title: Injustice to transsexual women in a hetero-normative healthcare system.
abstract: BACKGROUND
  Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process.
  
  
  OBJECTIVE
  The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa.
  
  
  METHODS
  An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded.
  
  
  RESULTS
  Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women.
  
  
  CONCLUSIONS
  A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African.
authors.affiliation: Division of Nursing and Midwifery, University of Cape Town. douglas.newman-valentine@uct.ac.za.
authors.forename: Douglas
authors.initials: D
authors.lastname: Newman-Valentine
authors.forename: Sinegugu
authors.initials: S
authors.lastname: Duma
mesh_terms: D003695:Delivery of Health Care / Q000941:ethics; D005260:Female; D006297:Health Services Accessibility / Q000941:ethics; D006801:Humans; D011287:Prejudice; D057829:Gender-Affirming Procedures / Q000941:ethics; D012935:Social Justice; D013019:South Africa; D063106:Transgender Persons; D008297:Male