Transsexual Women: Negotiating health care in a hetero-normative health care system

Monday, 18 November 2013

Douglas D. Newman-Valentine, M Cur Education, B Cur
Division of Nursing and Midwifery, University of Cape Town, Cape Town, South Africa
Sinegugu Duma, PhD, MCur, BCur, RN
Department of Health and Rehabilitation Sciences, University of Cape Town, University of Cape Town, Cape Town, South Africa

Learning Objective 1: The learner will be able to gain insight into the unique health needs of transsexual women.

Learning Objective 2: The learner will be able to reflect on the new knowledge acquired in order do change his practice to render better care to transsexual women.

A transsexual woman was biologically born as a male individual yet she identifies as a female. She will explore the available treatment package of chronic hormonal and surgical sexual re-assignment to align her physical sexual characteristics with her gender identity.

The treatment package is in itself empowering, but it leaves transsexual women vulnerable to an array of side effects of treatment such as hypertension and associated cardiac conditions, diabetes, an increased risk of cancer development, vulnerability to the contraction of HIV and mental health related conditions such as depression. As a result of these side effects, transsexual women would need chronic care and they would need to negotiate a hetero-normative health care system for their care. Globally reviewed literature demonstrated that these women have poor access to health care services and that the knowledge of health care providers with regards to trans-related health care needs is limited. It is also unknown if transsexual women have adequate knowledge with regards to their unique health needs that would assist them to negotiate appropriate health care.

This study explores and describes the self-reported awareness of the adverse effects of the treatments package among transsexual women. It also explores and describes their health seeking behaviour and negotiation skills for appropriate health care.

This South African based study included 18 participants selected through purposive sampling. Individual and focus group interviews were utilised together with participant observation to gather data. Data is analysed with qualitative techniques.

The results of this study aims to inform the practice of health care providers to render appropriate care to transsexual women.