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Title: Bridging the Gap: Enhancing Healthcare Accessibility and Gender-Affirming Services for Transgender and Gender-Diverse Individuals in the Western Cape
Authors: Moscoe, Bella
Advisors: Sharkey, Alyssa
Department: Princeton School of Public and International Affairs
Certificate Program: Global Health and Health Policy Program
Class Year: 2024
Abstract: The transgender and gender diverse (TGD) population across the globe has historically been disenfranchised, typically due to unequal protections in policy that make accessing resources for this community more difficult. However, although guaranteeing equality to health regardless of gender within one of the most progressive constitutions, the TGD population of South Africa is suffering significantly worse health outcomes compared to cisgender patients. Multiple barriers exist to accessing health systems for this community as stigmatization and discrimination caused by a lack of education and adherence to cultural and religious beliefs by health professionals make primary healthcare (PHC) an unsafe space. This, coupled with the lack of accessibility to gender affirming resources within South Africa and more specifically, the Western Cape, exacerbate the unfortunate health outcomes that this population faces. Policy change is needed to ensure that the unique needs of this marginalized and vulnerable population are met. This study aims to qualitatively assess existing attitudes towards improving gender affirming healthcare (GAHC) held by policymakers, health professionals, and other stakeholders whose voices are critical to enacting change in the policy sphere. Additionally, these semi-structured interviews gathered context on the struggles being faced by TGD patients, identified limitations of existing funding efforts, underscored the relevance of culture and religion on attitudes towards the TGD population, and identified additional challenges in pushing for change in this area. After analyzing my results, I provide recommendations for policymakers on what can be done to improve health service accessibility for the TGD population. My findings suggest that there is a large opportunity for policymakers to enact positive change in this space. The themes of Culture and Religion, Stigmatization and Discrimination, Health Literacy, GAHC and its Connection to HIV/AIDS, and Evidence Based Policy Creation were identified through framework analysis and guided the recommendations provided at the end of this study. I conclude that policy makers must prioritize culture building, sensitization training and standardized medical curriculum that teaches the needs of the TGD population. They must also demonstrate the connection between HIV/AIDS initiatives and GAHC to garner donor funding and utilize NGOs to create the evidence base needed to push for policy change.
Type of Material: Princeton University Senior Theses
Language: en
Appears in Collections:Princeton School of Public and International Affairs, 1929-2024

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