres in contrast to MTF for whom breast augmentation, is classified as cosmetic surgery in South Africa

Challenges in accessing health care for trans persons in South Africa

  • Self-medication remains a huge problem among especially trans women.
  • Little to no research exist on the HIV vulnerability of bodies post sex reassignment surgery.
  • Little to no research exist on the cross drug interactions between certain hormone treatments and ARV’s
  • Rural transgender people’s access to gender affirming treatment is disproportionately affected in relation to those in the urban centres
  • The concept of validative sex among trans women is ever increasing. This is problematic in the context of HIV vulnerability.
  • Looking at issues in isolation is problematic. My race, my gender, my homelessness, my HIV positive status is all one struggle. Integration of these intersectionalities should be key in the HIV response.
  • Harmful traditional practices remain challenging. The cultural obligation to go through cultural circumcision drives many trans women into sex work because by refusing to go through the ritual, they lose access to family resources and a sense of belonging.
  • Religious fanaticism is challenging to trans people in South Africa because many religious and cultural institutions feel these concepts are new and that they are imported from the West
  • Some trans people find it difficult to access ARV’s without the change of gender markers in their identity documents because some have medical records in their old names and/or id numbers

Strategic opportunities for advocacy on trans health issues in South Africa at the moment

South Africa is having their national elections for president in 2014. This is an opportune time to advocate a more comprehensive public health package.

There is an ongoing conversation on re-engineering public health and this offers room to advocate for better services for trans people.

We are giving two presentations on the upcoming ICASA conference where we can talk about the unique health, and HIV needs of transgender women, removed from an MSM intervention.

After a long and hard effort, the ECAC has recently called on us for conversation on the unique HIV needs of transgender women.

There is a tripartite alliance of organisations who established SATHRI to advance transgender health in South Africa

The most recent contraception policy guidelines mention the needs of LGBTI persons in terms of accessing contraception in South Africa.

The Groote Schuur transgender clinic has domesticated some guidelines of the WPATH standards of care version 7 and we continue to disseminate this to primary health care practitioners.

S.H.E has contributed to the Key Populations Guidelines for HIV management in public health sector.

Where do we go from here?

  • As a first step, we need to develop language around trans terminologies. We need to develop literature in vernacular languages of trans people.
  • We need to create, strengthen and maintain safe spaces and support groups for transgender people.
  • Biomedical research on the vulnerabilities of trans people (women) should be on the research agenda.
  • Donors fund advocacy and that is a great thing but while we are advocating for the inclusion of trans people in government services, trans people continue to be negatively affected. We need to start thinking about service provision models for trans organisations
  • Core funding is essential to creating health and well-being spaces for trans organisations. I can’t advocate for other trans people when I am experiencing many shortcomings myself

 

 

 

 

 

Open letter to the One in Nine Campaign

Published April 11, 2013 by transfeminists

11 April 2013

The divisions in an already fragile women’s movement in South African are not helpful.

An open letter to the One in Nine Campaign in response to the exclusion of transgender and intersex persons in the Feminist Political Education training.

Dear colleagues

It is with great disappointment that we learnt about the exclusion of transgender and intersex persons from a feminist political education training, presented by the One in Nine Campaign. We were truly shocked when a colleague forwarded to us an invitation for the Feminist Political Education 2013 Programme, which set out, amongst others, the following requirement:

The course is open to female-born people who are not male-identified.

This requirement effectively sets out to exclude transgender and intersex individuals from the course. Asked about this blatant exclusion, 1 in 9 campaign director, Carrie Shelver responded as follows:

“I am glad that you raised these concerns with us directly and we welcome the opportunity to respond and share with you our ideas and thinking. I need to forward your email to the board of the Campaign so that we can collectively respond to the issues raised with the seriousness they warrant. I am cc’ing Pumla Gqola, One in Nine Campaign Chair of the board. I hope you will give us a few days to do this. Once we have sent this through we would also be happy to meet and discuss it in person with you and others who may be interested”.

The final response from the One in Nine Campaign came on 23 February 2013 from which we drew two very disturbing implications:

“The organisation (One in Nine) is not an LGBT organisation, even though many of the active members identify as lesbian, bisexual and gender non-conforming. Based on our analysis of social oppression and our capacity to respond, the campaign focuses its limited resources on developing leadership of female born people who are socialized as women and who live their lives within the social category women and whose access to resources and spaces are accordingly determined and so frequently under attack”.

The interpretation of this sentiment wishes to imply privilege on the part of transgender and intersex women in South Africa. This is not a true reflection of the lived experiences of this group of vulnerable women often excluded from mainstream personal development opportunities, and the denial of basic human rights such as education, exacerbate this context for transgender and intersex women in South Africa.

“The criteria for the One in Nine Feminist Political Education Program is an articulation of patriarchal values. As a woman, I was born intersex, socialized as a woman and lived within the social category of woman. Intersex women also experience limited access to resources, their lives and health are frequently under attack, and therefore, you can never imply privilege on my part”. – Nthabiseng Mokoena, Transgender and Intersex Africa (TIA).

“On 13 April 2013, the One in Nine Campaign is called all on LGBTI persons to gather for a public mass meeting to discuss Joburg Pride.  As much as we don’t support the privatisation of our sexual identities, as has been the case with Joburg Pride.  We find it ironic that Transgender and Intersex person affected by Joburg Pride is called upon to support this initiative, however, the One in Nine Campaign in not clear on its partnerships in a broader feminist agenda that advances all women and feminists irrespective of how society has biologically imposed an identity.  The One in Nine Campaign seems to affirm this very state construction of gender which goes against the human rights approach taking place in other countries”. – Jabulani Perreira – Iranti – Org.

Carrie went on to explain that in the past “One in Nine Campaign had very successful collaborations with a broad range of progressive organisations – including those that work with men, including gay and transgender men and women”. 

This statement echoes the very problematic categorization of gender, gender identities and sexual orientations. From where we are, this seems to echo the conglomeration of both gender identities and sexual orientations into one big category of masculinity and masculine identities. This does not speak to the autonomy of transgender people as an identity separate from those of both cisgender and gay men. Moreover, this places transgender women on a very masculine spectrum of identities. With all due respect, no feminist, no women and no person can determine the gender identity of another human being, least of all, the expression thereof. Says Liesl Theron of Gender DynamiX: “This is an articulation of 1970’s, second wave feminism characterised by a very transphobic attitude”.

S.H.E, the social, health and empowerment FEMINIST collective of transgender and intersex women of Africa is an organisation established in 2010 to address the concerns and issues of transgender and intersex women through feminist analysis. We have organised and established ourselves to advocate against the very attitude portrayed by the One in Nine campaign.

We are familiar with this mentality of exclusion and have long been advocating against it. What is particularly disappointing about this instance is that it plays off against the backdrop of an already very fragile women’s sector.

At S.H.E, we advocate for women, all women, despite the fact that our name mentions only transgender and intersex women. We advocate for transgender and cisgender sex workers alike. Our work in the Amanitare coalition on sexual and reproductive health rights had a broad focus and as an organisation, we particularly voiced for rural, HIV+, transgender & intersex women, and sex workers. Our focus has always been to create an enabling legal and policy environment for all women.

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“If you can recall, I was one of the women in the audience at a presentation on the IPAS tool used in surgical abortions at the People’s Healthy Assembly during July 2012. This was not because I want to force myself and the organisation I represent in cisgender women spaces but because abortion rights is a cross cutting issue in all our communities. Again, with women at the centre of this problem, as a transgender woman, I fully support abortion rights for ALL women, even those gender non-conforming. The same goes for all the other women issues like breast cancer, domestic violence, discrimination in employment and high HIV rates amongst women. These issues and many others we support for transgender and cisgender women alike. We do this because we don’t believe in the creation of categories of women. This is the very tendency that creates hierarchies of power, the same hierarchies of power visible in patriarchy. What we need, as a country right now, is to look beyond our differences and recognise the bigger issues that oppress and marginalise women”.- Leigh Ann van der Merwe – S.H.E

An interesting question on which we are pondering is whether this sentiment is supported by all the members of the One in Nine Campaign? We do believe that your membership comprise some transgender and intersex supportive organisations and it would be interesting to find out whether or not they support the sentiment uttered by the secretariat.

We urge the One in Nine Campaign to do away with this discriminatory requirement for participation in this training course. It echoes inequality and discrimination, the very qualities that we see in the transphobic societies in which we live and survive each day of our lives. I am ending my letter with a quote from the transgender feminist, Julia Serano:

“Feminism is based on the conviction that women are far more than merely the sex of the bodies that we are born into, and our identities and abilities are capable of transcending the restrictive nature of gender socialization we endure in our childhoods”. Love and kinship are two of the most central tenets of feminism.

We trust our words will find a place in your hearts and minds. Moreover, we hope this letter will set off some much needed dialogue to bridge the divide that exists.

We shall await a response from you.

Best regards

Leigh Ann van der Merwe – coordinator S.H.E

This letter is endorsed by the following organisations:

Gender DynamiX

Saartjie Baartman Centre

Klipfontein Road

Athlone

Tel: 021 6335287

Email: info@genderdynamix.org.za

Transgender and Intersex Africa

2249 Block F

 Soshanguve

 Pretoria

Tel: 012 7972612

 Email: nthabi.tia@gmail.com

Iranti-Org

 House of Movements

123 Pritchard Str

 Floor 4, Room 404

Johannesburg

Tel: 011 3331015

Email: getinfo@iranti-org

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Boys do cry……………….!

Published February 5, 2013 by transfeminists

Dear friends, colleagues and supporters. It has been a while since you have read something from my pen (well…..my computer really..) and so I thought I might share with you an issue on which I have been pondering for a really long while.

First, let me welcome you all to 2013…….I have baptised this year as the year of infinite possibilities. I have a very positive feeling about this year and I do believe it will be a revolutionary year for trans feminist activism.

The year got off to a really positive start. We formalised ourselves a bit more at S.H.E and launched our website on the 17th of January 2013. This will be our mouthpiece in our communication with all our stakeholders. Please see our work at www.transfeminists.org and feel free to sign up for our quarterly e-newsletter, The Transfeminista!

In this piece I am writing about a very ironic issue, given my herstory as a transgender woman. Yes, you guessed right, I am addressing the issue of masculinity.

This is an issue on which I have pondered for a long while now. It is really ironic for me to write about masculinity, given that I have rejected the notion of masculinity with my transition from male to female. Not really so ironic looked at from a feminist perspective. The key word here is feminism…….that is my political identity.

OK, so back to the issue of masculinity. Why did I choose to write about masculinity and the construction thereof? Simple, I feel if we were to tackle patriarchy, the proverbial plucking of the root lies in examining masculinity and the construction thereof. There has to be an inquiry into the concept of masculinity and influencing change at that level. I feel our activism has been much centred upon women, females, femininity, proving to the world our strength as women…..tada tada tada. Fighting these inequalities, one has to be strategic, study those inequalities, dissect it, and construct an alternative ideology. It is on this premise that I base my argument. We have to examine masculinity as a concept, see how it is constructed and find ways of deconstructing it in order to shape “the man of tomorrow”.

So why am I rambling on about this topic of masculinity when all our resources (physical and mental energy included) should be focussed on improving the lives of women and sexual & gender minorities?(and all those pushed to the margins) Again, very simple, all the inequalities that we experience are very deeply rooted in patriarchy. There must also be an analysis of the link between patriarchy and masculinity, in other words,” my entitlement (patriarchy) because I am a man (masculinity)” conversation. The hate of transgender and intersex women has its roots in patriarchy. The idea that persons born with male genitalia (in the case of trans women) could reject masculinity is engendered from a very cultural, patriarchal, misogynistic view of the world and all in it. This is so accurately captured in the words of Ian McEwan:

“Girls can wear jeans and cut their hair short and wear shirts and boots because it’s okay to be a boy; for girls it’s like promotion. But for a boy to look like a girl is degrading, according to you, because secretly you believe that being a girl is degrading.”
― Ian McEwan

A lot of the time you will find a mother advocating for her son, regardless of his flaws. Many mothers acknowledge their sons are no angels and yet you will find the same mother defending her son’s position in whatever goes wrong in his life (OK, so sue of us for being inherently nurturing, compassionate beings!). I am pointing this out to highlight the collective responsibility that we have as women, and mothers, and sisters, and daughters to advocate for the construction of an alternative masculinity. One in which we say to men that it is OK to be equal with women, it will in no way affect you masculinity. A masculinity that is not so highly challenged that men feel they have to rape lesbians in order to “correct” them. A masculinity that will stop the war on women’s bodies. A masculinity where men don’t have the need to sit around talking about women as if they are only a collection of body parts. How many times have you heard: “ That girls has a fine ass” or “I’m turned on by big titties?”. These are not the only features to women’s bodies – it is just an objectification of women, one that is dripping with testosterone.

This is the one thing that all men have in common: trans men, cis-men, black men, white men, short men, tall men. Misogyny is not a reinforcement of your own masculinity, its simply adds to the inequalities that women (like your mother and sisters and daughters) have had to fight, and will still fight for years and years.

 

So what I propose: an alternative masculinity. The re-socialization of boys. Tell your boy its ok……….

to treat girls and women well

to express emotion

its ok to love

to work on self-development and self-improvement; and most of all……..

 

Boys do cry……………..

 

“We’ve begun to raise daughters more like sons… but few have the courage to raise our sons more like our daughters.”
― Gloria Steinem

As usual dear friends, let us know what you think. Please engage with us on this blog, our website at www.transfeminists.org or drop me a line at coordinator@transfeminists.org

Until next time

au revoir

Leigh Ann

2012 in review S.H.E. Thank you to all of you for your kind support

Published January 7, 2013 by transfeminists

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 1,900 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 3 years to get that many views.

Click here to see the complete report.

Girls like us

Published October 30, 2012 by transfeminists

Good day friends and supporters of S.H.E

I am overjoyed at announcing the success of our strategic planning meeting in East London. I am working on the blog post for that meeting and you will have to wait and see. In the meantime, I am making the announcement that our executive have been put together in our board meeting before the strategic planning and is as follows:

Chairperson: Barbra Muruga, Nairobi, Kenya

Deputy Chair: Marion Stevens: Cape Town, South Africa

Treasurer: Busi Deyi, Port Elizabeth, South Africa

Secretary: Revelation Xakoshe, Pretoria, South Africa

Congratulations to all and I am hoping for a long fruitful working relationship with you all. Our new chairperson, Barbra, has written a good analysis of what it means to be a transgender woman in Africa. For all who read our blog and would like to feature as a guest writer, please drop me a line at transfeminists@gmail.com and I will upload it onto our blog provided it is in line with our feminist agenda. Enjoy this read and do send us your comments.

Girls Like Us

 

I am a beautiful woman. I know that. People tell me that all the time. Men swoon over me numerous times. Women too. I’m getting used to it.

 

But its not easy being me. Girls like us have body issues. Its what they call gender dysphoria. You know, when you’re born with a brain that’s a different gender than your body. We know that changing the brain has been tried countless times with drastic results. But changing the body has bore many a good fruit.

 

African girls like us are not so lucky to get this though. They sail through life not even knowing what is wrong with them. They live miserable lives of mere existence. They just exist. Nothing more. The ones who are lucky enough to know what they are dealing with and get the courage to live their lives face constant hatred, backlash and sometimes violence. We struggle to be ourselves.

 

The one thing that is constant for all of us is; we don’t like our bodies. Especially if we are older. Everything just seems out of place. Like a broken mirror. No one looks at that and says, “wow, I like the reflection”. They simply give it a smirk and leave.

 

The ones who are lucky enough to live out as they are supposed to and actually ‘succeed’ (yes, we live in a patriarchal world that tells us how black and white must look like) have their own struggles. Yes, they are pretty, and smart, and get hit on a lot. But its not all rosy. We may look pretty on the outside, but we definitely still have issues with our bodies.

 

Dating for girls like us is a nightmare. You find someone you like and obviously the ‘sex’ question pops up at some point. The question we all dread. Most of us date straight men. Straight men have particular, usually simple, expectations. Simply put, they want ‘pussy’. We don’t have pussy to give. We have ‘other stuff’ ‘down there’. We hate that ‘stuff’. It completely kills the mood. All the time. Its even worse for those of us who don’t enjoy or have anal sex!

 

So whenever we are with a nice man, our minds are constantly wondering whether we look okay. Whether he can tell. Whether he can see our tiny bump on our necks. Whether they can notice our voices are a few decibels lower than most other girls. Whether they will ask for sex. Whether we can trust them enough to tell them. Whether they will tell others about us once we tell them. Whether they will do something to us if we tell them. So many questions. So many thoughts. Very little enjoyment of the moments.

 

Its our lives. Its who we are. And until we can afford those expensive surgeries that can only be got in a few places and require a whole deal of paperwork that we’d rather not endure, we will survive somehow. We slowly learn to love ourselves. We slowly get to like what we see in the mirror. Every compliment is a boost to our self esteem. Every smile we get for ours is a reminder that someone else likes us. And we can live.

 

We will survive.

Until next time

 

Leigh

 

So what is it with the make-up?

Published August 7, 2012 by transfeminists

The application of make-up to the face and a shield to the sould

Greetings dear friends of S.H.E, social, health and empowerment feminist collective of transgender and intersex women in Africa.

Wow, that’s a mouthful, isn’t it? Following a very hectic last week of training, we kick off this week with another morsel straight from the coordinators pen. In this piece of writing, I want to unpack the issue of make-up. Yes, make-up!!! As unusual a topic it would seem, this plays a big role in the lives of most transgender women I know and believe it or not………..the simple topic of make-up has gained sharp criticism for transgender women.

I’ve always got a little irritated with all the layers and layers of make-up transgender women tend to apply everyday. I apply make-up everyday, so i find it a little hypocritical when I get so annoyed at other trans women applying make-up and making themselves presentable to the world. For me, this presentation centers on one belief, the more the make-up, the bigger the affirmation of their female chosen gender. And this brings me to a burning question. Who decided that make-up and femininity are co-requisites? Well, I know women are programmed from a very young age to apply the foundation, add some colour to the eyes and top off with a nice colourful lipstick. Like most women, transgender women follow this almost religious regimen every morning. And so, when I applied my make-up one morning over the weekend, I thought of unpacking this issue of the context of womenhood, femininity and gender affirmation.

Acceptance of their gender is a top priority for most transgender women. But we tend to associate womenhood with red lipstick, hair extensions and high heels! This also speaks to the sexualization of transgender women. The higher the heel, the longer the extension and the brighter the lipstick, the bigger the sexual fetish around it. I meet gentlemen who question whether I am really trans because, apart from the little eyeliner and vanishing cream, I dont do red lipstick, bright nailpolish and I am particularly put off by weaves and hair extensions. All these things are not unique issues to trans women only. These are stereotypes perpetuated by everyday women, especially sex workers who “create” a “beautiful” concept and we play right into the hands of patriarchy becoming the visual, sexual stimulation sought by men. Without making the conversation too academic, basically we play into the vision men create for us!!!!

Taking men out of the spotlight and not blaming them for all we experience, my reflection on the single issue of make-up points me back to self confidence and security. As a set rule, I would never leave the house without make up, even to buy bread and milk at the corner cafe. For me, it comes back to the way that it makes me feel about myself because social programming has kicked in a long time ago to believe that a woman is no more than her red lips and blossy cheeks. Yes, even my brain is wrapped around that kind of thinking!

During this woman’s month of 2012, I want to encourage transgender and intersex women to explore the issue of make-up, hair and high heels in the context of social femininity. I want all the beautiful trans and intersex sister to realise that we be not defined by all this superficial stuff. No! I’m not saying take it all off. I just want you’ll to be cognisant that you are more than your hair. To the haters out there.

Transgender woman from Pretoria, South Africa

The next time you walk past a sister who slapped her mask on that morning, please stop going: “Girl, what happened to you, that is way too much”. Understand this comes from a place deep within, needing love, security and acceptance. It is an expression of individual identity. We all have that little something something that makes us unique and sets us apart from the rest. Eminem, the American rapper is known for his fowl lyrics, demeaning women in his songs and yet, his music is selling like hotcakes! Whitney Houston was killed by her drug habit and yet she was revered as a international musician. Now a sister wants to express her femininity and she gets sharp criticism from all corners, kinda hypocritical, isn’t it? In the same breath, I want to encourage fellow trans and intersex sisters with the words of India Arie from her song I am not my hair:

Good hair means curls and waves
Bad hair means you look like a slave
At the turn of the century
Its time for us to redefine who we be
You can shave it off
Like a South African beauty
Or get in on lock
Like Bob Marley
You can rock it straight
Like Oprah Winfrey
If its not what’s on your head

Its what’s underneath and say HEY…

I am not my hair
I am not this skin
I am not your expectations no no
I am not my hair
I ma not this skin
I am a soul that lives within

Happy Women’s Month to all the transgender and intersex women around the globe.

Until next time

Leigh Ann and all the folks at S.H.E