while I celebrate top surgery… THE most often told South African trans story #Health4Trans #beingtransgenderandblack

And while I celebrate my top surgery… The chasm between racial experiences of healthcare in the South African transgender landscape:


Portrait by Germaine de Larch, for Anova Health Institute’s Health4Trans platform

Given (his face and real name have been obscured for his own protection from homophobic and transphobic violence) is a 23-year old, trans man, born and bred in Johannesburg, He currently lives in the Vaal, and is a student at the local university #Health4Trans #ThisIsTransZA

Given’s story with regard to general healthcare as a trans person, and his access to trans healthcare:

“I spent most of my childhood in the Johannesburg children’s home, where my grandmother worked as a caregiver until I moved to the Vaal in Vereeniging, where I have been ever since. I am not out as trans to my family or my community and live as a “girl” at home and my real self as a boy in situations where people don’t know that I’m transgender.

I have been self-medicating for two years [obtaining testosterone through friends or on the black market] before considering the public healthcare system as an option to assist in terms of transitioning.

Money can be extremely tight because I am a student so sometimes I’d have to choose between food and T and most of the time T would win… When my mum got constructively dismissed, things went downhill… As we speak, I decided to take the difficult route of studying and working at the university where I get a little over two grand per month, which has been a way to start saving for top surgery. I know it’s not much but its better than nothing I guess… Some might feel it will take forever, but I am willing to; although it’s hard because from that two grand I need to also set aside money for T, the doctor and gym, and all the gym gear needed, most of the time it would come down to priorities.

I guess its true when they say that once things start happening on hormones, it’s not all perfect… I struggle so much with the marks acne left on my face, I shy away from pictures. I feel like I am scary and can’t bare me sometimes, but I don’t regret the decision to start hormones. In a way when I am medicating it feels like I am doing something to run from the unwanted body.

Without hormones I feel like an alien in a boy’s body – boys don’t bleed once a month. I don’t even tell my family I need sanitary pads because this is not supposed to happen to me. So I sit at home, don’t go out and miss school and everything else until the bleeding stops. As we speak right now, dysphoria has crept into my bed last night; once more the red robot has made its’ stop once more like it always does monthly…

Binders have been my best friend as I live in what is dubbed the Capital Murder Area for Lesbians [“corrective rape” and the violence and murder enacted on people who embrace masculinity – documented by photographer Zanele Muholi – See Faces and Phases]. More than anything, the T and the binders have protected me from the harshness of this place.

The public healthcare system experience hasn’t been pleasant. For many reasons: because of the way we are treated, the stigma attached to seeking trans healthcare, and the huge amounts of time and money I need for travelling. The healthcare system for trans identifying persons is a personification of a monster and further highlights that it’s a journey and/or experience that leaves one oozing with depression and feelings of worthlessness. I find myself daily questioning whether the rights expressed in the Constitution actually translate to trans healthcare needs.

The situation that prevails is what leaves most of us caught up between a rock and a hard place when it comes to transitioning via public healthcare services, after being rejected, even though I’ve already been on the hormone for two years. I was faced with having to choose to self-medicate or allow the dysphoria to destroy me like cancer slowly. In summary, being black and trans or gay is like SIN PERSONIFIED in black communities…. I just wanna be a normal boy. Is that too much to ask…?

Thank you so much for allowing me to retell this story … I never realised how liberating it was to speak up like this until a few years ago. Although I never really do it because it’s dangerous for me, the Vaal is really scary… But thankfully, the binder and my voice [deepened by Testosterone] has become my watchdog.”


I’m very blessed and privileged to have been asked to project manage and collaborate with the six transgender and gender non-conforming people in the making of their portraits in this series by Anova Health Institute‘s Health4Trans Health4Trans platform.

The importance of Given’s story: 

Never forget that the Caitlyn Jenners of the South African trans story are the minority; just as her story is not the story of the majority of American transgender and gender non-conforming people.

Given’s story is the experience of the majority of masculine transgender or gender non-conforming people in South Africa. I don’t use the word “transgender” as a blanket term here, because while some black Africans call themselves transgender, many don’t, because there are no words in black African languages for the word “transgender”, and black African people’s understanding and expression of gender and sexual orientation is not the same as the white, Western understanding, especially before Colonialism.

The experience of Given and others in the same position is an issue misunderstood by South African and international society through the media’s misrepresentation of people who are raped to “cure them” of their homosexuality (“corrective rape”). The issue of the rape and murder of young, black, masculine-presenting people is not a homosexual issue. It’s a gender issue, as Given himself said to me and as Zanele Muholi‘s and Inkanyiso powerful work proves over and over again, only to fall on deaf ears and blind eyes. Given’s story underlines that the targets of this rape and murder are, in many cases, the gender non-conforming, masculine-presenting partner of the feminine-presenting partner.

Thank you to Anova Health Institute for their Health4Trans project and platform, raising much-needed awareness of the healthcare issues faced by transgender and gender non-conforming people in South Africa – both general medical care, and gender-affirming healthcare.

And huge thanks to Given for sharing his story with Health4Trans and for agreeing to collaborate with me in this portrait of him. Siyakuthanda and ngiyakuthanda kakhulu, mfwethu.


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