Cape Town - People wanting sex change surgery at the province’s only transgender health-care unit, at Groote Schuur, could wait for 15 to 20 years, thanks to limited funding and staff shortages.

Only two to three gender reassignment surgeries are performed at the unit every year.

Writing in the SA Medical Journal, Dr Don Wilson, of UCT’s department of psychiatry and mental health, said lack of resources included limited theatre time and a shortage of specialists trained in transgender issues. The unit received three or four clients every month, mostly from outside the Western Cape.

“This translates into a surgical waiting time of up to 15 and 20 years, which is a source of great distress for patients.”

Increasing numbers of people were going to the unit, with some as young as 13 and some aged 60.


At the Groote Schuur unit – one of the only two public health-care centres that offer transgender services in the country – there are at least 148 patients waiting for sex change surgery.

The centre, established in 2009, is the only transgender unit that offers a comprehensive package of care including gender research, technical support and follow-ups for the families. The transgender clinic at Pretoria Academic Hospital offers only a partial service.

Wilson said since the unit opened about five years ago, it had assisted just over 100 people, with about 83 percent saying they realised as adolescents they were gender “diverse”. About 20 percent had psychiatric disorders. Psychiatric problems were likely to be due to stigma and discrimination associated with being transgender. Almost half the patients were white, 40 percent were coloured and 10 percent were black.

Wilson said while mental health practitioners no longer acted as “gatekeepers” to transition services for transgender people and now played more of a supportive, evaluative role, the lack of undergraduate and postgraduate training in transgender issues restricted the number of trained professionals.

There was also a need for more reconstructive and plastic surgeons to take an interest in the treatment of transgender people.

He called for the government to consider investing more in transgender treatment.

“As the unit currently also treats patients from outside the Western Cape, there are legitimate grounds to motivate for quaternary funding from the national Department of Health,” he said.

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Cape Argus