CPD Articles

An introduction to gender affirming healthcare: What the family physician needs to know

Madeleine Muller, Elma de Vries, Anastacia Tomson, Christine McLachlan
South African Family Practice | Vol 65, No 1 : Part 4| a5770 | DOI: https://doi.org/10.4102/safp.v65i1.5770 | © 2023 Madeleine Muller, Elma de Vries, Anastacia Tomson, Christine McLachlan | This work is licensed under CC Attribution 4.0
Submitted: 09 May 2023 | Published: 31 July 2023

About the author(s)

Madeleine Muller, 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, South Africa
Elma de Vries, School of Medicine, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
Anastacia Tomson, My Family GP, Cape Town, South Africa; and, Shemah Koleinu, Cape Town, South Africa
Christine McLachlan, Department of Psychology, Faculty of Social Sciences, University of South Africa, Pretoria, South Africa


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.


gender affirming healthcare; transgender; key populations; patient centred care; gender diverse; access to care; hormone therapy


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