| dc.description.abstract | Transgender persons often require aligning their physical characteristics with their gender other than the gender assigned at birth. Aligning their physical characteristics with their gender requires gender affirming treatments. However, there is scanty information to help social work researchers understand how transgender persons access gender affirming treatments. This study explored access to gender affirming treatments for transgender persons in Kampala with a specific focus on the barriers to access to gender affirming treatments through the lenses of the access to healthcare theory. To execute the study, a cross-sectional exploratory research design using qualitative methods was employed. I conducted a total of 9 in-depth interviews with 9 transgender persons. In addition, I conducted two FGDs with transgender persons. I also interviewed 3 leaders of transgender organisations; 2 employees of human rights organisations working with transgender persons; 2 organisations providing health services to transgender persons; 2 officials from the Ministry of Health and 2 from the Uganda AIDs Commission (UAC). All interviews were audio recorded with permission and later transcribed into Word documents. Data were analysed thematically following a step-by-step framework analysis for qualitative data by Braun and Clarke (Braun & Clarke, 2006). In interviews and focus group discussions, it was revealed that both medical and non-medical gender affirming treatments are need by transgender persons in Kampala. However, gender affirming treatment services are not available through the formal health care system. Because of this, services are accessed through the network of friends and the internet. Given that there are no known places or areas where gender affirming treatment services for transgender persons are openly provided, transgender persons reported that they obtained information on the existence of the gender affirming treatments through friendship networks. It was reported that such treatments are not prescribed by doctors and there is no follow up by health workers on transgender persons accessing these treatments. Transgender persons also pointed to existing health systems and socio-economic barriers to access to gender affirming treatments. Health system barriers reported include stigma and discrimination by health workers, limited knowledge of gender affirming treatments by health workers, exploitation by health workers providing these services, protocol and unfriendly procedures in health centres, and lack of guidelines and policies on the provision of gender affirming treatments within the health system. Socio-economic barriers include the high cost of the treatments, societal stigma and discrimination, lack of social and family support systems and a restrictive legal environment. Health system and socio-economic barriers have pushed transgender persons to access gender affirming treatment through networks of friends and the internet. Given the risks involved in access to gender affirming treatment through friends and the internet, there is a need for an inclusive legal and policy environment that makes it easy for transgender persons to access such services in a formal healthcare setting. Social workers should be at the centre of advocacy efforts towards promoting such an environment. | en_US |
