North West trans community desperate for hormone replacement services


The trans community in North West cannot access hormone replacement therapy from public health facilities in their province

Transgender people in the North West province are being forced to travel sometimes hundreds of kilometres to Soweto in Gauteng to access hormone replacement therapy (HRT).

The North West Department of Health (NWDOH) has confirmed that it does not have facilities that provide HRT for transgender people.

The admission was included in a response to a complaint lodged against the NWDOH by the organisation Action for Social Justice International (AFSJI) with the SA Human Rights Commission.

In the complaint, AFSJI said its transgender members in the North West do not have access to HRT and that they are forced to travel to Soweto in the neighbouring province of Gauteng to receive the service; a distance of 267km from the provincial capital, Mahikeng.

The group pointed out that its members come from disadvantaged backgrounds and cannot afford to travel so far to access the treatment.

In its response, the department said it was “aware of the challenge of availability of the specific services of managing gender dysphoria in North West province”.

According to Mr OE Mongale, Head of Department for the NWDOH, only nine public hospitals in the country offer HRT services to the trans community. Four are located in Gauteng, two in the Western Cape, one in the Free State, one in KwaZulu-Natal and one in the Eastern Cape.

Services are rendered at these hospitals and at satellite gender clinics linked to the facility such as Chiawelo clinic in Soweto which is linked to Chris Hani Baragwanath Hospital.

“We’re all aware that our government has made empty promises to our community…”

Mongale said the department hopes to start to address the problem in the North West through several measures, including a needs assessment for the service in the province.

It will also look at establishing satellite gender clinics at tertiary and regional hospitals in North West linked to the hospitals in Gauteng and develop a “structured referral strategy between the two provinces for seamless upward and downward referral of patients for this service”.

The NWDOH will further investigate dispensing HRT medication (oestrogen and testosterone) for gender dysphoria that has been approved as National Essential Medicines List items.

“Such medicines can be stocked at tertiary and regional hospitals and be dispensed as ‘per patient prescription’ that can also be delivered to the closest District Health Services facility to the patient,” said Mongale.

He added the proviso, however, that “all these plans are resource dependent and will require appropriate funding to the NWDOH”.

Thabiso Mogapi wa Tsotetsi, Chairperson of AFSJI, told Mamba that he was “not that excited” by the NWDOH response. He commented that “we’re all aware that our government has made empty promises to our community members and not kept them.”

Tsotetsi had hoped that the department would make interim arrangements “for our trans community to be able to access [HRT] services from a central point or else make transport arrangements for them to go to Gauteng until they have finalised their provincial plans on providing the treatment to our communities”.

Nevertheless, Tsotetsi said, the organisation “will continue to follow up this matter through the South African Human Rights Commission to ensure everyone is getting what’s due to them equally as citizens of this country”.

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