On the 26th of June 2023, Iranti hosted the Margins to Mainstream Stakeholder Policy Dialogue in Durban. This followed the Durban Pride demonstrations and provided a space to reflect on progress and shortcomings relating to trans and intersex rights in Southern Africa. The dialogue was attended by government officials, transgender and intersex people as well as representatives from action groups such as Uthingo Network and TransHope.
Sazi Jali, executive director of TransHope, raised concerns on the inaccessibility of gender-affirming healthcare- particularly for transgender individuals. In attempt to combat this, TransHope began facilitating training sessions on gender-affirming healthcare which were targeted towards healthcare practitioners. They also reached out to the Department of Health with hopes of setting up a program that would allow transgender people to access gender-affirming surgeries provided by surgeons who had received the training. Unfortunately, the project received no response from the department, as well as a low turnout of surgeons at the training sessions. This has resulted in gender-affirming healthcare only being available to those who can afford private healthcare. Those who are able to access private facilities often complain about hostility from service providers which in turn makes them reluctant to continue using these services. This is not limited to the healthcare sector, as transphobia and homophobia are often reported from officials operating government LGBTIQ+ help desks. Government stakeholders acknowledged the importance of putting in measures to foster LGBTIQ+ friendly services, highlighting how this could be combated through the refinement of hiring criteria as well as setting quotas that consider diversity, equity and inclusion.
The reluctance of healthcare practitioners towards gender-affirming healthcare has long been a prominent issue in the intersex community. Medical coercion towards unnecessary and harmful surgery has been a common experience for many. In these cases, medical practitioners often coerce intersex people and their families into agreeing to unnecessary medical interventions by misleading them into believing that intersex characteristics are life threatening and in need of surgery. Often times, these surgeries are only cosmetic and do not necessarily improve the intersex person’s quality of life. This coercion is exacerbated by a lack of educational resources surrounding intersex healthcare. Crystal Hendricks, Iranti’s Intersex Officer, reiterated a need to move towards the recognition of autonomy and self-determination where intersex people are given the opportunity to live their lives as normal and only receive surgery and medical interventions at their request. Hendricks also highlighted a need for more educational resources around intersex healthcare, especially those that accommodate the diverse language landscape of South Africa. Whilst South Africa has twelve official languages, comprehensive education is seldom provided in indigenous languages which often leads to gaps in understanding medical procedures and the reasons for them.
Whilst there has been a positive shift towards gender-affirming policy in other areas, such as Legal Gender Recognition (LGR), implementation has been a challenge. Many transgender and gender diverse individuals experience long waiting periods when it comes to securing identity documents – reporting waiting periods that span over six months. This directly negatively impacts the ability to access housing and job opportunities, a reflection of the intersecting challenges gender diverse people face. To combat this Ntuthuzo Ndzomo, Iranti’s Advocacy Officer, expanded on laws and policies that are currently in place in South Africa, such as the Alteration of Sex Description and Sex Status Act 49 of 2003. Sylvester Kazibwe, Iranti’s Intersex Officer, expanded on the legal system within the African Commission on Human and People’s Rights, and how organizations further advocate and lobby for these rights, as well as support the court sessions. There was a clear need for more sessions that expand on legal frameworks and the steps stakeholders should take in order to access the rights stipulated within the African Charter – especially when it comes to using soft laws such as Resolution 275 to their advantage.
The session cultivated a space for learning about intersex and trans issues as well as strengthening the collective work towards the actualization and protection of trans and intersex rights. It also highlighted the importance of utilizing collaborative efforts when combating the push-back against creating a more safe and inclusive society. Not only would this increase the impact and reach of the work that is being done, but also build a uniform voice when addressing trans and gender-diverse issues.