Outside of the biological, social and cultural dynamics that produce girls and boys, is a growing intersex and transgender community. Mmegi Staffer BABOKI KAYAWE looks at the experiences of gender variant persons in Botswana
From a high profile career as an Olympic paralympian, Tshotlego Morama’s career went down spectacularly following allegations in 2007 that “she” fathered a child.
The Botswana National Sports Council (BNSC) pulled her out of active competitions and sent her for counselling.Today, as Paul Morama, he is well settled into his identity as a man and a father.
He tells Mmegi that growing up as a female teenager in Letlhakane in central Botswana, he increasingly felt uneasy as he begun shunning skirts and everything feminine. The athlete, whose left arm is truncated, was living uncomfortably as a female.
“I didn’t feel like a girl anymore. I preferred trousers and everything boyish. I disliked the dresses and skirts they bought me,” Paul says. Paul never told any family member how he felt. Even at school, he did not share his feelings, and none of his teachers asked anything regarding his gender expression.
“I was confused; I really didn’t know what was going in me. I wondered why I was noticing changes in my make up since I knew I was a girl. I thought the transition was due to intense exercise as I was a sportsperson.
“My family didn’t say anything besides rhetorically asking why I didn’t grow any breasts while my age mates already had them.”
Like others in the environment he was in then, Paul lacked information on issues of gender identity. He lacked a professional explanation regarding the transition and the issue anguished him.
“It took me years to understand that I was intersex. As the male hormones continued to dominate, I felt trapped in a completely different body,” he says. Paul’s intersex status came out in the open in 2007 with media reports that he fathered a child. The young athlete found himself devastated, as the public outrage grew, with allegations that he had cheated by competing as a woman at the Paralympics in Athens. “I was emotionally broken. I didn’t know how to handle the whole thing. Sports authorities were only doing their job to counter the reports. They didn’t know my condition then.”
Asked whether he is a father, Paul is unable to give a specific response. “While it is true I was in an intimate relationship with the woman in question at the time, for one to father a child, they need to have testes, which I don’t have.
No medical tests have been done to see whether I can bear children without these critical organs,” he says.
“But I treat the nine-year-old child as my own and we have a good relationship.”
Paul hopes to get married and have children through artificial fertilisation one day.
The Rainbow Identity Association (RIA) is a trans and intersex-led group that provides mentoring and support to trans and intersex people in Botswana.
Its advocacy and media personnel, Refilwe Mogorosi says due to lack of awareness and knowledge surrounding the gender spectrum, parents do not openly talk about issues of intersex and transgender with their children and vice versa. Mogorosi says most parents would rather hide behind religion and the maxim, “God does not allow such things” or blame demonic forces for this “unnatural behaviour”.
This often leads to exclusion from family activities, according to Mogorosi.
“Families would rather exclude these people because they are keen to avoid embarrassment by their transgender or gender non-conforming children. This sends a message of shame because parents want their children to ‘behave and dress right,’” says Mogorosi.
Mogorosi adds that many have been rejected because of how they identify as families are in denial about how their children express and identify. In the education system, RIA believes most children identifying as transgender and intersex cannot express themselves because there are school uniform regulations particularly determined by societal upbringing modelled on gender binary.
“We get a lot of transgender and intersex students dropping out of school at a very early age or even affected by anxiety, depression and sometimes suicidal thoughts,” says Mogorosi, although he is unable to provide statistics.
“For example, in boarding schools we get students waking up as early as 4am to shower so that others do not see the body features they are uncomfortable with.”
Though it is not illegal to be transgender in Botswana, Morogosi says the lack of laws that speak specifically to transgender and intersex issues makes it difficult for one to be able to change national documents to align them to the gender that they identify with and not necessarily the one they were born with.
“This leads to instances where one is unable to access a number of services because one’s documents do not match how they express or identify,” he says.
Further, difficulties in changing the gender marker have resulted in this community experiencing stigma and discrimination, which Mogorosi feels could be intentional or otherwise, emanating from service providers’ lack of awareness and ignorance about transgender and intersex issues.
“Because of the issue of the gender mark and national identity, it is difficult for transpersons to access health care, particularly in government facilities, because of the discrimination, ridicule, and stigma they face when entering such facilities. Their documents do not match their gender expressions and they are often made to feel out of place.”
A Motswana transgender woman and gender rights advocate based in Cape Town, Tshepo Kgositau feels Southern Africa is a far much better place for gender variant persons to live in than all other regions of the continent.
Kgositau, who underwent gender reassignment, is director of Gender DynamiX - an organisation that seeks to realise full human rights for transgender and gender nonconforming people.
She cites challenges to affected people as revolving around lack of access to legal gender recognition and gender or sex marker change in most countries, lack of access to education for many gender variant persons as well as lack of access to general health care services including HIV prevention, testing, treatment and care.
“Lack of access to sexual reproductive health rights and services, compromised social security and a lack of legal remedies against violence based on perceived or real gender identity, are still problematic as well,” she adds.
“Tolerance is not a state that professionally I and many other human rights advocates strive towards unlike striving for acceptance and inclusion.”
In her view, tolerance in itself denotes a state of forced or coerced co-existence with something that one does not like nor accept. Tolerance, she says, is short-lived as opposed to acceptance and inclusion.
“With that in mind, we are still a bit of a distance away from a full acceptance of transgender diverse persons in our sub-region although there are various instances where we are beginning to see governments change their stance on disregarding and denying the existence of transgender persons.”
Kgositau believes the reason many Southern African countries have not been able to curb the HIV/AIDS
On a social level, the acceptance and social integration of transgender persons varies from country to country and community to community. Kgositau cites countries such as Botswana, Namibia and Mozambique as prime examples of a social state where transgender and gender variant people co-exist with non-gender variant persons with lower cases of violence and repressions.
South Africa has relatively strong legislation on paper, for instance the Alteration of Sex Description and Sex Status Act 49 of 2003, which provides for transdiverse and other persons to change their gender markers on their identity documents officially. However, the country has a violent and hostile social sphere where cases of corrective or curative rape of transgender men and women is on the rise and where these cases go without legal or judicial remedy due to a lack of hate crime legislation.
Activists also note that there is lack of investment on the part of government to educate, sensitise and raise awareness in the society on what a transgender person looks like and is, which defeats the effective implementation of such laws.
“Perpetrators of violence and assaults against transdiverse persons continue to go unconvicted for their human rights violations against gender minorities,” Kgositau says.
She says Sexual Reproductive Health Rights (SRHR) messaging and services are packaged, designed and implemented with a binary lens that then denies transpersons the health care that they need.
“For instance a transgender man – someone assigned female on a birth record but identifying as male or man – might have undergone sexual reassignment and as such have the secondary sexual characteristics of males such as a beard, flat chest and deep voice. They however still need to undergo a pap smear to screen him for cervical cancer.
“Some of these men have been denied such necessary services by professionals who regard pap smears as procedures segregated only for women.”
Likewise, the activist says transgender women also need prostate cancer and testicular cancer screenings in the course of their lives but many do not seek such services as health care providers who have not been exposed to transgender literacy do not know how to provide health care without offending the gender identity of the patient.
Many transgender men and women wanting to undergo sexual reassignment continue to face a denial of these services by public health facilities due to a cosmetic misunderstanding of the necessary procedures and services, Kgositau adds.
When asked about the position of his ministry’s sexual reproductive health services towards minority populations like Lesbians, Gays, Bisexuals, Transgender, Intersex and Questioning (LGBTIQ) Ministry of Health deputy permanent secretary (preventative services), Dr Haruna Jibril concedes: “It’s a very sensitive issue. The Ministry is still looking at how best to address the situation.
“The LGBTIQ community is in full force now and they need inclusive reproductive health care provided in an environment that is conducive, where they are free and accessibility is friendly.
“We are trying to address the rights issues,” he says.
Comparing the needs of transgender population to those of sex workers, he said the health ministry is very aware of the rights challenges bedevilling both groups.
“We are very much aware of the rights issues of these populations. We are yet to educate ourselves on how we best provide for their sexual and reproductive health services.”
Interestingly, Jibril says homosexuality is a practice that has existed for centuries in African societies though its practitioners were not out in the open.
“We are trying to understand the issues and see how to address their needs,” he says.
In a very sharp contrast, Veronica Leburu, the Department of Public Health’s deputy director, says SRHR services in the country are very inclusive.
She says access to SRH and sexual orientation or gender identity are not in anyway intertwined. Rather Leburu argues service delivery is enshrined from the Patients’ Charter, which upholds dignity and confidentiality.
“Once a person walks in our facilities, the patient receives sexual health services tailor made to suit her or his sexual orientation. Therefore our services are non-discriminatory,” she says.
This variance, Kgositau says, is a reflection of the “contradictions and denialism” faced by human rights advocates particularly those working with minority groups such as the transgender and gender non-conforming community.
Assistant Local Government and Rural Development Minister, Botlogile Tshireletso, a renowned minority rights advocate, says the groups have voiced their concerns to her.
She says recently an intersex individual sought her intervention because they were having difficulties changing their gender marker with the department of civil and national registrations. The process was almost impossible, Tshireletso says.
“This is a person who was assigned the female gender at birth but later on their male organs dominated and they developed into a full man. However, the name and all identity documents are feminine. So the physical make up doesn’t match the identity,” she says.
Changing these documents is a tedious process.
“I spoke to the Ministry of Labour and Home Affairs and I have appealed that they ease these processes instead of turning the affected people into laughing stalks,” Tshireletso says.
Likewise, she says health systems must also be cognisant of gender variant populations and strive to provide specialised services. Tshireletso says since health services are highly subsidised, government must set up a public facility targeting this community.
“We need to have a specialised centre offering health services exclusive to these people. The centre has to be equipped enough for gender reassignments to be performed. I know one centre won’t be enough to address their current health challenges but we need to start somewhere,” she says.
She echoes Morama’s view that the education sector must design programmes geared towards helping transpersons and intersex to psychologically and emotionally deal with their inner selves. Beyond that, she says facilities in boarding schools must be user friendly to all.
“It is disturbing that we have learners who wake up at the early hours of dawn to bath because they fear that when their nudity is exposed to co-learners they will be subjected to ridicule,” she says.
Another political leader championing the rights of this community is Leader of Opposition Duma Boko who condemned the predominance of gender binary, during a discussion of the National Policy on Gender and Development in Parliament last year.
Transgender and intersex people wait to see whether this support will transform into radical interventions in their lives.
*Kayawe is a 2016 Thompson Reuters Foundation Taboo Reporting Fellow