Zim to prioritise previously marginalised groups
ZIMBABWE will soon conduct a nationwide survey to ascertain the transgender population and include them in the HIV and Aids programming as the country moves towards ending the disease by 2030.
The Ministry of Health and Child Care director for Aids and TB Unit, Dr Owen Mugurungi, told Sunday News in an interview that they were taking a stance towards this previously marginalised group.
He said the Government could no longer afford to ignore such groups or pretend they do not exist if it was serious about meeting the United Nations target of eradicating Aids by 2030.
“Our main thrust is to end Aids by 2030 and this starts by scaling up of services and making programmes accessible to everybody in the country. We are moving towards including everyone in the country,” he said.
Dr Mugurungi said the ministry was not facing challenges offering services to groups like young people, women and men as they were an easy to reach class.
The challenge, he said, was a group of people who he said now exist in the country — the transgender community.
“We acknowledge the presence of a new group of people among us which is the transgender people, they do exist. This sub-population within our communities is actually a key population just like sex workers. They need inclusion,” he said.
He said the Health Ministry had realised the presence of gaps as they were used to dealing with sex workers, long distance truck drivers and people who spend long periods away from home as drivers of HIV.
He said transgender people and men who have sex with men in Zimbabwe’s prisons were the new important groups that needed priority in order to have more and maintain gains already made in the fight against HIV and Aids.
Dr Mugurungi said the transgender group was an ambiguous one which needed research in order to plan for its inclusion in health programmes.
According to online research, people identified as transgender or transsexual are usually people who are born with typical male or female anatomies but feel as though they’ve been born into the “wrong body”.
For example, a person who identifies as transgender or transsexual may have typical female anatomy but feel like a male and seek to become male by taking hormones or electing to have sex reassignment surgeries.
Dr Mugurungi, however, said there were people whose sex was not clearly defined that needed help.
“Within our communities we have people who are born without definite anatomies that can neither be called male or female but are socialised in one preferred gender by their parents. However, as they reach adolescence the dominant sex begins to manifest and the person may begin to behave as such. They may have been socialised as a woman yet when they grow they exhibit more masculine tendencies. These are a challenge,” he said.
He said these transgender people were not seeking sexual reproductive health services as they felt they do not qualify to be called male or female.
“It is very difficult for a person who has a female appearance to go with a condition found in males such as a penile discharge, it confuses the health worker and they themselves end up shying away from health care institutions as they cannot explain why they have a complicated condition. So, as a ministry we want such people to get assistance and they can do so only if we include them in our programming. They need to come forward,” he said.
Transgender people, he said, show themselves as they grow as they end up attracting people who seem to be of the same condition but said it would be purely a genetic issue.
He said one could be socialised as a female but get attracted to other females which shows that their hormones would be male but physically they develop as a female.
“Such people tend to hang around men and they act male but society wants them to act more feminine because physically they appear female. It is mostly genetics at play and this is why some of them opt for sex change to suit their most preferred gender,” said Dr Mugurungi.
He said there was a need for a voice that speaks to this community as they needed access to HIV and Aids services just like any ordinary human being.
“Failure to include them will make them continue failing to access health services as this group includes those who have anal sex and they do get infections such as gonor r h e a but do not open up. Those that come to hospital come under the pretext of having back aches, and other illnesses shying away from the real problem which medically is not recommended,” he said.
The Ministry of Health and Child Care said they were starting off by doing an estimate of the key population then they would do a snow balling exercise to get numbers. Snow balling is a procedure by which respondents are recruited for interviews or group discussions by means of informal contact between them. This means when one respondent (transgender person) is successfully recruited, they suggest others known to them who might similarly be eligible. It is useful for particular types of sample that would otherwise be difficult to recruit, such as participants who are a minority. After the snow ball exercise they will then do a formal size estimate and plan accordingly. Dr Mugurungi said people living with disabilities are also a new focus as there were no materials in Braille that spoke to those with visual impairments about HIV and Aids. He said people with hearing impairments also need information about the disease in Sign Language and the interpreters need training too.