While there is growing awareness and activism surrounding gender identity and expression outside of the binary – especially in urban spaces and among the youth – there is still widespread stigma and misunderstanding of these queer identities in South Africa.

This is according to Jacqueline Pienaar, senior technical director at the Aurum Institute, a research and healthcare organisation based in Johannesburg that focuses on the prevention, treatment and care of persons diagnosed with Human Immunodeficiency Virus (HIV) and Tuberculosis (TB).

“I think that South Africa has a very beautiful constitution that does protect the rights of the LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual) community, but there is so much work that needs to be done towards actualising these rights and making sure that they match lived realities. That’s where a big part of the disconnect is.”

This is according to Mogau Makitla, a media representative for Iranti. Iranti is a Johannesburg-based media advocacy organisation that champions the rights of LGBTQIA+ persons, with a specific focus on lesbian, transgender (including gender-nonconforming individuals) and intersex persons in Africa. 

According to Makitla, gender-nonconforming individuals are people whose expressions of gender do not align with societal expectations for the sex that they were assigned to at birth. They say that this can include many things, such as the way in which they dress, their behaviour and their interests.

“Progress is evident in some areas, like visibility in media or public discourse, but there is still significant work to be done to ensure equity in healthcare, education, employment and safety for gender-diverse individuals,” says Pienaar. 

The major challenge that gender-nonconforming individuals face is accessing healthcare that is non-judgmental and free, according to Makitla.

While South Africa’s constitution states that every person has the right to healthcare, there is often a challenge when it comes to actually accessing that promised healthcare. 

Additionally, due to the recent retraction of the United States Agency for International Development (USAID) and the United States President’s Emergency Plan for AIDS Relief, public healthcare facilities that were supplemented by this funding have also been forced to withdraw some of their programs, according to Makitla.

These programs included that of gender-affirming healthcare, leaving many transgender and non-binary individuals across South Africa unable to access this healthcare at their local public clinic, says Makitla. 

According to Pienaar, individuals who express themselves differently face many challenges compared to those that fall under a cisnormative identity.

Cisnormativity refers to “[the] discourse based on the assumption that cisgender is the norm and privileges [cisgender] over any other form of gender identity”, according to lgbtq+ primary hub.

For Makitla, this includes facing hostility within the public healthcare sphere.

“So you go into a healthcare facility and everybody, from the security guard, to the receptionist, to the nurse, is hostile towards you because of your gender identity. And that is an issue,” says Makitla. 

This has forced queer individuals to rely on the private sector for affirmative healthcare, which is not financially accessible for everyone, they say.

Another challenge faced by queer and transgender individuals is accessing job opportunities. This is due to the fact that employers may view these individuals as “abnormal” due to their inability to “achieve an understanding that gender expression is completely unrelated to a person’s physical or intellectual capacity to perform duties”, says Pienaar.

In addition to these instances of discrimination, transgender women and gender-nonconforming individuals are consistently affected by physical and sexual violence, hate crimes and police harassment, says Pienaar. 

They also state that this is particularly common in townships or rural settings, where visibility can lead to being targeted. 

Safer and inclusive spaces

Greater investment in community-led organisations, public education and government accountability is essential to foster truly inclusive environments for transgender and gender-nonconforming individuals, according to Pienaar.

QueerUs, a student society at Stellenbosch University (SU) that fosters a safe and active space for LGBTQIA+ students on campus, has played a vital role in helping students choose which titles are displayed on their student cards and accounts.

This is according to Fawaaz Cupido, a third-year BA (Human Resources Management) student at SU and chairperson of the QueerUs society for the 2024/2025 executive term.

Cupido says that an initiative led by QueerUs, with the help of the Women and Queer Empowerment portfolio, has given SU students the freedom to choose how they identify on their student cards and accounts since 2021.

“Usually, […] students couldn’t [choose their desired titles] without having proof from home affairs that they are going to change it on their ID,” says Cupido. 

Since the initiative, students have been able to more freely opt for ‘Mx’ rather than ‘Ms’ or ‘Mr’ when they identify as non-binary.

Cupido emphasises the importance of the initiative in helping to create a more inclusive space for gender-nonconforming students on campus. 

Iranti actively works towards fostering the freedom of gender expression in South African society, helping to facilitate the production of two short films that bring awareness to the importance of healthcare designed for transgender and intersex individuals, says Makitla.

One of the films, The Parents of Intersex Children – Their Experiences with Healthcare, was produced in collaboration with Intersex South Africa, an organisation that advocates for the well-being and rights of intersex individuals in South Africa. The film engaged with parents of children who were born intersex and asked them about their experiences raising an intersex child, says Makitla.

Many parents of intersex babies expressed that they were pressured by healthcare professionals to agree to intersex genital mutilation (IGM) surgeries, says Makitla. “IGM is basically when doctors perform harmful cosmetic surgeries on intersex children to make them fit more into the binary.”

Iranti was also involved in a short film called Gender Affirming Healthcare in South Africa, which was launched earlier this year and explores the experiences of transgender women and their challenges with healthcare in South Africa, they say.

According to Makitla, the film “explores their journey as they navigate accessing healthcare within South Africa […], where the hospital staff are not sensitised or they have to travel to clinics in another province because hormonal therapy is not as accessible within their own province”.

Juxtaposing masculinity and femininity

Asanda Khwabe lives in the Western Cape as a masculine-presenting non-binary person.

“My experience has been more or less consistent. I haven’t necessarily experienced any extremeness or extreme reactions from people. Mostly, they’ve accepted me for who I am,” says Khwabe. 

Because of this experience, Khwabe states that they sometimes feel unable to understand the full extent of that which most of their queer friends and counterparts experience in terms of facing blatant discrimination or discomfort in public.

“I am fortunate enough to not experience that,” they say.

According to Khwabe, there is a juxtaposition when it comes to the expression of masculinity and femininity. 

If you are more masculine-presenting or associated with masculinity, then people will tend to take you more seriously, regardless of your gender identity, Khwabe claims. If you express yourself as feminine, it tends to present challenges that become an everyday battle, they say.

“When I say no, it’s taken as no. I don’t get asked any further questions. But my female friends who identify as gay women… when they say no, they’re provoked, they’re constantly questioned,” says Khwabe. “If they do, then they’ll be classified as the ‘angry black woman’ or ‘angry coloured woman’.”

 The continuous journey in transforming spaces

“Queerness, in its own transgressing space, is a movement of existence.” 

This is according to Abongile Quthu, a feminine-presenting transgender non-binary student at SU completing a master’s degree in intercultural communication.

Quthu hopes that the younger generation of queer students will experience a more welcoming environment, where they can freely grow into their identity.

They reflect on how challenging and isolating their first few years in Stellenbosch were. “Those years are so important in discovering who you are and growing into your identity as a being,” they say.

According to Quthu, when they first came to SU, they were placed in a male residence. They found this to be a challenging experience, as they had to navigate their place as a non-binary person in a predominantly cisnormative space designated for male students. 

“I faced so much hostility in my first year because my initial roommate was supposed to share a room with me. He lashed out and said he would never, ever be comfortable staying with a queer person in a room,” they say.

Since then, Quthu has come a long way in expressing and owning their queerness and stresses the importance of curating spaces that cater for, and embrace, gender-nonconforming people.

Regarding gender nonconformity in South Africa, Quthu says “it’s a continuous journey of trying to transform the space”.

“In my mind, I think about all the Abongiles, who are in their first year and are queer-identifying, coming into themselves. I hope that the kids are doing better now,” says Quthu. “I hope that they are safer and more protected.”