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current issues

The National Department of Health or female in different situations. for being different, the quicker that I
added hormones for the treatment Resist the urge to place me into can feel like I am moving toward the
of ‘gender dysphoria’ to the Tertiary descriptive buckets and respect my body I am inside, the better and more
Essential Medicines List in December individual identity, which may well comfortable I will feel with myself.
[24]
2019. be somewhere along a continuum. 8. Please train your staff as well. There
4. Names, pronouns, and gender have been many times where I go
How would trans people like to markers are important. I want people to medical appointments and I
be treated? to understand me and respect me am called by my birth name and
for the person I am. When you call am looked at funny or questioned
Gender-affirming healthcare is more me by the wrong name or pronoun, because my outward appearance
than just transition-related care and this can feel like an insult. If you are might not match the gender marker
refers to an affirming experience in not sure what to call me, just ask, it is in my medical record. Please train
all healthcare encounters. A focus always better to ask than to assume. your staff to look for my preferred
[16]
group of transgender and gender- 5. Don’t ask about my genitals unless name in my medical record, as this
nonconforming youth identified the medically necessary. Many people might differ from my legal name, and
top ten things they want healthcare are curious about what I have or ask me what my preferred pronoun
workers to know, in their own words: [25] want ‘down there.’ But please, is, rather than assuming.
don’t ask me about my genitals just 9. If I am depressed or anxious, it’s
1. Sexuality and gender are two because you’re curious. I wouldn’t likely not because I have issues with Harm reduction for people who
different things. Totally separate. ask you about yours. If there is a my gender identity, but because
2. Talking to strangers about these medical reason to ask me about my everyone else does. Many of us are
things is uncomfortable. Talking to a genitalia, please let me know the anxious and depressed not because use drugs in Southern Africa
medical provider about my gender reason before asking the question. we are transgender, but because
identity and puberty can be painful 6. Genital and breast exams are other people have a problem
and awkward. Be patient and do uncomfortable for most people, with us being transgender. Please
all you can to create a comfortable and they can be particularly acknowledge this when talking to
atmosphere. uncomfortable for me. I may be me about my mental health. A P Scheibe, MB ChB, Dip HIV Man, MPH
3. Nonbinary people exist. When extremely uncomfortable with my 10. Let me know that you are on my
health workers think of transgender current physical body, because it team. Many of us have had to put up
people, they usually think of people doesn’t match who I know myself to with bullying and misunderstanding

[6]
who identify as 100% girl or 100% be. If it is necessary to examine me, in school and in our communities. Drugs Sugar is an extreme example, but shows of economically powerful nations.
boy. A lot of us don’t think that way. please explain the reason. We want to know that health how we view various mind-altering Several international conventions outline

[7]
I may feel that neither label fully 7. Cross-sex hormones can save my life. professionals are on our side and We all use psychoactive substances. substances that have the potential to do the international scheduling of drugs.
describes me or that I feel male As I know people are judging me will not judge us. This includes substances we may not harm differently. The example highlights However, this classification is not based
think of as drugs. Sugar, for example, how regulations have life-changing, on scientific evidence. The Single
[1]
is a substance that releases endogenous often unacknowledged consequences. Convention on Drugs (1961) framed the
opioids in our brain, giving us a sense As healthcare providers, we would use of drugs as ‘evil’, and this moral view
[8]
References of pleasure when consumed. Animal not accept using interventions to treat has endured. Schedule 1 substances
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reproductive health care in Kwazulu-Natal, South Africa: A qualitative study. Afr J Prm Heal Care Fam 2017;17(16):1–10.
Med. 2019,11(1):a1933. 15. Psychological Society of South Africa. Practice Guidelines For Psychology Professionals Working With sugar leads to tolerance and cessation people. Nor would we require people to be ‘highly addictive and liable to
[2]
2. Republic of South Africa. Constitution of the Republic of South Africa. 1996. Sexually And Gender-Diverse People. 1st ed. Victor CJ, Nel JA, editors. Johannesburg: Psychological of intake results in withdrawal. Even with diabetes to reuse or share their abuse’ – and included heroin, cocaine
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faculty: addressing the gap. BMC Med Educ. 2013;13:174. 20. Müller A, Daskilewicz K, Southern and East African Research Collective on Health. Are we doing
alright? Realities of violence, mental health, and access to healthcare related to sexual orientation and bought in pure form from a reputable affect an individual physically, mentally methamphetamine (MDMA), commonly
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nine countries. Amsterdam; 2019. [7]
9. Luvuno Z, Ncama B, Mchunu G. Knowledge, attitudes and practices of health care workers related to seller, with very low risk of poisoning from and socially. They may also affect society known as ecstasy. Despite the risk of
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[5]
Behav. 2017;15(2):8694–8706. intersectional microaggressions: Understanding influences of race, ethnicity, gender, sexuality, and adulterants, and can be used without risk in these ways. However, society’s view developing dependence, or public health
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