Sex as a spectrum : inclusive anatomical education and the translation thereof into clinical practice

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ENGLISH ABSTRACT: Introduction: Transgender and non-binary individuals repeatedly experience erasure of their identity in healthcare, ultimately leading to avoidance of healthcare environments, and unsupervised, self administered healthcare practices. The erasure of transgender and non-binary identities in healthcare starts at medical school level. Cisnormative teachings and binary views of sex exclude transgender and non-binary identities from the training healthcare workers in South Africa receive. Methods: Data was collected in three parts. a Mix method, cross-sectional survey was sent to students and lecturers at Tygerberg Medical Campus who are involved in the learning and teaching of anatomical sciences at Stellenbosch University (N=154). Simultaneously, individual interviews were conducted with transgender and non-binary adults who have previously used the South African healthcare system before (N=13). After recommendations, knowledge levels and lived experiences were collected from the cross-sectional survey and individual interviews, data was used to triangulate and explore selected themes in a focus group session with community members who participated in the individual interviews (N=6). Results: Students self-reported a lack of resources on transgender and non-binary content in the medical curriculum at Stellenbosch University and expressed willingness to incorporate of this content in the future. Transgender and non-binary adults who have accessed healthcare in South Africa shared how the binary nature of medical teachings have impacted their experience of healthcare in the Country. Discussion: Transgender and Non-binary individuals in South Africa report experiencing complete erasure of their identities in healthcare. Ultimately leading to avoiding healthcare facilities in South Africa; as well as discrimination from undereducated healthcare workers. Majority of Students, lecturers and gender diverse community members reported a lack of transgender and non-binary resources in healthcare. Students and gender diverse community members believe that incorporation of fact-based knowledge and representation of transgender and non-binary individuals throughout the curriculum of transgender and non-binary bodies in healthcare could improve healthcare worker attitudes towards transgender and non-binary individuals, creating a safer and more inclusive environment in healthcare facilities for the individuals of South Africa. Conclusion: Tygerberg Medical Campus is contributing to the passive erasure of transgender and non binary identities in South African healthcare, by not offering any resources to students or lecturer on transgender care or language. An intervention is required to include transgender and non-binary visibility in the training of future healthcare professionals at Stellenbosch University. The present study believes that teaching sex as a spectrum in anatomical sciences and including a primer lecture (discussing gender, sex and medicine beyond the binary) could be a small, yet effective intervention to introduce healthcare students to bodies that are not only cisgender, working towards less of a binary approach to healthcare practices that are life threatening to transgender and non-binary patients.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MSc) -- Stellenbosch University, 2022.
Transphobia, Transgender people -- Identity, Sexual minorities, Anatomy, Surgical and topographical