The socio-economic determinants of health for transgender women in South Africa: findings from a mixed-methods study

Abstract

abstract Research conducted among transgender women in South Africa shows a marked tendency toward health disparities and poor access to appropriate mental, sexual and reproductive health services. Little is known about the socio-economic conditions underlying the health of transgender women in the country. A study was conducted to examine the cost of being a transgender woman in South Africa, in relation to physical, psychological, economic and social well-being, and vulnerability to gender-based violence. Among other disparities, the findings revealed a high level of substance abuse and poor access to hormones for gender affirmation. These findings are consistent with already published literature on stigma, discrimination and poor health outcomes among transgender women. This paper draws on the findings to report on the socio-economic determinants of health for transgender women in the South African healthcare context. It argues that efforts must address the intersections of transgender women’s lives, such as economic, health and educational status, and geographic location, to ensure comprehensive health and human rights services reach transgender women. It also proposes that further research is needed to understand the forces that shape the public health landscape for transgender women in South Africa.