Botswana health system struggling to deal with gender identity confusion patients

The general lack of information about gender identity issues that plagues the country’s health care service means that Botswana’s Transgender community is suffering. A recent incident involving an eighteen year old was brought to the attention of Rainbow Identity, an organization that deals with transgender and intersex people and their issues.

The incident took place at the Princess Marina Hospital’s department of infectious diseases. The teenager suffering from gender identity confusion went to seek medical attention from a physician. Mrs Monareng, a nurse within the department, came across the young person while on her regular rounds which usually focus on counselling and testing for cervical cancer.

This is Kagiso, an only child who lives with grandparents in a settlement called Hunhukwe, 67km from Hukuntsi, a village in Kgalagadi District (Kalahari) in Botswana.

Mrs Monareng told Behind the Mask, “I met this young person, ‘Kagiso’, who was born male and to me it did not occur that maybe this person was a female inside. When I asked what I could do for the client, the client responded by saying: I am referred by a doctor to come and see a physician.” Monareng continued, “When I asked what the complaint was, I was shocked.”

Nevertheless, as much as there is lack of information within government hospitals the client was eventually seen by doctors and in the client’s card, the doctors have written that the client is intersex. However much to their surprise the characteristics they observed were male.

Monareng said, “The sad part is that this client is from a disadvantaged background and even the mother has no idea on how to support the child. As far as she [the mother] is concerned, she gave birth to a boy who preferred to associate with girls. She clearly never knew that a person could change their sex.”

At school Kagiso only managed to reach junior level (Form 3) and was forced to discontinue studies because of poor results probably made worse by the difficulties faced at school when one has a gender identity crisis.

Monareng said, “When Kagiso when was the age of 12 or 13, he told the mother that he wanted to be a girl but the mother did not understand why her son now wanted to be her daughter and had no idea such a thing was even possible.”

Monareng continued, “Kagiso`s journey has not been an easy one as no one understood what Kabo was going through. I really salute Kagiso for the courage to come all the way from the Kalahari District to Gaborone to seek assistance.”

The doctors and nurses at the hospital did all they could with regards to Kagiso and it was they who referred the case to Rainbow Identity who will now see how they can help Kagiso.

Kagiso arrived at Rainbow Identity dressed in a pink jacket, pants and high heels looking for help with answering questions that no one in the village can help with. Staff from Botswana’s only transgender and intersex organization that focuses on gender identity, met with Kagiso.

Often people are accused of “learning” to be transgender or homosexuals, the staff at Rainbow Identity asked Kagiso if she had ever heard of the terms transgender and intersex before. “I have never heard of or seen anyone who is a transgender or transsexual before all I know is that I want to be a girl,” said Kagiso

The society that Kagiso lives in accepts her as a woman and sometimes feels sorry for her as they asked themselves why God gave Kagiso male genitals. Meanwhile her grandparents are looking forward to the day that Kagiso will stop being trapped in the wrong body.

When interviewed, Kagiso`s mother Martha said, “I do not have problem with the way Kagiso wants to be addressed but my problem is why can’t Kagiso wait until she is older to make the decision on her own? The sad part is Kagiso will never be pregnant and have her own kids.”

Not many parents can go through the process when their child needs to reassign their sex. However it took a 38-year-old woman from Hunhukwe to travel to Gaborone to see the doctors at the main government hospital, the Princess Marina. Here the child was taken into laboratory for hormone tests, an ultra sound and a skin test.

“My mother has been with me in this journey and we want to thank Mrs Monareng who referred us to Rainbow Identity. I had so many questions that even the doctors couldn’t help me, but today I feel more relieved “said Kagiso

Responding to this incident Rainbow Identity said it is responsibility for both parties to take stand and introspect, Trans people should not want parents to accept them just like that they must give parents time to mourn and cry if they need to as transition is not one sided. Also parents need to respect their children’s decision and support them.

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