Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, East London, South Africa; and, Department of Family Medicine, Cecilia Makiwane Hospital, East London.
S Afr Fam Pract (2004). 2023 Jul 31;65(1):e1-e5. doi: 10.4102/safp.v65i1.5770.
Gender affirming healthcare (GAHC) is a relatively new field in primary health care that describes a range of gender affirming practices, including hormone therapy, for transgender and gender diverse (TGD) people. In 2019, gender affirming hormones were approved by South African National Essential Medicine List Committee (NEMLC) for tertiary-level care, and in October 2021 the Southern Africa HIV Clinicians Society published a GAHC guideline for South Africa. Unfortunately, TGD people still experience discrimination and stigmatisation in healthcare facilities in South Africa, leading to poor access to care and higher health risks with poorer outcomes. Gender affirming care in the primary health care clinic can improve access to health care, with improved provision of preventative services. This article defines key transgender concepts, describes the informed consent process and outlines the initiation and monitoring of both feminising and masculinising hormone treatment for TGD people. Staff at healthcare facilities need to receive training on gender affirming practices and how to ensure a safe environment for TGD clients.
性别肯定医疗保健（GAHC）是初级保健中一个相对较新的领域，描述了一系列性别肯定的实践，包括跨性别和性别多样化（TGD）人群的激素治疗。2019 年，南非国家基本药物清单委员会（NEMLC）批准了性别肯定激素用于三级护理，2021 年 10 月，南部非洲艾滋病毒临床医生协会发布了南非 GAHC 指南。不幸的是，TGD 人群在南非的医疗保健机构中仍然经历着歧视和污名化，导致他们获得医疗保健的机会较差，健康风险更高，结果更差。初级保健诊所的性别肯定护理可以改善获得医疗保健的机会，同时改善预防性服务的提供。本文定义了关键的跨性别概念，描述了知情同意过程，并概述了 TGD 人群的女性化和男性化激素治疗的启动和监测。医疗保健设施的工作人员需要接受关于性别肯定实践的培训，以及如何确保 TGD 客户的安全环境。
