Magudulela, who celebrated his 22nd birthday on Monday, has been sharing some of his journey with friends and family online.
“The major barriers are that the private options available are too expensive for most South Africans, and public hospitals offering the surgery I need have long waiting lists, from 2-10 years,” he said.
Such surgery is classified as a cosmetic surgery and not medically necessary. Because of this, there is no medical scheme that will pay for the surgery costing between R50 000 and R80 000, he said.
“In addition there is a lack of knowledge. There are only a handful of doctors or surgeons who know and understand what being transgender is and what surgeries transgender people need.
“This has resulted in me emailing and calling surgeons and hospitals across the country and being asked questions like ‘What is transgender? Why do you want this surgery? Is transgender a mental illness?’ and in some instances being told there is no such thing.
“This is both emotionally draining and psychologically harmful,” he said.
Magudulela said he had always known that who he felt like “inside” did not align with this physical body.
“The journey has not been so much a desire to be male, but more me learning about what being transgender is and how to go about transitioning.
“In 2016 I learnt more about trans people and decided mid-year that I was ready to start my transition.
“It was after meeting other trans men and masculine people that I found the courage to start my own journey,” he said.
Magudulela started hormone replacement therapy six months ago. “Highlighting how difficult it is to access hormones, to change your gender marker, to get basic services at public hospitals because of stigma and discrimination, is part of why I’m sharing elements of my journey,” he said.
Professor André van der Merwe of Stellenbosch University and Tygerberg Hospital said gender re-assignment surgery for the province was done by Groote Schuur Hospital, and only a very few cases were done a year.
“There is a bigger need than the service offered in state hospitals. These patients are evaluated over years by psychiatrists and only if a firm diagnosis of gender dysphoria is made would they then be referred for surgery. Patients do not contact a surgeon directly for surgery, but they are referred by a psychiatrist who specialises in this,” he said.
* Magudulela’s “Go fund me” page can be found at: https://gogetfunding.com/siphes-top-surgery/