Advancing Transgender Human Rights
HEALTHCARE
Rapid Review of Gender-Affirming Healthcare
Evidence belongs in the public conversation
Evidence supports the safety and effectiveness of gender affirming healthcare for trans and gender diverse youth. Strengthening affirming care, timely clinical access, and protective policies in South Africa may improve healthcare engagement and support the delivery of integrated adolescent, sexual health, and HIV-related services for trans and gender diverse youth.
Since the publication of the Southern African HIV Clinicians Society Gender-Affirming Healthcare (GAHC) Guidelines in 2021, the global evidence base on trans and gender-diverse youth has expanded substantially. An updated, locally grounded and evidence-informed assessment of health outcomes is therefore needed to inform South African stakeholders and programmes.
This findings of a peer-reviewed rapid review examining gender affirming healthcare for trans and gender diverse persons; led by South African researchers and human rights activists, synthesised evidence indexed between January 2021 and August 2025 across five areas: psychological, endocrine, surgical and non-medical care, as well as policy and legal conditions.​
AUTHORS: Ingrid Lynch, KL Dunkle, Chris McLachlan, Pierre Brouard, Landa Mabenge, Sakhile Msweli, Liberty Matthyse, Marion Stevens, Robin Dyers, Jenna-Lee de Beer-Procter, Kevin Adams, W.D. Francois Venter, Elma de Vries.
Copyright:
This document paraphrases and reformats the original for public communication. The article is published under CC BY 4.0. Adaptation is permitted with appropriate attribution.
Access to Safe Hormone Therapy
Some Transgender people have a great need to undergo physical changes to have the body more closely aligned to the experienced gender. For many members of this group hormone therapy, with- or without surgery, is medically necessary.
Until recently hormone therapy was available almost exclusively from a handful of endocrinologists who were rendering specialised transgender services in the public and private sector.
Of those patients who have to travel long distances and/or are unable to afford specialist care the vast majority will never have access to safe hormone therapy. Some of them sadly go without treatment and some resort to dangerous therapy with hormones obtained from non-medical sources.
To go some way towards addressing this problem the South African Trans Health Initiative in partnership with the Groote Schuur Hospital Transgender Unit developed a system of technical support and tools to assist the general practitioner who may be approached by a transgender patient for hormonal therapy.
It is now possible for a transgender person to get hormone therapy from a general practitioner in a primary care setting and an increasing number of patients are receiving therapy much closer to home and at reduced cost.
The general practitioner can now download the following documents from this website:
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South African Gender Affirming Healthcare Guidelines that is a practical clinical guide
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South African Gender Affirming Healthcare Guidelines – Expanded Version​
General Practitioners who are considering initiating therapy for the first time or who otherwise need further professional advice are encouraged to consult with the Transgender team members attached to the departments of Psychiatry and/or Endocrinology at Groote Schuur Hospital, Cape Town.
Please contact Dr Elma de Vries on devrieselma@gmail.com
GDX COVID-19 Resource
Standards of Care for the Health of Transgender and Gender Diverse People V8
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8.
Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment.