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27 June 2022 | Story Sivuyisiwe Magayana | Photo Supplied
Sivuyisiwe Magayana
Sivuyisiwe Magayana is the Senior Officer: Gender Equality and Anti-Discrimination Office in the Unit for Institutional Change and Social Justice, University of the Free State (UFS).

Opinion article by Sivuyisiwe Magayana, Senior Officer: Gender Equality and Anti-Discrimination Office, Unit for Institutional Change and Social Justice, University of the Free State.
South Africa is one of the most progressive countries in advancing the rights of sexual and gender minorities in Africa, and its Constitution is the first in the world to prohibit unfair discrimination on the grounds of sexual orientation . But even though South Africa's Constitution guarantees all citizens' rights, many factors still conspire to make transgender and gender-diverse persons particularly vulnerable to life-threatening marginalisation, oppression, violence, and exclusion. Some of these factors include access to education, socioeconomic status, health status, stigma, housing, and discrimination. Because of these and many other factors, the delicate topic of how South African communities and institutions of higher learning treat sexual and gender minorities, particularly the transgender community, is one area that still demands considerable attention. Transgender and gender-diverse students continue to be marginalised, neglected, mistreated, harassed, and silenced because of their gender identity; as a result, universities must develop policies and tactics to combat transphobia and transcend the gender binary.

A spiral of exclusion and marginalisation of trans and gender-diverse students in institutions of higher education

University communities around the world have seen an increase in the number of persons who identify as transgender, gender-diverse and non-binary. As a result they have experienced equally increased enrolment of trans and gender-diverse students. However, it appears that universities are not comprehensively ready to meet the needs of trans and gender-diverse students. While universities acknowledge trans and gender-diverse people, they do so in ways that sustain societal beliefs of underlying gender distinctions and heterosexuality. South African institutions are largely heteronormative, resulting in an institutional setting that is not prepared to meet the needs of transgender and gender-diverse people. Institutions continue to operate under the premise of catering to cisgendered individuals, subjecting those who deviate from this to institutional and social alienation and discrimination. Institutions are fixated on societal distinctions between men and women, which are a primary source of social categorisation and, as a result, feed differentiation and inequality in everyday cultural practice and processes. The binary categorisation excludes transgender and gender-diverse people. Not only is this categorisation hostile, but it also silences and erases the above-mentioned individuals.

As a result, trans and gender-diverse persons experience multiple forms of marginalisation, exclusion, and discrimination in institutions of higher learning, including being denied access to or questioned within campus housing and facilities, harassment, bullying, and alienation – because of their gender identity and expression. Moreover, trans students are faced with being exposed to university systems that lack knowledge about trans persons and issues altogether, including challenges with their forms, such as applications that do not recognise and cater for students that identify outside of the gender binary. Exclusion and marginalisation are also evident in the lack of gender-inclusive residences and facilities, which demonstrates resistance and slow progress towards inclusivity. As a result, some trans students are subjected to aggressive treatment in residences because of a life they did not choose. For instance, trans students who identify as transmen must be placed in women's residences because their official documents still reflect that they are female; similarly, transwomen are placed in male residences. This placement system exposes them to bullying, harassment, and violence from other students who do not “feel at ease” or “safe” among transgender people – because they do not understand the concept of “transitioning”. 

Also, in cases where students must share a room, cisgender female students are paired with transmen in female residences, and when the former expresses any discomfort or feelings of unsafety, the transgender or gender-diverse is more likely to be removed and placed in another residence; it is never the other way around. For people who identify as transgender or gender-diverse, this requires an ongoing negotiation of space. 

Trans persons are evidently caught in a spiral of exclusion and marginalisation, as they are often rejected – not just by their families, but also by the system and by the very institutions that are supposed to equally advance and cater for everyone, regardless of their gender identity, sex, and sexual orientation. 

The violence experienced by trans persons and strategy of invisibility within and outside of universities.

Despite South Africa's constitutional and legislative provisions against discrimination based on gender, gender identity, and sexual orientation, transgender people continue to be violated and become victims of transphobic violence and discrimination. These acts are motivated by society's preconceived notions of what a trans person's gender identity should and should not be. For example, our communities and our institutions of higher learning currently represent a stern heterosexual matrix in which a hegemonic social order posits that all persons should and/or must have a set gender and sexual identity.

This creates a scenario in which those who present gender diversity are perceived to be foreign, “responsible for the collapse of African traditional values” or “un-African”, and are shamed and become victims of violence because they are “not God’s creation”. Many in our society believe that being transgender is a violation of “God's natural order and creation”, which then exposes people outside the gender binary to varying forms and levels of physical, verbal, and emotional violence. These forms of violence impact and trample on their human rights and dignity, self-esteem, and academic progress. As a result, universities lose these students to other institutions that they perceive to be better, more inviting, transformed, and inclusive.

For their safety and wellbeing, trans persons hide and remain invisible to avoid violence, bullying, and discrimination. They do this because society and institutions want them to exist in silence so that the “natural” order of existence in their communities and institutions is not disrupted. As a result, their use of invisibility protects them from humiliation, bullying, transphobia, and general exclusion from social activities that other people enjoy regardless of gender identification.

Way(s) forward
Universities are a direct reflection of our societies. Transphobia attacks, harassment, and discrimination are on the rise in communities across South Africa, and students are more likely to imitate these behaviours that replicate where they come from. As a result, it is past time for institutions to develop safe spaces for everyone, especially gender minorities. Universities should lead the charge for change, but they remain some of the most unaltered and unsafe spaces for people who identify differently. Universities continue to explicitly fight other societal ills such as racism and gender imbalance, but there is still a long way to go in the fight against homophobia and transphobia. Therefore, universities must strengthen their efforts to combat homophobic and transphobic prejudice, discrimination, and violence through policy formation and reformation, advocacy, and awareness campaigns denouncing such treatment.

Additionally, higher education institutions are strongly gendered spaces; they are physically and symbolically divided along gender lines, and remain weaved in the normalised construction of a gender binary. Universities must abandon a binary perspective, adopt and execute gender-inclusive policies, and provide gender-inclusive facilities and housing. They must encourage equality for all, rather than viewing institutions of learning through a gender binary perspective.

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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