'We expect respectful, dignified treatment from doctors'
Dr Anastacia Tomson, who is a transgender woman, tells Bethany Ao that many doctors are transphobic and judgmental because they lacked understanding about the issue.
Cape Town - Seeing a doctor for a diagnosis or prescription is a natural step for anyone who is sick.
However, for many transgender people in South Africa, the doctor’s office is often a source of distress due to a lack of sensitivity, respect and knowledge.
Joburg doctor Anastacia Tomson, who is a transgender woman working to educate her peers, said many doctors were transphobic and judgmental because they lacked understanding about the issue.
“It takes me five minutes to teach a doctor how to prescribe hormones. But it takes me two-and-a-half hours to make them care enough to do it.”
Tomson once encountered a doctor who didn’t believe she was transgender, because she said she presented as male in front of him. “It seemed like my lived experience was secondary to what he saw in front of him,” said Tomson. “You don’t say to a diabetic, You’re not diabetic enough, come back when you’ve had a heart attack.’”
Tomson, who recently published a book about her experience entitled Always Anastacia: A Transgender Life in South Africa, said when she studied medicine at the University of Pretoria there was almost no material on transgender health issues in the curriculum. She remembered just one mention of transgender patients from a lecture, during which the professor said: “Surgery doesn’t help those people.”
Today, doctors who work regularly with transgender patients often pick up the necessary skills through experience and exposure. “Education and competence training with doctors is necessary,” Tomson said. “It’s so important to help someone who is cisgender (who conforms with the gender that corresponds to their biological sex) understand that they can’t look at this in a reductionist way. We make ourselves vulnerable to strangers when we seek out health care, so when someone has a bad experience, it can drive them to self medicate.”
Ronald Addinall, a clinical social worker, sexologist and academic in UCT’s social development department, said he frequently received reports from transgender clients about prejudiced and uneducated doctors.
“I still get a distressed call at least once or twice a week from a patient in tears saying, I went to clinic today and there was this new doctor and literally the doctor asked me, do you know what you’re doing is against God? Why would you want to do this to yourself?’” he said.
“Our clients are very vulnerable when they do attempt to access health care because they don’t know what the level of knowledge, expertise and particularly the attitudes of the healthcare practitioners are going to be.”
Respectful and dignified treatment can set the tone for the rest of the relationship a transgender patient has with a doctor, according to Sandile Ndelu, a transgender woman and activist with Gender DynamiX. “That’s basic first point of call when engaging with a medical professional, it’s just actually having warm practitioners you don’t have to give trans 101 to.”
Leigh Davids, a transgender woman, said unless there was serious education within departments at hospitals to create visibility and understanding, clinics would never work for transgender people.
“I will go into a normal clinic and the doctor will look at me and say, So what do you moffie now want?’ So now, I’m not going to tell you what I’m here for really, what my issue is, what my situation is, which means I will never get the help I need now, just because of how you greeted me in the first place. One is just being discriminated against based on what you look like.”