A concerning opinion was published in The Witness on News24 on 25 August 2021:
PATHSA’s response was published on 3 September 2021 at this link https://www.news24.com/witness/opinion/columnists/path-to-quality-of-life-a-response-to-diesel-20210903
The full letter follows below.
In addition, a trans activist Kellyn Botha wrote a beautiful response which was also published on 3 September 2021 at this link https://www.news24.com/witness/opinion/columnists/facts-over-phobia-a-response-to-diesel-20210903 The full text be posted on this website.
The Witness published a response by Diesel to PATHSA’s letter by Diesel on the same day (3 September 2021), see https://www.news24.com/witness/opinion/columnists/sa-situation-has-not-demonstrated-openness-to-critical-discussion-20210902
PATHSA letter to The Witness regarding “Breaking boundaries safely” (25 August 2021) – published on 3 September 2021
As the Professional Association for Transgender Health, South Africa (PATHSA), we would like to respond to “Breaking boundaries safely” (25 August 2021) by Alleyn Diesel as we believe it is not an accurate reflection of gender-affirming healthcare. PATHSA is an interdisciplinary health professional organisation working to promote the health, wellbeing, and self-actualisation of trans and gender diverse people.
While we acknowledge that a minority of individuals who accessed gender-affirming healthcare will detransition and that their stories need to be taken seriously, we assert that this is not the whole picture. Regret is very rare and the majority of people who access gender-affirming healthcare have significant improved quality of life.
The approach to gender-affirming healthcare is different for prepubertal children, adolescents and adults. An affirming approach is followed for prepubertal children, which means that instead of attempting to direct a child toward a particular identity, parents and
caregivers accept a child’s own individual journey. (Temple Newhook et al., 2018) Following careful assessment by a qualified mental health professional, social transition may be recommended. (Durwood et al., 2017) Within this model of care, it is understood that the gender that is the “right fit” may differ at different ages and stages of life. Research has shown that transgender and gender diverse children who are affirmed in their gender have mental health outcomes equivalent with cisgender children (whose gender identity and sex assigned at birth are aligned). (Olson et al., 2016)This is in stark contrast to the high levels of psychological distress and behavioral problems documented among children who were discouraged from asserting their identities in childhood. (Turban, 2017)
It can be very distressing for a transgender adolescent to experience the puberty changes in their body, of a gender they do not experience themselves as. In this context, puberty blockers can be safely used to halt the progression of physical changes. Gonadotrophin-releasing hormone agonists (GnRHa) suppress the hormonal axis that results in secretion of endogenous oestrogen and testosterone responsible for induction of secondary sexual characteristics, such as breast growth and menstruation in trans boys and voice deepening and facial hair development in trans girls. This permits the adolescent to develop emotionally and cognitively, before making decisions on gender-affirming hormone therapy which is likely to have irreversible effects. Pubertal suppression has been shown to improve mental health and decrease suicidality. (Turban et al., 2020) The effects of puberty blockers are reversible and when the treatment is stopped, the development of secondary sexual characteristics will continue unless the adolescent is started on hormone treatment. Follow-up studies after puberty suppression from the Netherlands show that the rate of adolescents that stop the reversible blockers because they no longer wish to transition is very low; between 1.9% (Wiepjes et al., 2018) and 3.5% (Brik et al., 2020) in two respective studies.
For older adolescents, hormone treatment is an internationally accepted option. Given that this can have potentially irreversible effects, the International Endocrine Society Guidelines recommend initiating treatment after a multidisciplinary team has confirmed gender incongruence and sufficient mental capacity to provide informed consent. While we agree with Diesel that “hasty and ill-considered diagnoses and treatments” are not in the best interest of anyone, gender-affirming healthcare that follows a thorough informed consent process can be lifesaving and improves the lives of many transgender and gender diverse people, including in South Africa. The informed consent model of care ensures a process where the risks and benefits of various treatment options are discussed with the adolescent and their parents / legal guardians to enable an informed decision. The membership of PATHSA includes health professionals who have collectively cared for hundreds of transgender and gender diverse young people, who have better lives as a result.
Diesel uses very distasteful language to describe gender-affirming surgery such as “mutilations” and “a Frankenstein body”. This is an insult to both transgender individuals who access surgery and the surgeons who perform these procedures. Research has shown that satisfaction following gender-affirming surgery is usually high, with less gender dysphoria, reduced psychological turmoil, and resulting in better integration into society. In contrast to Diesel’s allegation of bodies being “frequently not sexual functioning”, research shows improved sexual functioning following vaginoplasty with high satisfaction reported for intercourse and orgasm. (Zavlin et al., 2018)Regret following surgery is very low, with a large Dutch cohort reporting regret in 0.6% of trans women and 0.3% of trans men. We would like to clarify that gender-affirming surgery is rarely performed in adolescents. There are cases where a multidisciplinary team will recommend mastectomy for a trans boy with severe chest dysphoria before the age of 18, but that will be following careful consideration that it is indeed in the best interest of the specific individual.
Diesel refers to the principle in medical ethics of “first do no harm”. We would like to point out that withholding gender-affirming treatment is not a neutral act and can indeed be harmful, as South African doctor Anastacia Tomson argues eloquently in an article on Gender-affirming care in the context of medical ethics. It would be unethical to withhold treatment with a strong evidence base for benefit, because of the small percentage of individuals who may later regret their decision and detransition. The autonomy of transgender and gender diverse individuals needs to be respected to make choices about their treatment, and our role as health professionals is to facilitate safe access to care. We certainly do not force any individual down a particular path.
Although Diesel calls for a more “tolerant world”, she appears not to be tolerant of either health professionals providing gender-affirming healthcare or transgender and gender diverse individuals who make autonomous decisions to access care. PATHSA yearns for a world where all transgender and gender diverse people will be respected and accepted as fellow human beings and be able to access responsible and quality gender-affirming healthcare.
Almazan, A. N., & Keuroghlian, A. S. (2021). Association between Gender-Affirming Surgeries and Mental Health Outcomes. JAMA Surgery, 156(7), 611–618. https://doi.org/10.1001/jamasurg.2021.0952
Brik, T., Vrouenraets, L. J. J. J., de Vries, M. C., & Hannema, S. E. (2020). Trajectories of Adolescents Treated with Gonadotropin-Releasing Hormone Analogues for Gender Dysphoria. Archives of Sexual Behavior, 49(7), 2611–2618. https://doi.org/10.1007/s10508-020-01660-8
Durwood, L., McLaughlin, K. A., & Olson, K. R. (2017). Mental Health and Self-Worth in Socially Transitioned Transgender Youth. J Am Acad Child Adolesc Psychiatry, 56(2), 116–123. https://doi.org/10.1016/j.jaac.2016.10.016.Mental
Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V., & T’Sjoen, G. G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658
Olson, K. R., Durwood, L., Demeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3). https://doi.org/10.1542/peds.2015-3223
Telfer, M. M., Tollit, M. A., Pace, C. C., & Pang, K. C. (2018). Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Medical Journal of Australia, 209(3), 1. https://doi.org/10.5694/mja17.01044
Temple Newhook, J., Pyne, J., Winters, K., Feder, S., Holmes, C., Tosh, J., Sinnott, M. L., Jamieson, A., & Pickett, S. (2018). A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children. International Journal of Transgenderism, 19(2), 212–224. https://doi.org/10.1080/15532739.2018.1456390
Tomson, A. (2018). Gender-affirming care in the context of medical ethics – gatekeeping v . informed consent. S Afr J Bioethics Law, 11(1), 24–28. https://doi.org/10.7196/SAJBL.2018.v11i1.616
Turban, J. L. (2017). Transgender Youth: The Building Evidence Base for Early Social Transition. In Journal of the American Academy of Child and Adolescent Psychiatry (Vol. 56, Issue 2, pp. 101–102). Elsevier. https://doi.org/10.1016/j.jaac.2016.11.008
Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 145(2). https://doi.org/10.1542/peds.2019-1725
Wiepjes, C. M., Nota, N. M., Blok, C. J. M. de, Klaver, M., Vries, A. L. C. de, Wensing-Kruger, S. A., Jongh, R. T. de, Bouman, M.-B., Steensma, T. D., Cohen-Kettenis, P., Gooren, L. J. G., Kreukels, B. P. C., & Heijer, M. den. (2018). The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in Prevalence, Treatment, and Regrets. The Journal of Sexual Medicine, 15(4), 582–590. https://doi.org/10.1016/J.JSXM.2018.01.016
Zavlin, D., Schaff, J., Lellé, J. D., Jubbal, K. T., Herschbach, P., Henrich, G., Ehrenberger, B., Kovacs, L., Machens, H. G., & Papadopulos, N. A. (2018). Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic, Functional, and Sexual Outcomes. Aesthetic Plastic Surgery, 42(1), 178–187. https://doi.org/10.1007/s00266-017-1003-z
Trans young people and school uniforms
This article was published today and refers to the open letter to the Education Department regarding discrimination against LGBTQI learners, of which PATHSA is a signatory. It is great that different organisations are working together for a common aim, to improve the lives of TGD people. The letter can be viewed here:
“Dit is beter om te dink oor gender as ’n spektrum eerder as twee pole. Omdat daar meer openheid is, is dit ook nou meer moontlik vir niebinêre persone om uitgesproke te wees oor hulle genderidentiteit.” ‘n Gesprek tussen die teoloog Pieter GR de Villiers en Elma de Vries.
Lees die hele artikel hier.
Difficult questions about gender diversity, and how church communities can be more understanding – for the Afrikaans journal LitNet.
The New Deal was a domestic programme of the administration of U.S. President Franklin D. Roosevelt between 1933 and 1939, to bring about immediate economic relief after the Great Depression. Opposed to the traditional American political philosophy of laissez-faire, the New Deal embraced the concept of a government-regulated economy aimed at achieving a balance between conflicting economic interests.
Where human rights in South Africa are concerned, and perhaps trans rights more specifically, there has been a similar balancing act between regulation and freedom. We forbid hate speech but we recognise freedom of speech. We recognise the rights of trans people to self-identify and change important official documents, but Home Affairs officials seem to get away with indulging their personal scruples about processing a trans person’s papers.
How does the State enforce contemporary rights when social attitudes are stuck in the 1950s? This is the quandary for trans people, and their allies, in South Africa. Push too hard and there is resistance, act too timidly and trans lives not only don’t matter, they are invisibilised (or sensationalised for clickbait).
On paper, trans and gender diverse people in South Africa have a good deal. Or do they? All deals are a compromise, and some deals aren’t worth the paper they’re written on, negotiated by unequal partners. Often subsumed into rights for same-sex loving people, trans rights are in some ways the “poor cousin” of the greater queer struggle, tacked on to conversations about gay men and lesbian women, bogged down in prurient curiosity about hormones, surgeries and genitalia. Or the push for trans dignity is reduced to “gender panic” conversations about toilets, or sporting codes where winning is everything.
So what are the rights trans people have in South Africa? Well they have a number of general rights enshrined in the Constitution, including rights in workplaces, places of education, in health care settings, and in the broader society where they may face harassment and harm. And trans people can change their legal sex marker on identity documents. These rights come with caveats of course, largely that these are paper rights and worth nothing if there is no implementation or oversight. There are very few resources for trans people to access hormones and surgeries through the State, and only two hospitals carry out gender affirming surgeries, and then sometimes at the whim of over-burdened practitioners. Covid has also caused a brutal prioritisation of services, and trans people are very low on that list.
Where recognition of sex markers is concerned, activists have noted that beyond the often hateful treatment trans people receive in Home Affairs offices, the system is still steeped in the gender binary: one must be one thing or another. All credit to the State, a proposal is on the table for the development of an identity system which simply provides a newborn with a number, with no reference to sex. This would allow people to move in the world freed from the constrictions of gender binaries. Of course there will be other ways for gender data to be aggregated, but the trans and gender diversity struggle has shown that many people are simply beyond the binary, and should be free to be so.
Trans activist and psychologist working in sexualities, gender and trauma in KwaZulu-Natal province, Chris McLachlan, spoke recently of their sense that hate crimes against trans people are on the rise. Against a backdrop of recent murders of queer people, this makes sense. Well it does and it doesn’t, because making sense of anti-queer hate crimes is always a tortured exercise in psychological and sociological theorising. It’s also almost impossible to access a reliable and updated database of hate crimes aimed at trans and gender diverse people. What you don’t record you don’t plan for.
So what is the plan? Perhaps we don’t just need a New Deal on trans rights, but a New Deal on human dignity, recognition of which is in short supply in our country. As an organisation PATHSA recognises the resistance to trans rights, but argues that meeting the needs of trans people, not just in health but in all spheres of social engagement, is a social good. While it’s unhelpful to position trans people only as marginalised victims, the truth is rather bleak. We need a New Deal on human dignity, one where there is no compromise, just an unflinching aim at the highest possible target, respect, equality, equity and the freedom to be.
South Africa, it is enough
Over the past two and half months, South Africa’s LGBTIQ+ community has been rocked by a series of brutal hate crimes against its members – from KwaZulu-Natal to Gauteng, from the Eastern Cape to the Western Cape. At least six lives – that we know of – have been snuffed out in cold blood.
We have been here before
Since the dawn of democracy, LGBTIQ+ South Africans have been brutalised, raped and killed across our nation. The list is long. Names like Sizakele Sigasa, Salome Maoosa, Eudy
Simelane, Gift Makau, Sana Supe, Nare Mphela, Kirvan Fortuin and Lindo Cele may stand out but so many others did not make headlines. So many more have gone unrecognised as hate crime victims at all because even today we still have no hate crime legislation in this country.
Today we still fear to simply be ourselves, to dress how we choose or to share an embrace – not only in public but also among those who we may count as friends and neighbours. They too are our murderers; sometimes children as young as 14.
Not only do we fear for our very lives, but we continue to face discrimination all around us. Social media platforms are replete with queerphobic words, threats and slurs with no consequences. Religion continues to be used as an excuse to debase our community in ways that would never be tolerated when it comes to other citizens or groups. Our state dehumanises us in police stations and government offices.
Our community’s plight is a bloody stain spreading across our constitutional democracy and our leadership. We’ve seen a seemingly endless stream of conferences, workshops, task teams and statements but truthfully there has been little action.
South Africa’s Constitution does not just come with rights but also responsibilities, including leading by example. Our great continent is still plagued by LGBTIQ+ hate that has roots in its colonial past; a twisted heritage that we simply refuse to acknowledge or shake off and have misguidedly embraced as African.
Today, we are here to say enough. We are tired of lip service. We are tired of promises. We are tired of excuses. Today we demand the following:
That by the end of this week (Friday 23 April 2021) the President of the Republic of South Africa unequivocally speaks out, condemns and calls for an end to the violent attacks on the LGBTIQ+ community.
Furthermore, the Government of South Africa must:
We also demand that Religious, Spiritual and Traditional Leaders and Organisations:
We also demand that the South African Media more comprehensively report and speak out on these incidents to raise awareness and provide information to society.
Finally, we demand that all of South Africa’s citizens take responsibility to stamp out the abhorrent queerphobic views and actions of their friends, families and neighbours.
South Africa, enough is enough!
This statement is supported by the following organisations:
#SpeakUpCyril #JusticeForQueerSA #EnoughIsEnough
PATHSA response to the Bell vs. Tavistock judgement
PATHSA with professional conviction disagrees with the recent judgement of the London High Court in the strongest possible terms.
The judgement concludes that:
Each point will be discussed below.
This judgement has profoundly serious and damaging consequences to the future health and happiness of transgender youth, not only in the UK, but potentially all over the world. They appear to have relied heavily on information from transphobic ‘experts’ who have presented a very inaccurate picture of the reality of why hormone blockers are standardly used in gender clinics all over the world. The language used is at times transphobic and disrespectful of young transgender youth’s gender identity. (e.g. natal girls and natal boys as opposed to birth assigned girls and boys.)
The conclusions drawn in this judgement indicate that these judges have failed in several ways to understand transgender youth and their needs.
We, as PATHSA, strongly oppose this appalling judgement and support the appeal with the hope that the judgement will be overturned.
16 days of activism – relevance for trans and gender diverse people
As South Africans we often say we have a remarkable constitution and bill of rights; it is the realisation of those rights at the coalface that remains a challenge. Now in 2020, we can add to that: we have a new National Strategic Plan on Gender-Based Violence and Femicide 2020-2030(1); the challenge will be the implementation of this ambitious plan. This document defines “woman” in the glossary of terms, as “a person that defines themselves as female and includes not only cis women, but also trans women and femme/feminine-identifying genderqueer and non-binary persons”. The vision is a South Africa free from all forms of gender-based violence (GBV) directed at all women, children and LGBTQIA+ persons. One of the ten principles that will guide the implementation is “Inclusiveness, embracing diversity and intersectionality, recognising the importance of being rooted in women’s experiences who are most marginalised by poverty, race, age, disability, sexual orientation, sexual identity, gender identity and nationality.”
From a recent research report by Muller et al.(2), we know that trans persons in South Africa experience alarming high levels of violence, with 33% of trans women and 23% of trans men reporting physical violence in the past year, and 35% of trans women and 28% of trans men reporting sexual violence in the past year. The lifetime exposure to sexual violence is devasting: 67% of trans women and 50% of trans men(2). Part of the complexity for trans men is that many carry the painful memories of sexual violence before transition. Trans and gender diverse persons, who present visibly as non-conforming, experience more violence compared to their gender-conforming counterparts(3). There is often little tolerance in our society for people who do not fit neatly into the western construct of a gender binary, such as masculine expressing and presenting lesbian women and trans men. Many trans and gender diverse persons who experience violence are reluctant to access health care for fear of discrimination. Sadly, discriminatory and insensitive treatment by health care providers have been well documented(4). Trans and gender diverse children are at increased risk of bullying, because they do not conform to society’s expectations(5).
Intersectionality theory says that various oppressions create and mutually constitute one another to sustain a complex matrix of power that is rooted in, and actively maintained by, social structures and institutional systems(6). GBV happens in a context where trans and gender diverse people may experience intersecting oppressions due to their gender identity, race, poverty, HIV status, and other factors(7).
As PATHSA, we share the vision of the national strategic plan, where president Ramaphosa wrote in the introduction, “The South Africa we want is a country where all its citizens are able to lead their lives of dignity and freedom, and where the vulnerable and marginalised are protected by our Constitution and Bill of Rights.” Though there are no quick solutions, we are encouraged that there is a national strategic plan on GBV that specifically includes violence directed at people based on their gender identity or gender expression. We would like to work with others towards the realisation of this vision.
The Professional Association for Transgender Health South Africa (PATHSA) would like to reach out to the parents who were present at, or impacted by, the meeting held by the Western Cape Education Department on 16 October 2020 about the Draft Guidelines for Sexual Orientation and Gender Identity in schools. We understand that this has been experienced by many as pathologizing your children, traumatising and infuriating.
We recognise the importance and crucial role that parents, family and friends play in supporting trans and gender diverse people and wish to applaud you for your compassion and understanding. As parents, you know first-hand the lived experience of trans and gender diverse young people and that this is a reality, and not an “ideology” as alleged by FOR-SA.
The standards of care for trans and gender diverse individuals have improved to a point where professionals world-wide realise that they should be committed to supporting and helping all trans and gender diverse individuals, and in particular those who are teens and adolescents, as they are especially vulnerable.
As an association we recognise that many harmful practices were allowed in the past and were driven by fundamentalist, conservative and subjective thinking. We are committed to correcting these inhumane practices and encourage all professionals to have compassion and empathy for all trans and gender diverse individuals.
Whilst we know that some professionals may still have outdated or historical approaches to care, we are committed to bringing them up to date with current standards of care that aim to help, support and affirm our young people’s gender identity.
PATHSA would like to be an ally for parents of trans and gender diverse young people.
“For those who have realized that rainbows exist on the inside. The ones that have stopped searching for gold but have found gold within themselves and have realized that the true value of a human life is rooted deep inside of each and every one of us. The ones that know that the true value of each breath is in the journey of becoming who you are, is in living an authentic life, is in being truthful and affirmed, being colorful in a world of black and white.” Charlie, 2020.
Individuals, organizations and associations around the globe participate in Transgender Awareness Week, to help raise the visibility of transgender people and highlight issues that the members of the trans community face in our societies, prior to the Transgender Day of Remembrance on November 20th. Transgender Day of Remembrance (TDOR) is an annual observance on November 20th that honors the memory of the transgender people whose lives were lost in acts of anti-transgender violence in that given year (Glaad, 2020).
As the Professional Association for Transgender Health South Africa (PATHSA), we are in support of trans and gender diverse individuals, organizations and allies that are taking action during this important time to raise awareness of trans related issues by becoming visible agents for change, through community engagements, sharing of narratives and experiences. We support those that advance advocacy work around the issues of prejudice, discrimination, and violence that continues to affect the trans and gender diverse community across the country and the globe.
As PATHSA we acknowledge that the majority of trans and gender diverse persons in our country still face harrowing amounts of prejudice, including when accessing healthcare. We remain committed to our PATHSA constitution that seeks to promote trans-led, trans-centered and trans-focused access to healthcare and gender-affirming healthcare services. Through our continued support and consultations with professionals who work in trans health, as well as trans and gender diverse individuals and families, we aspire to become a knowledge-hub, for healthcare practitioners in the country, across a variety of disciplines, to sensitize them about the trans experience. We believe that the more educated each one of us becomes and the more aware of the context in which we find ourselves, the more confidently we will be able to enter into these amazing giving and learning experiences tailormade, to undo the power injustices of the past.
Nee. Jy kan nie iemand wat transgender is met “terapie” en/of gebed “genees” nie. Ook nie mense wat gay is nie, want indien jy dit voorstel, is jy bloot onsensitief en onkundig.
Baie kinders en volwassenes word verneder, geboelie, en gehaat; party neem hul eie lewe, omdat hulle nie aanvaar word vir wie hulle is nie. Soms word mense doodgemaak.
Hulle menseregte word vertrap, terwyl ons Grondwet duidelik sê dit mag nie gebeur nie. Maar, al was mense se regte nie verskans in ’n kragtige Grondwet nie, behoort ons nie só om te gaan met ander wat boonop ’n minderheidsgroep is nie. Die beskerming van minderhede se regte sorg dat ’n demokrasie sterk is. Wanneer mense regte bykry, verloor ’n ander groep nie hulle regte nie – dit is nie ten koste van iemand anders nie; dit is ten beste van ons almal.
Dit het nou weer gebeur dat minderhede se regte misken word.
’n Kaapse dokter wat besig is om as psigiater te kwalifiseer, het op 16 Oktober tydens ’n vergadering van die Wes-Kaapse Departement van Onderwys (WKOD) na bewering iets gesê wat hy nie moes nie, naamlik dat genderdiversiteit ’n keuse is en terapie gebruik kan word om dit te “verander”. Dít is eintlik maar niks anders as die gruwelike “omkeringsterapie” nie. Dit werk nie; dit is nie wetenskaplik nie, en dit is onmenslik.
Die dokter was deel van ’n afvaardiging van ’n organisasie genaamd Freedom of Religion of South Africa, ’n redelik uitgesproke organisasie wat ook uiters homofobies is, sou jy lees en luister wat hulle op video’s sê. Dit is nie mense wat liefde uitstraal nie.
Maar, waar kom dié vergadering vandaan? In Maart 2017 het die Gelykheidshof in Seshego in Limpopo ’n uitspraak gelewer nadat die Suid-Afrikaanse Menseregtekommissie opgetree het namens ’n transgender kind. Die kind is by die skool verneder en geteister, maar die skool het niks gedoen om ’n veilige omgewing vir haar te skep nie. Uiteindelik kon sy nie matriek voltooi nie.
Die hof het bevind dat die skoolhoof en Departement van Onderwys verantwoordelik was en is om ’n veilige, beskermende, stresvrye omgewing vir leerders daar te stel. In haar geval het hulle versuim.
Intussen het die Wes-Kaapse Departement van Onderwys riglyne ontwikkel om openbare skole en gemeenskappe te help om ’n omgewing te skep wat nie teen enigeen diskrimineer op grond van gender, geslag, seksuele oriëntasie, oortuiging, geloof of kultuur nie. Dit was op só ’n vergadering, waar daar openbare insette gevra is, dat die betrokke dokter en die geloofsgroep opgedaag het.
Die Sexual and Reproductive Justice Coalition het ’n petisie geloods wat vra dat die Raad vir Gesondheidsberoepe vir Suid-Afrika (HPCSA) dié saak moet ondersoek, onder meer omdat die geneesheer ’n konserwatiewe geloofsgroep verteenwoordig het en nie klinies objektief was nie; omdat hy klaarblyklik praktyke voorgestel het wat skadelik is en glad nie op bewese praktyk geskoei is nie; dat hy nie opgelei is op die gebied nie; en dat aversieterapie oneties is. Dit is waarskynlik teen die Suid-Afrikaanse Grondwet, en in sommige lande is dit reeds onwettig.
Die Professional Association for Transgender Health South Africa (PATHSA) het ook ’n standpuntsverklaring uitgereik. PATHSA sê dat dit verkeerd is om ’n transgender kind of tiener te probeer oortuig om die gender wat by hul geboorte toegeken is, te aanvaar al strook dit nie met hulle genderidentiteit nie. Dit verhoog aansienlik die kanse op selfdood, of om hulself te beseer. Sulke tipes praktyke is oneties en daar moet sanksies wees teen mense wat dit bedryf. Boonop kan sulke uitsprake ouers verwar om nie in die beste belang van die kind op te tree nie.
Die WKOD het op 23 Maart hulle konsepriglyne in die provinsiale staatskoerant gepubliseer. Hulle behoort geprys te word dat hulle skole vry van diskriminasie wil maak; ook dat hulle ’n bewustheid van die spektrum van genderidentiteit en -uitdrukking probeer bevorder. Die beleid sê sulke leerders moet sensitief hanteer word, met professionele hulp, en dat die kind die reg het om sy of haar eie voornaam en kleredrag te kies. Hulle mag nie afgeknou en geteister word nie, en die toilet gebruik wat hulle verkies. Verder mag die kind die tipe klere dra wat hulle wil, dus by die gender waarin hulle gemaklik voel, ook na die matriekafskeid, en hulle kan ’n maat van hulle keuse saamneem.
Daar word aanbeveel dat skole daarna strewe om ’n omgewing te skep waar LGBTQI+-leerders die versekering kan kry dat hulle ongeag hulle seksuele oriëntasie en genderidentiteit gerespekteer en waardeer sal word en beskou sal word as deel van die normale spektrum van seksuele oriëntasies en genderidentiteite. Hulle beveel aan dat skole die stigting van sosialediversiteitsverenigings, waar die viering van diversiteit aanvaar word, sal ondersteun en erken, lui die konsepdokument.
Skole moet ook lesplanne gebruik wat leerders sal help om genderstereotipering te identifiseer en gesprekke te voer en om maniere te oefen waarop leerders genderstereotipering en -verkleinering op skool kan staak.
Skoliere moet ook leer hoe hulle bondgenote kan wees en mekaar kan ondersteun. Presies dit: As jy dit nie by die huis kan leer nie, leer dit dan op skool dat ons in die wêreld bondgenote kan wees en mekaar kan ondersteun, altruïsties kan wees en empaties kan wees, twee van die eienskappe van die mens wat alte min gesien word; om jouself in ’n ander se skoene te plaas en oor hulle seer te huil en saam oor hulle geluk te lag.
Die kerk is nie (meer) die staat nie en biologie en wetenskap berus op bewese praktyke, anders as geloof. Die wetenskap het deur al die eeue aangepas en geleer. Wat is feit en wat is fiksie? Dit is naïef om te dink die lewe is binêr. Selfs van die kerke is besig om hieroor na te dink; vergelyk byvoorbeeld hierdie artikel in LitNet Akademies deur Ian Nell. Daar is ’n wye spektrum van gender- en seksuele oriëntasie. Ons is nie meer die mense van 2 000 of 20 000 jaar gelede nie, want ons het intussen geleer oor onsself.
Ek hoop hierdie konsepriglyne van die WKOD word deurgevoer, want dit is die wêreld waarin ek kinders wil sien groei en grootword; een waarin almal aanvaar word om te wees wie hulle weet hulle is, waar daar nie meer gefokus word op of jy by die groot groep “inpas” nie, maar waar individue aanvaar word vir wie hulle is.
Waar elkeen saak maak.
Want ons lewe is maar kort en dan gaan ons dood en wat maak al die veroordelings van mekaar dan saak? Kom ons probeer om goed dood te gaan, op ’n aarde waar daar plek is vir almal.
Geslag: Dit is die biologiese geslag waarmee jy gebore is, of wat by geboorte aan iemand toegewys word; in die geval van interseksmense is die geslag nie duidelik nie.
Gender: Gender het te doen met die manier waarop ons in en vir sekere rolle grootgemaak word en wat ons assosieer met wat ’n man en vrou is. Dit gaan onder meer oor hare-, klere- en gedragskeuses en sogenaamde norme, maar daar is ’n baie wye genderspektrum.
Genderidentiteit: Dis wat jou brein vir jou sê jy in terme van gender is. Is ek ’n man? Is ek ’n vrou? Of iewers tussenin? Dit het te doen met wat jy as individu voel en is.
Om ’n transgender persoon te wees beteken dat die geslag waarmee jy gebore is en die een waarmee jy jou identifiseer (jou genderidentiteit), nie met mekaar strook nie. Die wêreld sê dat ons moet konformeer en in spesifieke kassies van “streng manlik” en “streng vroulik” moet pas, maar dit is nie vir almal so eenvoudig nie. Sommige mense se genderidentiteit stem nie ooreen met hul biologiese geslag nie.
’n Transgender vrou is met geboorte as manlik geïdentifiseer, maar haar genderidentiteit is vroulik.
’n Transgender man is met geboorte as vroulik geïdentifiseer, maar sy genderidentiteit is manlik.
’n Cisgender persoon is iemand wie se genderidentiteit ooreenstem met die biologiese lyf waarmee sy/hy gebore is.
’n Gender-vloeibare persoon is iewers op ’n spektrum en pas nie in die binêre definisies van “manlik” of “vroulik” nie.
Seksuele oriëntasie: Gender moet hoegenaamd nie met seksuele oriëntasie verwar word nie. Dit is glad nie dieselfde nie. Jou seksuele oriëntasie het te doen met tot wie jy seksueel aangetrokke is.
’n Gay persoon is iemand wat aangetrokke voel tot ’n persoon met dieselfde genderidentiteit. Gayverhoudings kan dus tussen twee gay mans wees, of tussen ’n gay man en ’n transgender man, of tussen twee transgender mans. Of dit kan ’n verhouding tussen twee gay vroue (sommige verkies die woord lesbies) wees, of tussen ’n gay vrou en ’n transgender vrou, of tussen twee transgender vroue.
PATHSA is an interdisciplinary health professional organisation working to promote the health, wellbeing and self-actualisation of trans and gender diverse people.