Breaking barriers: How transwomen meet their healthcare needs.

Transgender women in the study expressed primary healthcare needs centered on hormone replacement therapy, HIV treatment and prevention, and STI treatment.

• Study conducted in the City of Ekurhuleni Metropolitan Council in South Africa's Gauteng province
• 10 transgender women aged 26–50 participated
• Participants were purposively selected
• Individual semi-structured interviews were conducted over 2 months

Experiences of transgender women within the mainstream healthcare system were predominantly negative, with discrimination, stigma, and privacy violations being commonplace.

• Participants reported frequent instances of discrimination when seeking healthcare at health facilities
• Stigma was identified as a recurring barrier to accessing mainstream healthcare
• Privacy violations were reported as commonplace within the healthcare system
• These negative experiences are consistent with broader literature showing transgender women disproportionately encounter barriers when seeking care

Transgender women employed multiple alternative strategies to meet their healthcare needs when faced with mainstream healthcare access barriers.

• Three main alternative strategies were identified: self-medication, consulting traditional healers, and utilising non-governmental organisations (NGOs)
• The use of traditional healers was identified as a novel, alternative strategy not previously documented in this context
• This study provided a first look in a South African context into how and to what extent transwomen employ these alternative healthcare strategies
• Self-medication was used as a direct response to barriers in accessing mainstream healthcare

Transgender women are disproportionately affected by HIV, other sexually transmitted infections, and mental health issues.

• HIV, STIs, and mental health issues were identified as key health concerns for transgender women
• This disproportionate burden is noted in existing studies referenced by the authors
• The study was set in South Africa, where these health disparities are particularly relevant

The authors concluded there is an urgent need for equitable and inclusive health management of transgender women in South Africa.

• The study used a case study design with purposive sampling
• Sample consisted of 10 transgender women, limiting generalisability but providing in-depth qualitative insight
• The findings highlight systemic gaps in the South African mainstream healthcare system's responsiveness to transgender women's needs
• The contribution of the study is described as providing a first look at alternative healthcare navigation strategies used by transwomen in a South African context