Stigma against transgender individuals in small towns is a norm.
It’s 5pm on a freezing Friday in Quigney, East London. Malwande Onceya settles into a cream fur bodywarmer and prepares for tonight’s shift. “I’m a pleasure executive, my dear.”
Onceya pulls her dreadlocks into a ponytail and smacks her red lipstick into place. It’s going to be a long night on Oxford Road – especially with a scratchy throat threatening flu.
“Mna shem! I make no mistake to tell my clients that I am a man – I don’t want to be fed to the dogs!” she says in isiXhosa.
“I won’t lie. I called myself gay for a long time. I picked up the word ‘trans’ along the way. I was at a workshop where they explained what a transgender woman is. I said: ‘Hay’kaloku, what does that mean?’ I thought ‘trans’ might be a swearword.”
Onceya grew up in KwaNofeliti, a quiet village not far from King William’s Town. She remembers being taunted by boys at school who would say: “You have itotosie [a penis]! Why are you acting like a girl?”
As a child, Onceya loved cooking, especially for traditional ceremonies. She tried to ignore snide comments from neighbours who insisted that she should be “ebuhlanti [in the kraal]” with the men instead of “by the pots” with the women.
It’s been months since Onceya had the time and money to go home, but she is planning a trip on Saturday and offers to take us along.
As we approach KwaNofeliti, she points to a lone hut on the outskirts of the village. “See there, uyoluka? Thina sasibaninzi ekuyeni kwethu esuthwhini [There were many of us when I was initiated].”
Onceya’s initiation ceremony took place nine years ago, but it is still the talk of KwaNofeliti. Today an elderly woman laughingly welcomes her home with the words: “Hey, do you remember how you beat those boys esuthwhini [at initiation school]? The police, the whole village came out to see how you beat the hell out of them! They’ll never forget it!”
When she turned 18, Onceya made a conscious decision to go to the bush with her peers. She was motivated partly by respect for her culture, but she had other reasons too.
“Actually, I was running away from the double stigma. I didn’t want people to say: ‘One – you’re a moffie, and two – you’ll always be a small boy!’ So I told myself that I would prove to them that this custom had nothing to do with my gender identity,” she explains.
But she refused to participate in the traditional displays of manhood, choosing instead to remain in her hut. This angered fellow initiates.
“The other guys came into my space. One of them slapped me, and that’s when it all started. I hit them, all six. I was just protecting myself because I hadn’t done anything to them,” she says.
Cut off if you shun the snip
According to Leigh Ann van der Merwe, founder of the Social, Health and Empowerment Feminist Collective (She) – an advocacy group based in the Eastern Cape – cultural circumcision is a complex issue for transwomen.
“Being trans is seen as unAfrican and ungodly. So if you don’t agree to be culturally circumcised, you may be ostracised and cut off from family support and resources,” she explains.
Such isolation can have dire economic consequences, and sex work is often seen as the only way to survive.
Phiwe Ncengi, a transwoman and She advocacy officer, says sex work can take many forms and isn’t always just about the money. Sometimes it’s about self-acceptance, especially “when you know that a client will call you ‘baby’, ‘honey’ – those good words”.
“It makes you feel like a real woman and you become more comfortable with yourself,” she adds.
Like many in her community, Ncengi had never encountered the term “transgender” until she attended a She workshop. As a teenager, she knew she didn’t feel gay but could find no other word to define her identity.
“I heard someone using the name ‘femgay’, so that was the name I started using for myself,” she recalls.
Kerry Oosthuysen, a legal officer at the Commission for Gender Equality in the Eastern Cape, agrees that transgender as a concept can be confusing, and is often seen as synonymous with being gay or lesbian.
“There is no pure isiXhosa word for ‘transgender’ and if any other word is used, it is borrowed from other languages,” explains Oosthuysen.
This lack of understanding exacerbates stigma and discrimination, but many transgender people have lost confidence in the judicial system when it comes to reporting hate crimes and discriminatory abuse.
The gender commission and She are trying to change this. This year, for example, they have followed up on allegations of abuse by police officers, and have taken up the case of a Xhosa transgender teenager who was threatened with expulsion if she continued wearing a girl’s school uniform.
“We immediately intervened and ensured that the young girl could return to school in the uniform of her choice,” says Oosthuysen.
But discrimination against transgender people is most prevalent in the public health sector – especially when they try to book a psychological assessment so they can be provided with hormone replacement therapy. The shortage of endocrinologists in the Eastern Cape only adds to the problem.
Ultimately, this means that many in the trans community are excluded from “transitioning to where they feel comfortable”, Oosthuysen explains.
’Our bodies are controversial’
Seoketsi Moeketsi slams the door of her Ford bakkie, flips her hair and shouts to me across the dusty shopping centre: “Hey, woman! Welcome to Schweizer-Reneke!”
As we drive to her home in nearby Ipelegeng, she jokes that the North West farming town was named after two “German thieves” and is still as patriarchal as you can get.
She should know. Moeketsi is a transwoman, and the founder of Rural Trans Love – a pioneering organisation that supports transgender people from rural communities and builds partnerships with families and decision-makers, including tribal authorities.
“It’s difficult enough to be lesbian or gay in this community but when you identify as transgender, people become very violent because they don’t know who or what you are,” she explains.
“Our bodies are controversial. We need a space where we can cry and voice out our frustrations.”
Moeketsi describes her upbringing as a “living hell”, compounded by rape and confusion about her own sexual identity. Then she discovered the word “transgender”.
“I was like: ‘Wow! That’s me! I’m a transwoman,’” she recalls.
Moeketsi is studying politics and sociology at North-West University. She wants to bring her “privileged” academic experience back to Ipelegeng to help fellow Rural Trans Love members, such as 25-year-old Kabelo Sepato.
‘It’s easier to say you’re gay’
At school, Sepato – born genetically male – was accepted as “the diva”. Sometimes she misses those days.
“Even though I experienced discrimination, I would stand up for myself,” Sepato says. “I had that brave heart to go to school and face maniacs, lunatics. I had beautiful long hair that I would braid.”
Now Sepato feels stuck in limbo. With no stable income and unable to continue her studies, she knows it’s safer to identify as a gay man than as a transwoman. “I gave up,” she admits. “I had to withdraw myself.”
Kealeboga Tau (28) had a similar experience. Born a girl in the small village of Magogoa, 221km from Schweizer-Reneke, he always knew he was in the wrong body. “I even asked my mother to take me back to the hospital and turn me into a boy, and my brother into a girl,” he explains.
Tau teaches creative arts and Setswana at a local high school where he is seen – and generally accepted – as a lesbian. But he is uncertain about the future, and feels intimidated by the complexities of gender therapy and surgery options.
“I want to remove my breasts. I hate them, and my private parts. But I’m not sure about the health implications of taking hormones.” In the end, says Tau, it may be easier just to stay as he is.
Hurry up and wait for change
Matebesi Phakisa’s surname means “hurry up”, but her long wait for gender-affirming surgery has proved just the opposite.
It’s been eight years since she received her first referral letter for access to hormonal therapy from a mental health professional. Since then she has been “sent from pillar to post” in Mahikeng, in her attempts to find help.
The most common response from hospitals and medical practitioners has been: “Sorry, we don’t deal with that.”
Even when assistance was belatedly offered, it came with strings attached. “I felt like I was an experiment,” says Phakisa bitterly.
Growing up in Potchefstroom in the North West, Phakisa was always reminded that she was a “boy”.
“Entering pageants was my thing, growing up. I knew I was good at it and I was. I got tired of teaching the girls the choreography: how to stand, turn and walk. So I entered myself and I knew I could win.”
Phakisa thought her dream had come true when she was allowed to compete and to parade on stage with the other contestants. But it was not what it seemed. “Later, I found out that I wasn’t even scored. They didn’t even judge me. I was just their entertainment. I was their fool,” she says.
After completing her degree at the University of Pretoria, Phakisa moved to Mahikeng to work in a government department. With the support of newfound colleagues, she finally felt comfortable to transition fully into a woman. Little did she know how tough and frustrating her journey would be.
A friend told her about the Luthando Clinic at the Chris Hani Baragwanath Hospital in Soweto, which deals with gender dysphoria. But it became too expensive to travel every month from Mahikeng to Johannesburg for her counselling sessions, so she was advised to find someone closer to home to assist her with the six months of required psychotherapy.
At every stage she has encountered stigma and discrimination.
“In 2013 a therapist told me I needed to bring my mother along, as if I was not over the age of consent. It was humiliating. I got discouraged and became depressed,” Phakisa says. “At some point I wanted to give up, or take out loans to pay private doctors. But I could not afford that.”
Phakisa still faces a long road ahead to full transition, as access to basic medical treatment is often hindered by the judgmental attitude of medical staff in rural areas.
Nurses face up to taboos
Edward Sibanda, Right to Care’s coordinator for its Global Fund programme, says: “LGBTI [lesbian, gay, bisexual, transgender and intersex] persons living in rural and periurban areas rarely have access to trauma counselling, and are still encountering problems with accessing health services – treatment, care and support – because of the stigma and discrimination at the hands of health personnel.”
Seeking to reverse this prejudice, the organisation has trained 7–000 medical professionals across seven provinces to deal with issues affecting the LGBTI community – including mental health – that require a special sensitivity.
For example, nurses in clinics had to be trained how to examine LGBTI people and discuss their sexual history.
“A case in point is that they [nurses] did not know of anal STIs [sexually transmitted infections], which they viewed as piles [haemorrhoids]. It was also noted that they were not familiar with diagnosing throat STIs,” says Sibanda.
Meanwhile, thousands of transgender people continue to wait for counselling and medical assistance – and social acceptance – to help them be themselves.
For Phakisa, the battle to be one’s authentic self is a daily conflict: “Even though they don’t see it as an emergency, for me it is – because the truest person I can be is the one inside of me.”
Mosibudi Ratlebjane is the Rosa Luxemburg Foundation’s social justice fellow at the Mail&Guardian