Transgender Visibility Day

Life through the lens of a Transgender woman


By Vikar Singh, National Officer for Sexual and Reproductive Health including HIV/AIDS (NORA)

5 December 2015 marked Africas first-ever Transgender Visibility Day. The initiative aims to fight Transphobia in all its forms and demands that transgender persons across Africa are protected against violence, economic oppression and should enjoy full human rights- including the right to healthcare and full legal protection.

The Committee on Sexual and Reproductive Health including HIV/AIDS (SCORA) has 5 main focus areas, which includes Sexuality and gender identity by committing to end stigma and discrimination in access to healthcare of LGBT+ individuals.

I recently caught up with Dr. Anastacia Tomson at the 7th African Population Conference in Pretoria, South Africa. She is a medical doctor, author, activist and a transgender woman.


VIKAR: Where do transgender individuals fit in the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA) community?

ANASTACIA: Not really anywhere specific, which is part of the problem. The acronym itself conflates a number of different concepts under a single umbrella, when it isn’t necessarily appropriate to do so.

For example, lesbian, gay and bisexual are all sexual orientations, while being transgender or intersex has nothing to do with sexual orientation at all.

The umbrella term is a grouping of all individuals who are not necessarily both cisgender and heterosexual, because those individuals are commonly marginalised by society. However, it’s really important to bear in mind that the challenges, needs and struggles of each of those groups might be quite different from the others.

VIKAR: What does Transgender woman mean?

ANASTACIA: “Transgender” is an adjective, and “woman” is the noun. It means, first and foremost, that I am a woman. And there are different kinds of women. Tall women, thin women, black women, lesbian women – these are all women, and the adjective tells us something additional about them.

“Transgender” means, simply, “someone who doesn’t identify with their sex assigned at birth (either completely or partially).

So I am a woman who doesn’t identify with her assigned sex at birth.

VIKAR: Why did you choose to transition now, at the age of 30?

ANASTACIA: I always tell people that being transgender is not a choice. My identity is something over which I have no say and no control. I have a female identity, and that is something that can never be changed.

Not all trans people will choose to transition. Some will continue to present in their assigned gender, even if it is at odds with their identity. Remember, transition is a difficult process. Often, it turns your entire world upside down. It can have consequences on your employment, your relationships with friends and family, and just about every other area of your life.

Whether to transition or not is a very personal decision, and one that should always be respected by others.

It took me until I was almost 30 to understand why I had spent most of my life feeling different, feeling uncomfortable, feeling like some really big part of me just never “fit”. Once I had learned enough about gender dysphoria to recognise that it was the cause, I knew that I had to pursue transition if I was going to survive. The idea of continuing to live the way I did before had become unbearable and unsustainable.

VIKAR: How has your journey been thus far?

ANASTACIA: Incredibly beautiful, immensely challenging, ridiculously difficult, and unbelievably turbulent. Among other things. It’s very difficult to sum up everything that I have experienced in a few short paragraphs. Transition is difficult and it is multi-faceted. I have faced so much adversity – from strangers, and from people close to me. I have had to deal with insensitive healthcare workers, confused family members, and ignorant friends who did not understand what I was going through.

I had to leave my place of employment in order to transition, and I had to learn how to navigate a world that is often hostile towards trans people. I’ve faced hurtful remarks and comments from people who are consumed by prejudice, and who see me as something that is lesser, or immoral, or intrinsically damaged.

But throughout this process, I have also learned to reconcile myself with the idea of who I am. I have grown to love and respect myself, when before I was never able to. I’ve found strength and passion and beautiful vulnerability that I never let myself embrace before. I have been able, for the first time in my life, to let people in, and to share with them who I actually am. Not having to hide myself away anymore has been liberating – at last I can be proud of who I am.

The journey is far from over – I often say it is one that will last me the rest of my life. And like anything in life, it’s neither exclusively good nor exclusively bad. It is complex and nuanced, but I know I am in a better place for having gone through it.

VIKAR: What has been the reaction of family and friends to your transition?

ANASTACIA: Each one has been different. The reactions I have received have run the gamut of human emotion. My disclosures have been met with anger, hostility, surprise, warmth, tenderness, indifference, fear or sometimes any combination of the above. What I came to understand was that “coming out” was much more an art than a science, and that it is something we as queer people often have to do multiple times. It’s not as though you “come out” once, and it’s all over.

I am very open about being trans – it takes about five minutes of Facebook stalking me to realise that – but even though I am very public about my identity, I still find myself having to “come out” to people (especially during job interviews – which can be quite harrowing while you wait for Home Affairs to change the name and gender marker on your legal documentation! For me, it’s now been 7 months, and my ID still doesn’t line up!)

What you have to realise is that every time we come out, it’s a leap of faith and an act of bravery on our part – but it also has a very big impact on those we come out to. It often shakes some fundamental ideas they had about their relationships with us, and sometimes even their concept of how the world works in general. It’s important not to lose sight of this fact, because often the reactions of friends and family can be quite upsetting or hurtful. We have to realise that it’s not always about us as individuals; sometimes it’s more about that person, and their reaction to having their worldview challenged.

VIKAR: In your opinion, what do you feel are the top 5 myths/misconception society has of transgender individuals?

ANASTACIA: It’s difficult to narrow it down to just five, and it’s difficult to rank them in any kind of hierarchy. There are a lot of misunderstandings and misconceptions that society has when it comes to trans people – in fact, as part of my work as an activist, I often give a presentation that centers around dispelling these fallacies. That presentation is just the tip of the iceberg, and it can take me a full two hours to get through all of the information in it.

If I had to cherry pick a few issues to highlight, it would be these:

  • The idea that something is wrong with trans people, or that they need to be fixed
  • The notion that transgender identity is somehow a matter of choice
  • The concept that gender identity is all tied up with sexual orientation – in truth, trans people (like cis people) can be straight, gay, pansexual, bisexual or anything.
  • The fear that trans people represent some sort of threat or danger to others because of their identity
  • That transgender people do not deserve the same level of respect as everyone else

VIKAR:  Can you tell us about any organisations that you are affiliated with?

ANASTACIA: There are two major organisations to which I have ties. The first is PACT – the Professional Alliance Combating Transphobia, an organisation which I founded in cooperation with a number of other professionals (psychologists, speech therapists, lawyers etc) to fight the systemic and institutionalised transphobia that exists within our society. The group’s goals are to help establish policy and guidelines for the medical treatment of trans people, to offer sensitisation programs and training to service providers, to streamline the process for amending ID documents, and to improve education around concepts like gender identity and sexuality.

The other organisation is the Sexual and Reproductive Justice Coalition, which is a very exciting initiative to fight for sexual and reproductive health and rights for all South Africans. Included in that portfolio is access to contraception, safe abortion, and autonomy for women and marginalised groups in making decisions about their own bodies, including the right to healthcare without prejudice for queer and trans individuals.

VIKAR:  What inspired you to write a memoir of your experiences? When will it be available to readers?

ANASTACIA: You can blame that mostly on my friends, who were watching the changes I experienced as I went through my transition, and who heard all the stories that I had to share about my experiences navigating the healthcare system, dealing with family, and reflecting on my own identity.

They urged me to keep some form of chronicle of my experiences – something like a journal, or a photo diary or a blog, which a lot of trans people do to document their transition. I wanted to do something a little different (because of my irrepressible defiant streak!), so I decided to rather write a book.

I knew that I had a talent for writing, but it was one that I often ignored, because the way I write is very intimate, and often very emotionally draining for me. But I understood that I could use that as a vehicle for communicating some of my experiences, and forging an emotional connection with people through my writing.

My goals for the book are two-fold – firstly, I’m hoping that cisgender people, who don’t understand the experiences of trans people will be able to gain a window of insight into what some of us go through.

And secondly, I’m hoping that someone out there will read about my journey, my feelings and my experiences and find some commonality that resonates with them, and that it might leave them more inspired and hopeful about their own journey or transition. Living a trans life is difficult, but I hope that sharing my experiences might make it easier for those who come after me.

The book will hopefully be on shelves in the first half of 2016.

VIKAR: What has been your experience in accessing healthcare as a transgender individual?

ANASTACIA: It has been really challenging. Even for me, having the resources to access healthcare in private, I have encountered so much adversity and misunderstanding, even from people who are regarded as “expert” in the field.

I always emphasise the point that healthcare for trans people is more than just hormones or surgery. Some of us choose to pursue gender affirming services, of course – but we all still have the same basic healthcare needs as cisgender people, and even accessing those can be difficult if you are trans or gender non-conforming.

And the gender affirming services themselves are often heavily gatekept, because the medical establishment is scared of giving hormones to the wrong people. There is so much fear and misunderstanding over how the medicines work and what they do, and this leads to huge barriers to access for those of us who need these interventions – and the interventions themselves can often be lifesaving.

The situation is even more bleak in the public sector, where only three facilities across the entire country offer gender affirming care for trans people, and it is extraordinarily difficult to access.

These kind of challenges are part of what motivates me to try to reach out to and educate healthcare workers and service providers, in the hope that spreading awareness and understanding will improve our access to safe and dignified healthcare.

VIKAR: What is your advice to Healthcare students and practitioners when dealing with transgender individuals?

ANASTACIA: I really think that students in the medical and allied fields are disadvantaged by a lack of education around trans issues. The best advice that I can give is to refrain from making judgments about a person. Treat your trans patients with the same compassion, dignity and respect with which you treat cis patients. And also try to understand that for many of us, our relationships with our bodies are very complex – don’t be afraid to learn from us, because when it comes to our own bodies, we are often the experts, and that isn’t something that should make you feel undermined or threatened as a healthcare provider.

VIKAR: Lastly, complete the sentence for me : A transgender friendly world can only be achieved by ….

ANASTACIA: Compassion, empathy, respect and understanding. Transphobia is no different to other forms of oppression. Striving to embrace our shared humanity, rather than looking for reasons to marginalise people, is the key to eliminating prejudice in all its forms.

For more information on PACT visit their website and follow Dr. Anastacia Tomson on Facebook and Twitter for more insight into her life and activities.