Trans Health Care and Recognition Advance as Brave Activists Step Forward

August 19, 2013

“I felt I was the only one like me,” says Musonda, 27, of his isolation at school in Zambia’s capital, Lusaka, where, self-identified as male from childhood, he silently wished he were treated as male by others.

Being treated as a girl since early childhood, Musonda, whose name has been changed to protect his identity, started at around age 13 to make sense of the word “transsexual,” which he had learned from books and movies.

In 2001, aged 15 years, he lost his mother, who had raised him alone, and moved in with an aunt and uncle who made him wear a dress to church and family gatherings. “If God accepts every child, I should be able to wear what I want,” he recalls thinking, and he soon began avoiding church.

At 23, Musonda returned from his relatives’ home in Kitwe, the country’s second-largest city, to Lusaka, where he met Chan Mubanga, co-founder of Transbantu Zambia – a group of eight trans men and women who met informally on a university campus.

“It’s so important for us to be able to get together and break the isolation,” he says, having since joined the organization as the finance and IT staff member. “But we have to be careful. The more visible our members, the greater the risk.”

Homophobia and transphobia present constant dangers in Zambia, where a sodomy conviction – a legacy of British colonial law – can carry a prison term of 10 years or more.

The trans community is aware of both a transphobic rape and a murder in 2012, but witnesses to the murder feared going to the police, who have taken no action “because of the nature of the person who was murdered,” according to Musonda.

With a membership of more than 40, Transbantu Zambia opened an office in 2012 and began new services, including a library of trans and intersex information, support groups, peer education, and outreach to families and communities miles away from Lusaka.

To illustrate how LGBT people in Zambia hide their identities, Transbantu produced a short video, “Behind the Mask,” for the 2013 International Day Against Homophobia and Transphobia.

The organization intends to raise awareness among healthcare professionals in Zambia, where hormone therapy is inaccessible, but for now only one physician is known to provide sensitive general health care to the trans community.

“As much as our groups’ reputations are growing, there’s no medical access for most people,” says Liesl Theron, co-founder of South Africa–based Gender DynamiX which is approached by trans people needing help all over the world.

Support for networking and meeting basic needs of small, local organizations benefiting multiple transgender communities was advanced in 2012 through partnerships with organizations such as Mama Cash, the Astraea Lesbian Foundation for Justice, and others.

Yet Gender DynamiX and its partners were forced to scrap a meeting of Southern African trans organizations in Nairobi, Kenya, in August 2012, when hotel staff, who became aware of the meeting’s topic and participants, evicted them.

Gender identity’ is rarely explicitly acknowledged as grounds of discrimination, and trans-specific hate-crime legislation is even rarer, according to a landmark report,Transrespect versus Transphobia Worldwide, published by Transgender Europe in 2012.

The report moreover found a continual upward march in transphobic killings, including 267 cases in 2012—five more than the prior year—for a total of 1,123 since the organization began keeping statistics on 58 countries in 2008. The highest numbers were reported in Brazil (452), Mexico (106), and the United States (69).

Following years of work by Global Action for Trans* Equality, Argentina became the first country in the world to pass a law, in May, making it legal to change name and gender titles on official documentation without surgery or a psychiatric diagnosis, and requiring that medical practitioners provide free hormone therapy or reassignment surgery upon request.

In a step that may also influence the future of trans rights in some other countries, the American Psychiatric Association voted in December to change the wording in its Diagnostic and Statistical Manual of Mental Disorders from Gender Identity Disorder to a new term, Gender Dysphoria: “a marked incongruence between one’s experienced/expressed gender and assigned gender.”

“Most trans people, and many doctors, would say that ‘transgender’ doesn’t belong in a mental health manual at all,” says Dr. Robert Winn of Philadelphia’s Mazzoni Center, an LGBT health and wellness organization that held its largest ever trans health conference during the year.

The conference brought together 2,500 attendees, among them medical and behavioral health professionals seeking to develop new protocols to help transgender populations and trans activists from around the world who came to share strategies and coordinate advocacy efforts.

Fielding an increasing numbers of calls from parents of trans children, in the summer of 2012 the center brought together health professionals from across the United States to develop a new protocol to help families.

“Wherever they are in the world, every trans person was once a trans kid, and they probably had no support,” Winn says, recalling the many individuals who sought his care or treatment.

“First, we have to inform people and make them aware,” says Musonda. “We will have to move from ourselves to family to religion to schools to government. It will take quite some time to change perceptions.”