No abstract available.

This article gives an overview of transgender issues in South Africa, with a particular focus on the work of the Transgender Unit, Groote Schuur Hospital, Cape Town, South Africa. The article presents current definitions, diagnostic considerations and healthcare options in the area of gender dysphoria, and then outlines the history, mandate and role of the Transgender Unit. It concludes with some of the current challenges in the field of transgender healthcare and makes recommendations for the way forward.

The commonly used Standards of Care for people with gender dysphoria, including those of the World Professional Association for Transgender Health and The Royal College of Psychiatrists in the United Kingdom, as well as those standards used in many other countries, usually require that two signatures of approval from qualified mental health professionals be provided before genital reconstructive surgery (GRS) À sometimes called sexual reassignment surgery or gender confirmation surgery À is undertaken. This is different from surgeries which are similarly irreversible and remove reproductive capacity carried out on cisgender people. This paper explores the transspecific issues from a standpoint of medical ethics and argues that, provided sufficient safeguards are in place, including assessment within a multidisciplinary team, a nuanced approach utilising a single signature may instead be appropriate.

No abstract