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To: Dr F Joubert Chairman of OUT LGBT Well-Being

Request for transgender programs with free access to hormones at TEN81 Centre Clinic.

• Allow for distribution of these hormones to be available at OUT LGBT Well-Being’s TEN81 Centre Clinic free of charge.
• Maintain the supply of hormones needed by persons that want or need to undergo Hormonal replacement therapy at the TEN81 Centre Clinic.
• Acknowledge the necessity of this treatment for the overall well-being of transgender people.
• Provide trans-sensitive health services.
• Counsel transgender and gender non-conforming people about their health needs and provide adequate advice and referral.
• Treat basic health needs of transgender and gender non-conforming people.
• Become competent health care providers for transgender and gender non-conforming people.
• Educate all your staff about transgender and gender non-conforming people.

Why is this important?

Hormone replacement therapy (HRT) acts as a very vital part for transgender people to feel more like themselves. Due to the fact that transgender men and woman will never be able to produce these hormones naturally, HRT is a lifelong treatment that needs to be used recurrently, similarly to chronic medication. People take either the hormone Oestrogen or testosterone with other drugs to help them attain the physical characteristics that society ascribes to the gender they identify with. Examples of this treatment include the development of breasts for transgender woman by taking the hormone Oestrogen whilst Testosterone aids masculinity advances for transgender men [3].

Transgender people are defined as those whose personal identity and gender does not correspond with their birth sex [4]. Navigation gender-affirming proves to be scarce and difficult in our country [2]. Section 9 of the Constitution prohibits discrimination, among others on the grounds of gender [1]. The Alteration of Sex Description and Sex Status Acts (2003) corresponds with our constitutions laws which permits one to change the sex description on their birth record under certain circumstances [4].

OUT provides direct health services to the lesbian, gay, bisexual and transgender (LGBT) community, MSN, sex workers, and injecting drug users, including HIV testing, counselling, treatment and general lifestyle advice and support. OUT is dedicated to the building of healthy empowered LGBT communities in South Africa with intentions of reducing heterosexism and homophobia in society [5]. The mission of the organisation is working towards lesbian, gay, bisexual, transgender peoples’ physical and mental health related rights [5]. The TEN81 Centre Clinic ran by OUT offers services that are professional, free, safe, confidential, non-judgmental and inclusive.

Trans South African you-tube Vlogger Glow Mamiii shares her personal journey on the struggles of gaining access to HRT. She began seeking treatment at Chris Hani Baragwanath (Soweto) but was told she would have to wait 3 months in order for them to administer the HRT. She then opted to seek treatment from a private doctor which not many people can afford as medical aids don’t cover gender-affirming treatments such as HRT and surgeries. She reveals her struggle of finding a trans-friendly private practitioner as well as her personal details regarding the bodily changes and psychological and emotional distresses she experienced on HRT [7]. During the course of her psychiatric consultations and psychotherapy meetings she speaks out against being diagnosed with gender dysphoria as transgenderism is classified as a gender dysphoria disorder [8].

Medical aid schemes don’t cover gender-affirming treatments such as HRT and surgeries as they are considered “lifestyle choices” which leaves trans people with the burden of covering these costs [1]. HRT can cost up to R800 a month adding up to almost a quarter of a million rand on medication [3]. 15% of transgender people are living in poverty compared to 4% of the general population. 19% of transgender people report lacking any form of health insurance including medical aid [6].

Studies show that access to gender-affirming treatment helps reduce thoughts of self-harm and suicide among transgender people.
The only public hospitals that offer trans-specific healthcare services in South Africa are [4]:
• Chris Hani Baragwanath (Soweto)
• Steve Biko (Pretoria)
• Groote Schuur (Cape Town)
• Helen Joseph (Johannesburg)

Treatments are often limited and dependent on how close you live to the facility and the lengths of their waiting lists. The treatment entails regular check-ups and to ensure correct dosage. Withdrawals from HRT lead to severe psychological and emotional distress like gender dysphoria, depression, anxiety and fatigue.

[1] https://www.2oceansvibe.com/2018/10/26/healthcare-medical-aid-and-the-transgender-struggle-in-south-africa/
[2] https://bhekisisa.org/article/2018-10-26-00-tips-for-finding-a-trans-friendly-healthcare-provider
[3] https://bhekisisa.org/article/2018-10-26-00-the-high-cost-of-being-yourself-transgender-healthcare-and-private-medical-aids
[4] https://www.sowetanlive.co.za/s-mag/2019-04-05-conversations-transgender-healthcare-in-crisis/

[5] https://www.out.org.za/index.php/about-out/vision-and-mission

[6] https://www.google.co.za/search?q=transgender+healthcare&client=safari&hl=en-za&prmd=inv&source=lnms&tbm=isch&sa=X&ved=2ahUKEwjfjq-ax6TiAhW2TBUIHTiOCGAQ_AUoAXoECA8QAQ&biw=375&bih=553#imgrc=kzBjfD4lQ0qMIM

[7] https://youtu.be/WXYiZK0l6mc

[8] https://youtu.be/CpCwS177WhU

Updates

2021-04-09 19:14:24 +0200

1,000 signatures reached

2020-07-24 08:48:58 +0200

500 signatures reached

2019-12-07 15:49:01 +0200

100 signatures reached

2019-05-25 11:11:29 +0200

50 signatures reached

2019-05-24 17:48:09 +0200

25 signatures reached

2019-05-24 13:07:02 +0200

10 signatures reached