![Sample our Humanities journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5939/TOC-Subject-Sample-2021-Humanities.jpg"})
abstract
The South African Constitution has been well known for its progressive entrenchment of gender, sex and sexual orientation into the Bill of Rights. Nevertheless, it was only in 2004 when the transgender and intersex rights were explicitly secured with the legal adjustment of their sex description and it was only two years later, in January 2006, when the term ‘sex’ in the Bill of Rights finally included and secured the rights of intersex people in South Africa. The South African medical system poses particular challenges for transgender and intersex people due to the scarity of knowledgeable professionals, the rigid understanding of gender and sexuality and discrimination based on gender identity and biological variation. There is also a lack of statistics and a need for more research to be done with transgender and intersex individuals in South Africa to deepen understanding of their particular sexual and human rights. This Article is an endeavour to rethink the constructed meaning of gender and human rights in light of the narratives of transgender and intersex individuals living in South Africa. The Article is based on investigation into particular governmental practices deployed by different social actors (medical service providers, researchers, LGBTI activists, transgender and intersex people themselves) in producing transgender and intersex individuals as subjects governed within a fixed gender order frame that is rooted in biological dualism. In the Article governmental practices are understood within the Foucauldian theoretical framework (Foucault, Citation1978b) as diverse heterogeneous ways and discursive techniques through which specific individuals and groups are constructed as ‘problematic’ and governed. These governmental practices are scrutinised through an analysis of routine, repetitive acts of situated ‘doing gender’, on the one hand, and the possibility of activating modes of undoing the gendered norm, on the other. There are two practices discussed: practice of naming and techniques of gendering biology.
Acknowledgment
I would like to acknowledge support of the African Centre for Migration and Society at the University of Witwatersrand where I was affiliated as a visiting researcher from August 2012–July 2013. My stay in South Africa and this research has been possible due to their institutional support. I express my gratitude to the EMMIR programme (Erasmus Master in Migration and Intercultural Relations) for their administrative and financial support which made my stay in South Africa possible. My deep appreciation goes to the Pretoria-based NGO Transgender and Intersex Africa for collaboration and all their efforts and arrangements that made the fieldwork possible. I would like to thank my supervisor Dr. Joanna Vearey and my colleague and friend Nthabiseng Mokoena for being with me all the way in this journey. I pay tribute to all the amazing participants that shared their stories – you are bold and beautiful human beings, and you have been an inspiration for me. My very special thanks go to Marlise, Marc, and Edwin for the encouragement, place and sense of belonging that I got while writing this article.
Notes
1. By ‘Western’ I primarily mean Anglophone America and Europe as “geo-spatial, discursive, and cultural boundaries” where transgender studies has been developed (Stryker, Citation2006: 14).
2. Therefore, I use ‘transman’ for someone who is born in a female body and seeks medical treatment to align his body with a male gender identity; and ‘transwoman’ for someone who is born in a male body and opts for medical intervention to align her body with a female gender identity.
3. Hormone therapy for transmen includes intake of testosterone which causes a process of bodily masculinisation (deepened voice, clitoral enlargement, growth in facial and body hair, cessation of menses). Transmen can opt for all or some of the following surgeries: mastectomy/chest reconstruction aims to remove breasts and create a male-looking chest; hysterectomy removes a womb; oophorectomy removes ovaries; vaginectomy removes a vagina; genital reconstructing surgery (Muller, 2013). Transwomen are prescribed two types of hormones – estrogen and anti-androgen (blockers). In case of transwomen hormone therapy leads to breast growth (variable), decreased libido and erections, increased percentage of body fat compared to muscle mass. Gender reassignment/gender affirming surgeries for transwomen include mammoplasty (breast enlargement), penectomy (removal of a penis), orchidectomy (removal of testicles) and vaginoplasty (WPATH, Citation2011).
4. Acknowledging the complex history of and debates around race and class divisions in South Africa, I would like to emphasise that all my participants self-identified (strongly) as ‘Black’ and offered a term ‘unprivileged’ during one of the focus group discussions to describe their collective identity pertaining to class while discussing the social and economic challenges they face. I will elaborate later in the Article on usage of ‘transgender’ as self-identification by the participants.
5. One of the participants, a transman, answering my question regarding different understandings of identities and tensions within the LGBTI community describes the situation as such:
“It is a lot of animosity and misunderstanding and there is a lot of prejudice… Like the most prejudice I get is from lesbian and gay people… It's very weird… It's very socially acceptable like trans jokes… And it's coming from people who are generally trans themselves. Like if you think about the actual meaning of the term transgender – butch lesbian is crossing a gender divide too…” (Interview with T., transman, 24 March 2013).
6. I do acknowledge problematic usage of the term ‘transgender’ in a narrow highly medicalised sense and I will elaborate later in the Article on strategic and fluid deployment of this term by the participants. Nevertheless, space does not permit me to scrutinise the complex relations between gender identity and sexual orientation described by the participants and to go deeply into how transgender people challenge and “[disrupt] the way in which sex, gender, and sexuality intersect with each other” (Tauches, Citation2006: 176).
7. There are different answers to the question what can be counted as intersex conditions. The Intersex Society of North America (ISNA) on their site defines intersex as “a socially constructed category that reflects real biological variation” and emphasises that “intersex anatomy doesn't always show up at birth, sometimes an individual might find out about their intersex condition during puberty, or when finding themselves infertile as an adult” (ISNA web-site: http://www.isna.org/faq/what_is_intersex)
8. A special protocol put in place in the mid-1950s by prof John Money suggested that gender normalising surgery has to be performed on intersex infants to ‘normalise’ their genitals and to allow a child to live a ‘normal’ life with a definite gender identity (assigned by doctors and reared by parents). The decision was (and still is) made by doctors based on the size of phallic structure in newly born infants: a stretched length of phallic structure falling between 0.9 cm and 2.5 cm is regarded as an unacceptably large clitoris. Usually it is reduced or removed and a child is reared as female. Therefore, in most cases of intersex infants born with ambiguous genitalia children would be forcibly feminised (http://www.intersex.org.za/index.php/en/publications/about-intersex/45-what-is-intersexuality). Sally Gross estimates that around 50 intersex infants in South Africa have forced genital surgery every year. See the ISSA web-site: www.intersex.org.za/index.php/en/publications/medical-ethics-and-practice/59-notes-on-intersexuality-and-ethical-issues-raised-by-the-standard-protocol-of-treatment-for-intersexed-infants-and-children.
9. Medical treatment of an adult intersex person may include a set of tests to be done (to determine particular biological condition), hormonal treatment and a set of surgeries (for example, to remove undescended testes) including gender reassignment/sex reconstruction surgery.
10. In 1992 the right of transgender people to get new identity documents which reflect their preferred/reassigned gender was withdrawn by the introduction of section 33(3) into the Births and Deaths Registration Act 52 of Citation1992. This section stated that the legal change of sex status could apply only to those who had started their gender reassignment prior to 1992 which left those who commenced their transition after 1992 without any legal option to bring their documents into correspondence with their newly affirmed gender identities.
11. Informal communication with Nthabiseng Mokoena, March and April 2013 and electronic correspondence with Nthabiseng on 18 September 2013: “The number one reason we get approached by constituents is because of access to health care, the second reason is seeking information related to trans and intersex health care and services available, the third reason is support for the individuals and family issues. The other not as frequent reason is assistance in terms of ID's”.
12. Her projections show that “South Africa has the highest prevalence of intersexuality in the world” See: Sally Gross on the Intersex South Africa web-site: http://www.intersex.org.za/index.php/en/publications/about-intersex/45-what-is-intersexuality
13. Sally Gross' hypothesis may be easy to dismiss without statistics. I found this comment by one of the intersex participants nonetheless supported her hypothesis that a large intersex population exists:
“I am coming from [name of the place – N.H.]. It is a small community while in this small community there are people who are LGBTIs. They are all there… Since I've been doing small research for three months, we have six or seven intersex people there, but they can't come out only because of judgement or discrimination” (Focus group discussion, 23 February 2013)
14. The research was undertaken when I was enrolled as a visiting researcher and intern in the African Centre for Migration and Society, University of Witwatersrand (Ethical clearance: H130218). It was done in close collaboration with Transgender and Intersex Africa (TIA). The research resulted in master thesis ‘Becoming a transgender/intersex internal migrant in urban Gauteng: Challenges and experiences of transition while seeking access to medical services’ (Husakouskaya, Citation2013).
15. Here I provide terminology that is widely used in the articles and works mentioned below where ‘transgender’ may refer to an umbrella term while ‘transsexuality’ applies to a person who opts for medical intervention. Authors often make their choices based on the preference of research participants (see, for example, usage of ‘transsexual’ in Vincent and Caminga [2013] and ‘masculine-identified transperson’ in Theron and Collier [2013])
16. In conversation with young research fellows about the term queer one of them said the term tended to be used among people located predominantly in academic or activist settings, ie educated and aware of current trends in feminist and queer theories. This brings back the need for analysis of how race and class intervene in South African context and how often discourse around race overshadows and substitutes debates around class (debates around Joburg Pride can be taken as one of the examples: see van der Merwe and Tidimalo, 2012; van der Merwe, 2013). This conversation also highlights the central role of access to education, information and technologies (computers and Internet) emphasised many times in the narratives of my participants. They mention the terms of race and class rarely but they frame inequality and disadvantages in terms of ‘lack of access’ and ‘place of origin/living’.
17. The SOC provides clinical guidance to medical and mental health providers who serve transgender, transsexual and gender non-conforming people worldwide.
18. For example, it is not uncommon that a psychologist would stick to an outdated requirement of a long-term ‘real life experience’ and requirement for hormone therapy and surgery for transgender patients introduced in previous versions of SOC.
Additional information
Notes on contributors
Nadzeya Husakouskaya
NADZEYA HUSAKOUSKAYA is a feminist and gender researcher from Belarus. Currently she is doing her PhD on transgender masculinities in Ukraine at the Centre for Women's and Gender Research at the University of Bergen (Norway). In 2012–2013 she was enrolled as a visiting researcher and exchange MA student at the African Centre for Migration and Society, University of Witwatersrand. Her masters research explored challenges experienced by black transgender and intersex internal migrants in urban Gauteng and their experiences of ‘transition’ while seeking access to medical services in the public health sector (European Masters in Migration and Intercultural Relations). Over the last seven years she has been a board member and associated researcher at the Centre for Gender Studies at European Humanities University, Belarusian University in Exile in Vilnius, Lithuania. She has extensive experience as a lecturer, gender trainer and gender expert. Nadzeya's academic interests include gender and socio-political transformations in non-western contexts; transgender and intersex experiences; sexuality; migration and mobility; body, technologies and ethics. Email: [email protected]