Costly Hormonal Therapies Force Zim Trans Community To Get Shots from the streets

Teckler (31) is a transgender women from Highfields in Harare. Even though she was born a man, Tekcler says she had always struggled with the notion of waking up in a strange body every single day of her life. In her own words, she has always viewed herself as a woman and was always determined to be identified as one at some point in life.

By Michael Gwarisa

At the age of 20 when she enrolled in University in 2011, she once shocked her neighbourhood when she turned home for her first semester break in clothes many deemed to be feminine. Her father threatened to banish her and withhold paying for her studies had she continued exhibiting feminine tendencies. She complied in her family’s presence but started living different life back in college.

I moved out of my parents’ house at the age 24 because I wanted my freedom. I couldn’t pretend anymore to be what I was not,” said Teckler.

It was around this period that Teckler got a job as a cashier at a local fast food outlet. This was also the same period she was determined to commence her Hormone replacement therapy (HRT). Hormone replacement therapy ( HRT ) is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity and treat gender dysphoria. However, in a desperate attempt to bring desired feminine changes to her body, Teckler got mixed up in something that almost cost her life.

“You know fast food outlet jobs don’t pay that much. By that time, it was even difficult to put food on the table. I couldn’t afford the feminising hormones, they are not affordable and to sustain that lifestyle, one needs a well-paying job. I was left with no option but to buy what my money could afford. Through a friend, I started getting some butt injections, cupsules and hip enlargement creams from the streets and would also take some birth control pills. The butt enlargement shots were coming through Zambia and the Democratic Republic of Congo.”

It started well and it did not take time for her to start noticing some changes. She was enjoying the process. However, one early morning, Teckcler woke up with a very sharp pain in her chest area and numbness around her right knee area. She ignored it at first and went to work as usual. This went on for about three weeks.

“One day, I was seated with a friend at a joint having fun. However, when I tried to stand up, felt dizzy and dropped fell back into my chair. I had not drunk any alcoholic beverage. So how could I be drunk? I asked myself. I then felt these heart palpitations and somehow started feeling confused. I asked my friend to rush me to see a private doctor in the Avenues are. I had my blood tests and other tests done. I was told that i had developed blood clots, a condition known as Thrombosis,” said Teckler.

Thrombosis occurs when blood clots block veins or arteries. Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body. Complications of thrombosis can be life-threatening, such as a stroke or heart attack.

“I was initiated on some thinners, you know those medications they use to deal with clotting. After some days the situation subsided. I was however discouraged from using butt injections and other supplements as they were the ones that had caused the blood clotting in the first place.”

Commonly used materials in buttock and hip injections including hydrogel and silicone can travel to other parts of the body, leading to granuloma lumps and cause blood clotting. Other complications include infections, disfigurement, and scarring. In some cases, stroke can occur. There have also been reports of death from these illegal injections.

Even though the actual size of the transgender community in Zimbabwe is not yet known, they are a sizable number and most of them are getting assistance from organisation like TRASNSAMRT and TREAT in as far as their Sexual Reproductive Health and Rights (SRHR) are concerned. Some like Queen Bee Chihera Meki, a Trans woman who is also the Program Director for the Trans and Intersex Rising Zimbabwe says access to Hormonal Therapies was costly and that is why most trans people were getting their hormones from the black market.

“As for me as leader and individual, i did my research, learning never to be pressured and also consider family, financial situation and my environment. This has kept me in line. I am a trans woman not yet in the process of being transsexual. I maintain my beauty and i keep myself safe from food and toxic Drugs that may reduce my opportunity to transition.

“However, hormones are very expensive and people are getting them from outside the country. It is risky buying from the streets and black market. It is also dangerous as people end up self-medicating without following any prescription or dosage. Estrogen comes in different forms and can be found in small quantities in family planning pills on the ( black market ),” said Queen Bee.

She however added that lack of information was the leading cause of such behaviour and there need to for more awareness raising in order to assist those who may be getting their hormones from the streets.
Meanwhile, Trevor Ncube, the Programs Manager at TREAT says they have done numerous efforts in lobbying Policy makers, Ministry of health and other relevant parties to provide Hormone replacement therapy ( HRT ) and make it accessible to trans persons in a safe manner.

“Some trans women use birth control while some use butt and hip enlargement creams that have dangerous side effects in a desperate attempt to bring desired feminine changes to their bodies. Some trans men use body building pills and supplements that increase testosterone levels in cis gender men to try masculinize their body and these alternatives may be burdensome to the liver while bringing little to no results.

“Some health implications of using not recommended therapies or HRT through the street market without careful supervision by a qualified professional include Venous Thromboembolic Disease, Cardiovascular Events, Type 2 Diabetes Mellitus, Hypertension and Polycythemia. While there is no exact size population of trans people on HRT in Zimbabwe currently there is a growing number of young trans people accessing hormones via the street market and a growing number reaching out to organisations like TREAT, TRANSSMART AND TIRZ asking for assistance in accessing HRT,” said Ncube.

Trevor added that Hormone replacement therapy was generally not accessible for the average trans persons in Zimbabwe and while hormones can be accessed at pharmacies if one has a prescription they are generally very pricey and most medical aids do not cover HRT. This often drives trans persons into desperation and they access their hormones via the street market at a lower cost.

For transgender men injectable testosterone is the most administered and recommended due to its ability to bring faster desired changes although other forms of testosterone like foam and pellets are available options in western countries. Types of testosterone used include Enathanate. Cypionate. Propionate and Nebido. Feminising hormones for trans women include Estrogen ( Available in the following forms pill, injection ,gel, patches and implants ) and Androgen blockers to suppress the production of testosterone in the body( These include Cyproterone acetate, Spironolactone, Finasteride / Duasteride, Bicalutamide ).

Some Trans people with money however prefer surgical transition. However, there is no provision for surgical procedures in Zimbabwe. Most trans people who can afford to do their surgical related transitioning go to South Africa , Lesotho , Botswana or western countries that legally recognize trans people.

For transgender men Top surgery ( Chest masculinization surgey ) ranges between $4000 – $10000 while bottom surgery( Phalloplasty ) can go as high as $10000 – $50000. For Trans women vaginoplasty can range between $10,000-$30,000 while breast augmentation can range between $3000 – $6500 ( These estimates vary based on a couple of factors such as country or if it’s a private or public hospital ).





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