“Trans Health Without Borders”
debate truly borderless
By Joshua Sehoole and Kellyn Botha
23 April 2018, South Africa
On 18 and 19 April, Iranti hosted a “Trans Leadership and Planning” meeting with trans activists from across the region to have a foundational discussion on different factors we needed to address as a movement in order to have a collaborative approach on improving gender-affirming care and general access to healthcare for trans persons. Delegates from South Africa, Namibia, Zimbabwe, Lesotho, eSwatini (Swaziland) and Malawi took part.
The group co-created an agenda for the meeting, and after a run-down of the history of the movement for the newer activists in the room, unpacking key moments, challenges, and victories, groups split to discuss 6 main points, the first of which was intersectionality and privilege. Advocacy for gender-diverse persons must be inclusive of issues such as language, class, race and disability. Everyone has many identities which inform their needs and context, and this needed to be a central consideration in crafting any interventions.
Resources and authentic mobilisation was debated in the second group. This was considered key to initiating meaningful change rather than speaking to the same group of activists at meetings and conferences. Discussions included the impact of current advocacy approaches on connections to community, as well as the restrictions created by and imbedded in the current approach to funding. The group mapped out needed changes, and what pushing those forward collectively might look like. The last group of the day reported back on visibility, wellness and safety. They focused primarily on activist and community vulnerability, mental health needs, and self-care.
The second day saw discussions on the language of identity, it’s complexity and Eurocentric origin. Jholerina Timbo of Wings to Transcend, Namibia, said “New terms are always adopted in this LGBTIQA spectrum, but often without any bearing on what we need. These words get given to us and now we feel we must define ourselves through them. Where is the freedom to self-identify in that?”. The group explored what amplifying an African approach to self-identification might look like across multiple languages and contexts, and what this could mean in terms of resonance with the general public as well as with gender diverse communities in our countries.
Also discussed were the intra-movement politics. Infighting, elitism and competition were identified as just a few of the key obstacles to presenting a unified voice in the region. “There’s an idiom in my language,” noted Lawrence from Malawi, “that when elephants fight, it is the grass that suffers”. The discussion included the impact of current broken organisational relationships on advocacy and community, the importance of rebuilding trust and centering healing as a key focus for the movement, as well as how to ensure a continued and regular focus on personal relationship building as a focal point in our work.
Finally, the immediate needs of the community were discussed and reported back on when the group reconvened. Discussions involved how donor funding affected the current lack of focus on service provision and economic empowerment, as well as challenging the impact of own positionality and involvement in organizing on our perceptions of community needs. The current challenge in accessing general healthcare, the widespread practice of self-medication for a wide variety of needs including gender-affirming healthcare, and the intersection of these with legal concerns and safety was discussed.
At the close of the meeting, delegates and members of Iranti staff attended the historic launch of the Psychological Society of South Africa’s Affirmative Practice for psychological professionals when working with sexual and gender diverse people. This huge leap for mental healthcare, it is hoped, will translate into better practice in South Africa, as well as neighbouring countries.
The regional meeting brought to the fore the core issues that need to be taken into account as the concept of Trans Health Without Borders is workshopped and explored, and indeed in strengthening all our collective and individual work if we are to crate meaningful change for communities on the ground. Delegates welcomed the structure of the meeting which allowed the most pressing issues to be tabled and discussed, and there was a general agreement to continue consultation in other spaces and with a wide diversity of trans organisations and communities in envisioning what a “Trans Health Without Borders” initiative might look like, while keeping in mind critical issues that will underpin the success or failure of the project in the region.