Trans Rights! Health Rights!

Regional Scan of the level of Access to Sexual and Reproductive Health Rights and HIV services for Transgender people in Botswana, Lesotho, Malawi, Namibia, Uganda and Zimbabwe

This report explores the socio-political contexts of trans men, women and non-binary persons, and the impact of law, policy, and practice on their access to sexual and reproductive health and HIV services in six Southern and East African countries. It is based on a regional scan of Botswana, Lesotho, Malawi, Namibia and Uganda and Zimbabwe and informed by interviews with individuals working for LGBTI+ and trans-led organisations across the six countries. Trans people experience hostility, stigmatisation and violence for being ‘different’ while simultaneously being invisible (in legal frameworks, in healthcare approaches, through NGO and other programming) and hypervisible (when in public, to law enforcement, when at work or accessing healthcare). This results in a unique set of vulnerabilities and forms of discrimination which continue to pervade the law, political rhetoric and interactions with service providers, family members and broader communities.

Centralising the voices and lived experiences of the respondents, this report shows how health interventions designed to specifically meet trans needs as a ‘Key Population’ may heighten and amplify the marginalisation of transgender people. It shows, through the different experiences of organisations and activists, how a focus on HIV/AIDS in particular has not only ignored the unique and specifi c needs of trans people to healthcare but also diverts attention from the many simple and effective forms of advocacy that LGBTI+ and trans-led organisations rely upon. These are strategies that have grown from the lived realities of trans people and which, in alignment with ARASA’s key principles, centre the rights to bodily autonomy and integrity in addressing social and structural determinants of health while advancing activism and solidarity.

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