Original Research

Transgender population’s experiences with regard to accessing reproductive health care in Kwazulu-Natal, South Africa: A qualitative study

Zamasomi P.B. Luvuno, Busisiwe Ncama, Gugu Mchunu
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a1933 | DOI: https://doi.org/10.4102/phcfm.v11i1.1933 | © 2019 Zamasomi P.B. Luvuno, Busisiwe Ncama, Gugu Mchunu | This work is licensed under CC Attribution 4.0
Submitted: 03 September 2018 | Published: 10 July 2019

About the author(s)

Zamasomi P.B. Luvuno, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Busisiwe Ncama, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Gugu Mchunu, Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa


Background: The transgender population has unique health risks, including increased risk of mental illness, substance abuse, suicide and a high prevalence of human immunodeficiency virus (HIV). Worldwide studies indicate that this population is marginalised and faces barriers in accessing health care. In South Africa, there is limited information and research on the transgender population’s interaction with health services.

Aim: The purpose of this study was to examine the experiences of the transgender population in accessing health care facilities for sexual and reproductive needs.

Setting: The study took place in KwaZulu-Natal province of South Africa.

Methods: A qualitative study combining phenomenological and critical ethnographic approaches was conducted to explore the experiences of the transgender population in the health care setting. Critical ethnography was chosen because it is an emancipatory method that highlights the plight of disenfranchised groups, and phenomenology was used to illuminate experiences of the transgender population. Purposive snowball sampling was applied to select nine transgender participants who had experiences of contact with a health care setting. Data collection was performed through semi-structured interviews and a focus group discussion.

Results: Participants provided details about the paucity of facilities, resources and targeted programmes to cater for the transgender populations’ sexual and reproductive health needs. The participants engage in high-risk behaviour, comprising unprotected sex and use of cross-gender hormones without medical supervision. Furthermore, the participants reported experiences of hostile and discriminatory behaviour by healthcare workers.

Conclusion: It emerged that there is a paucity of resources and knowledge to provide appropriate health care services to the transgender population, resulting in adverse experiences. Policies on transgender care and training of health workers will contribute towards improvement of health care access for the transgender population.


transgender population; transgender health; transgender; HIV; transphobia; health care access; health care accessibility


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Crossref Citations

1. School-going transgender youths’ experiences at health care facilities: a systematic scoping review protocol
Delarise M. Mulqueeny, Senzelokuhle M. Nkabini, Tivani P. Mashamba-Thompson
Systematic Reviews  vol: 9  issue: 1  year: 2020  
doi: 10.1186/s13643-020-01347-0