Critical Trans Studies in and beyond Europe

Nay, Yv E.; Steinbock, Eliza

doi:10.1215/23289252-8890509

Cited by 18 publications

(6 citation statements)

References 9 publications

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“…A critical inquiry explores how individual stories are mediated by broader sociocultural and political contexts, explicitly deconstructing stories to address and question the construction of knowledge, power, and reality entrenched in and through narrative accounts of human experience [ 21 , 36 ].…”

Section: Methodsmentioning

confidence: 99%

The complexities of trans women’s access to healthcare in South Africa: moving health systems beyond the gender binary towards gender equity

Shabalala,

Campbell

2023

Int J Equity Health

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Background Public health research highlights the influence of socio-political biases shaping obstacles to fair healthcare access based on gender. South Africa has shown commitment to resolving gender imbalances in healthcare, historically emphasizing cisgender women’s challenges. However, research gaps exist in exploring how public health systems perpetuate disparities among gender-diverse persons, like trans women, who face exclusion due to their deviation from cisgender norms in healthcare. Critical, intersectionality-informed health research carries the potential to reveal the diversity of gendered healthcare experiences and expose the systems and processes that marginalize trans patients. Methods This study adopts a critical trans politics perspective to explore the socio-political forces limiting South African trans women's access to public healthcare. Using a critical narrative approach, the research asks: 1) What narratives do South African trans women share about their experiences in health systems? 2) What gendered societal structures, practices, and norms enable or hinder their inclusion in health systems? Over a period of two months in 2022, five South African adult trans women between the ages of 22 and 30 participated in 60 to 90-min long, semi-structured individual, telephonic interviews, focusing on participants' subjective experiences in healthcare. Results Trans women's narratives unveiled a culture of medical genderism in South African public healthcare, discriminating against patients whose gender misaligns with societal norms. This culture is represented by the trans women's experiences of their identities being structurally stigmatized and delegitimized when seeking healthcare, reflected in institutional policies, practices, and protocols consistently disregarding and misgendering them. Trans women’s systemic erasure was illustrated by the restricted professional knowledge, availability, and adoption of gender-affirming healthcare in a ciscentric public healthcare system prioritizing cisgender needs. The intersection of gender, race, and class dynamics compounded the obstacles faced in accessing healthcare. Conclusions This inquiry underscores the structural hurdles trans women face when accessing suitable public healthcare. It introduces a gender equity framework for trans inclusive healthcare, outlining implications for research, theory, policy, and practice. Toward the goal of embracing complexity and diversity, this framework, for example, promotes the rigorous absorption of trans persons and their healthcare experiences in gender-responsive programming, and encourages the development of a comprehensive understanding of gender equity from an intersectional perspective incorporating the unique needs and rights of trans healthcare seekers. The framework also offers practical guidance for cultivating health systems attuned to gender diversity (such as addressing medical genderism and recognizing the broad spectrum of identity at a policy level).

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Section: Methodsmentioning

confidence: 99%

The complexities of trans women’s access to healthcare in South Africa: moving health systems beyond the gender binary towards gender equity

Shabalala,

Campbell

2023

Int J Equity Health

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show abstract

Section: Methodsmentioning

confidence: 99%

The Complexities of Trans Women’s Access to Healthcare in South Africa: Moving Health Systems Beyond the Gender Binary Towards Equity

Shabalala,

Campbell

2023

Preprint

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Background: Research in healthcare inequity has shown that health systems are shaped by broader socio-political contexts and biases that shape the institutionalization of healthcare, often leading to significant barriers to inclusive and equitable healthcare access. Health research has, however, overlooked how health systems marginalize gender-diverse persons and sustain health inequities among this population. Trans women, for instance, face multiple layers of exclusion due to their gender identity in health systems that could be considered patriarchal, binary, and cisnormative. Intersectionality-informed research can help challenge these gender structures within healthcare by acknowledging the diversity of identity experiences. Methods:This study adopts a critical trans politics (CTP) perspective to explore the socio-cultural and political dynamics limiting South African trans women's access to healthcare. Using a critical narrative approach, the research asks: 1) What narratives do South African trans women share about their experiences in health systems? 2) What gendered societal structures, practices, and norms enable or hinder their inclusion in health systems? Five South African adult trans women between the ages of 22 and 30 participated in semi-structured individual, telephonic interviews that focused on participants' subjective experiences within the healthcare sector. Results:Trans women are often stigmatized and positioned as outsiders in ciscentric health systems, which uphold traditional gender norms and favour cisgender individuals, while excluding and marginalizing trans positions. Three dominant thematic narratives emerged. First, the denial of trans women’s self-determination reflected in institutional policies and practices that misgender trans women, limited their access to dignified healthcare. Second, the lack of knowledge about gender-affirming healthcare held by healthcare professionals and healthcare institutions led to informational erasure. Third, barriers to accessible and equitable healthcare faced by trans women were compounded by gender, race, and class structural dynamics. Conclusions:This study sheds light on the challenges faced by South African trans women in accessing appropriate and respectful healthcare, highlighting the need for more inclusive and informed practices in local health systems. In response, a trans-inclusive health equity framework is proposed and its implications for theory, policy, research, and practice are outlined.

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“…Indeed, many activist movements—such as the Black Lives Matter movement—are explicitly driven by intersectional principles and foreground the fight for racial justice. Trans‐rights activists often align with activist coalitions which challenge white supremacy (Nay & Steinbock, 2021). Conversely, some climate action groups have been criticised for neglecting the intersectional and colonial dimensions of the climate crisis.…”

Section: Conceptualising and Researching Child And Youth Activismmentioning

confidence: 99%

Rethinking child and youth activism in challenging times

Wright,

Kustatscher,

Konstantoni

et al. 2024

Children & Society

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Critical Trans Studies in and beyond Europe

Cited by 18 publications

References 9 publications

The complexities of trans women’s access to healthcare in South Africa: moving health systems beyond the gender binary towards gender equity

The complexities of trans women’s access to healthcare in South Africa: moving health systems beyond the gender binary towards gender equity

The Complexities of Trans Women’s Access to Healthcare in South Africa: Moving Health Systems Beyond the Gender Binary Towards Equity

Rethinking child and youth activism in challenging times

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