Trans inclusive healthcare
Trans, intersex and gender diverse people face barriers while trying to access medical transition needs such as hormone therapy, puberty blockers, gender-affirming surgeries and referrals to community support. Many healthcare providers are untrained to provide trans-inclusive care to the trans community. Some are hesitant to provide trans-specific primary care, while others are unwilling to learn and refuse to provide it.
Gender-affirming healthcare
Gender-affirming care, including hormone therapy, gender-affirming surgeries and puberty blockers are essential for the overall health and wellbeing of trans, intersex and gender diverse persons. However, many trans, intersex and gender diverse people face significant barriers in accessing gender-affirming health care (Puckett et al., 2018).
Access to gender-affirming health care is almost non-existent for trans, intersex and gender diverse persons across East Africa. According to research done by EATHAN in 2019, access to gender affirming health services was found to be very low in the region. Only 15.3% trans women and 10% trans men reported to be on hormone replacement therapy. Similarly, only 8.3% intersex people reported to have had some form of gender reassignment surgery with none reported for trans women and trans men (Leone, D; Ukwimi, C; Akoth B; Wangare, B (2019)).
Health services for gender diverse persons are lumped under HIV related clinical services for “Key Populations”. This poses a great challenge for trans, intersex and gender diverse persons as the health and HIV/AIDS prevention, care and support interventions have largely focused on cisgender sex workers and men who have sex with men (MSM). This systematic exclusion of trans, intersex and gender diverse persons from tailored health services has resulted in limiting the health outcomes for the community in East Africa (Leone, D; Ukwimi, C; Akoth B; Wangare, B (2019)).
Country context
Trans, intersex and gender diverse people still do not have access to gender-affirming care. State-sponsored intolerance for sex and gender diverse people fuels stigma and discrimination against trans, intersex and gender diverse people in Burundi, with numerous reported cases of illegal arrests and detentions by law enforcement officers.This hostile context poses major challenges for trans, intersex and gender diverse persons to access health and legal services. This negative environment has resulted in almost no trans, intersex and gender diverse health care, with many lacking access to general health care as well as other gender-affirming care such as hormonal therapy and gender-affirming surgery. trans, intersex and gender diverse people are still involved in the LGBQ community and organising, particularly when it comes to health and HIV services.
( EATHAN 2019)
Access to gender-affirming healthcare is almost nonexistent. Trans, intersex and gender diverse organisations have a referral system to appropriate doctors such as endocrinologists, psychologists, psychiatrists, and surgeons, but these doctors provide services on a case-by-case basis and only privately. Trans, intersex and gender diverse people mainly access general friendly healthcare and HIV services at MSM or SW clinics. This is due to the high levels of discrimination that they face when trying to access these services at mainstream service providers, especially government hospitals.
( EATHAN 2019)
The continued harassment of trans people in Rwanda has been a major impediment to the provision and accessibility of services for trans and gender diverse people. The constitution of Rwanda protects all citizens from all forms of discrimination, owing to the lessons learned from the Genocide. However, the continued intolerance for people who do not conform to the hetero-norm endangers the lives of many trans, intersex and gender diverse people, leaving them with few options for legal protection, access to affirming health care, and the ability to make affirming legal changes.
( EATHAN 2019)
The government of Tanzania moved to introduce health policies that deny sexual minorities access to health services, which has resulted in adverse effects such as sexual minorities living with HIV not being able to pick up their medication from public health centers. The state-sanctioned and driven crackdown on sexual minorities had a negative impact on trans, intersex and gender diverse people’s health and legal outcomes in Tanzania. This meant that trans, intersex and gender diverse people lacked access to basic health services for fear of stigma, discrimination, and even arrest if they sought help. It follows that access to gender-affirming health services like hormonal therapy is also not easily available. However, there are several trans men who take gender-affirming hormone therapy, but very few trans women—this could be a result of the effects of patriarchy and religion, as well as a serious lack of awareness.
( EATHAN 2019)
The hostile environment in Uganda has made it difficult for trans,intersex and gender diverse people to access legal and gender-affirming health services, as well as increased their vulnerability to violence. Trans,intersex and gender diverse people, particularly trans women, live in hiding, suppressing their gender identity expression in public spaces.
( EATHAN 2019)
Videos
Creating Trans-Inclusive Reproductive Health Care Services
Using Inclusive Language When Taking a Patient History
How to Create Gender-Inclusive Healthcare Settings
Trans-Inclusive Healthcare Series from the Trans-ilience Team
Disclaimer: Please note no copyright infringement is intended and as EATHAN we do not own nor claim to own the videos used here.
Please Remember:
Gender-affirming care, including hormone therapy, gender-affirming surgeries and puberty blockers are essential for the overall health and wellbeing of trans,intersex and gender diverse persons. However, many ITGNC people face significant barriers in accessing gender-affirming health care (Puckett et al., 2018). Access to gender affirming health care is almost non-existent for ITGNC persons across East Africa.