The reality of gender reassignment surgery in SA
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Transwoman Lara Palmer, 29, was on the gender reassignment waiting list for nine years before she received the call to say that it was her turn. Her surgery would have taken place in June last year, but due to the pandemic, it was postponed to January. But the country then went into a second wave and the operation was postponed again. Palmer’s surgery eventually happened this month, on June 3.
While many transgender men and women would like to have the surgery done immediately, the average time spent on the waiting list is 25 years. Groote Schuur Hospital only performs four gender reassignment surgeries per year.
Although Palmer’s surgery was postponed twice, she counts herself lucky.
“When I received the operation date, it had not sunk in yet. I thought it will get cancelled because of the third wave. When I had my Covid-19 test done and signed the consent forms, I started preparing myself mentally for my surgery.”
Palmer, who is originally from Riviersonderend, moved to Cape Town in 2015 in search of work and to be closer to Groote Schuur Hospital where she received her hormone therapy monthly.
She started her hormone therapy in 2011, and this was where she first learnt about the surgery.
“Coming from a small town, I didn’t know that gender reassignment surgery was possible. I didn’t know it was an option for me to transition and have surgery done,” she said.
She added: “I always knew that I am a woman. When I realised that this is possible, I knew in my heart that I would start working towards having it done. Come what may, the surgery was my end goal.”
Now in her second week of recovery, Palmer describes her experience as surreal.
“I feel amazing! I cannot believe that I have a vagina now. It has taken so long, and the journey has been tough. I made it, the dream came true.”
Palmer said she didn’t think that she would get to the point of having the procedure. Over the last ten years, many have tried to talk her out of having the surgery done.
“Even after I had breast augmentation done last year, I still felt incomplete. It felt like something was missing,” she said.
Cassidy Hindley, 22, from Belhar, has been on hormone therapy for almost a year now and is under the treatment of the Wits Clinic.
At the age of 15, Hindley learned about what being transgender is from a friend at school.
“I always felt female. After researching what being transgender is, I realised this is my story, and this is what I identify as,” she said.
The 22-year-old never saw going on the waiting list as an option because she did not want to spend half her life waiting for the chance to have it done.
“My payment plan was to go and teach in Thailand for a few months, save up and have it done there. They’re one of the leading countries for this surgery, and they specialise in it.”
Hindley added: “Having gender reassignment surgery done in Thailand is like having botox done. With their exchange rate, I would pay less for it there than I will here in South Africa.”
Both Palmer and Hindley agreed that transgender healthcare in South Africa needs more funding.
Hindley said: “We are active members of society, and we contribute to the economy as much as the next person. The transgender community deserves more funding and accessible healthcare.”
Palmer added: “The doctors are available, the surgical theatres are available, but without proper funding, this means nothing, and the number of surgeries done per year won’t change.”
Programmes Manager at trans-specific organisation Gender Dynamix Anil Padavatan said that “gender-affirming” healthcare needs to be included in the country’s national health index.
“In the meantime, access to gender-affirming surgery should be seen as an essential, non-elective procedure for those who require it,” he said.
Padavatan added: “International studies are showing that gender-affirming surgery is essential for the mental and physical health of some members of the transgender and gender diverse community.”
“Providing better access to gender-affirming healthcare is vital, both in terms of the Constitutional rights to equality, human dignity and access to health care and in terms of public health. As a society, we cannot afford NOT to provide health care to vulnerable communities,” he said.