Transexual woman on the journey of sexual re-alignment in a hetero-normative healthcare system in the Western Cape

Newman-Valentine, Douglas David-John

Transexual woman on the journey of sexual re-alignment in a hetero-normative healthcare system in the Western Cape

Doctoral Thesis

2015

Publisher

University of Cape Town

Department

Department of Health and Rehabilitation Sciences

Faculty

Faculty of Health Sciences

Abstract

The purpose of this study was to understand the life-world of transsexual women in relation to their awareness of their unique health needs as a direct result of sexual realignment treatment, and their health-seeking behaviours, practices and experiences of responses in negotiating health care for their transgender-related health needs in the healthcare system. The overarching question asked in this research was: What are the lived experiences, and meaning of these experiences, for transsexual women during the sexual-realignment process when negotiating health care for their transgender-related healthcare needs in the healthcare system? Participants in this study were selected through purposive and snowball sampling. In-depth interviews were conducted with ten participants selected from urban, peri-urban, and rural areas of the Western Cape. Theoretical saturation was reached with the tenth participant, and further selection of participants was ceased. The data was viewed through a trans-inclusive feminist lens with a concurrent collection and analysis process as guided by the steps of analysis of Interpretative Phenomenological Analysis (IPA), as developed by Smith (2010). IPA is a modern qualitative approach to research inquiry which harnesses the strengths of phenomenology, hermeneutics, and ideography. The analysed data were illustrated in a master theme graphic which contained one superordinate theme, two subordinate themes and various categories. The superordinate theme of this study was named "Towards organic Womanhood", while the two subordinate themes were coined "Embracing Womanhood", and "Facing the Giant in order to Become". The subordinate theme Embracing Womanhood gives insight into aspects of transsexual women's journey of moving towards a state of organic womanhood, whereas the subordinate theme Facing the Giant in order to Become maps out powers in the healthcare system which prevent transsexual women from having a smooth transition journey. This study illustrates that transsexual women have a need to align their bodies with their gender identities, but even though South Africa has legislation which protects the health and rights of transsexual women, transsexual women find it challenging to make the transition. Health practitioners are ill-equipped to manage transsexual women, the care which they receive in the government-funded healthcare system is of a poor standard, and they are4subjected to extremely long waiting periods to have access to surgical sexual realignment services. Recommendations are made for the healthcare system, policy makers and educational institutions in order to stimulate the South African healthcare system to become inclusive and affirming to the needs of transsexual women. Furthermore, recommendations for researchers are made to stimulate the debate around transsexual health care in the scientific literature.