Skip to main content

Sexual Orientation, Gender Identity and Cancer in South Africa

  • Chapter
  • First Online:
LGBT Populations and Cancer in the Global Context
  • 261 Accesses

Abstract

In this chapter, I provide an overview of the sociolegal context of LGBT individuals in South Africa, the South African healthcare system and the epidemiology and treatment of cancer in the country. I analyse the health and lived experiences of LGBT people in South Africa against the inequality of South Africa’s healthcare system. I argue that whilst there are no specific data on cancer among LGBT South Africans, we can surmise that SOGI-related marginalisation increases cancer risk factors and exacerbates existing inequality in access to cancer treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    The term ‘black’ includes all South Africans who were classified as ‘non-white’ under apartheid. It continues to be used today to document persisting racialised inequality as a result of historical and contemporary structural, institutional and interpersonal racism.

References

  1. Republic of South Africa. Constitution of the Republic of South Africa. Pretoria: Government Printer; 1996.

    Google Scholar 

  2. HPCSA. General ethical guidelines for the health care professions. Pretoria: Health Professions Council of South Africa; 2008.

    Google Scholar 

  3. The Other Foundation. Progressive prudes: a survey of attitudes towards homosexuality and gender non-conformity in South Africa. Johannesburg: The Other Foundation, Human Sciences Research Council; 2016. https://theotherfoundation.org/wp-content/uploads/2016/09/ProgPrudes_Report_d5.pdf. Accessed 09.07.2022.

    Google Scholar 

  4. Mail & Guardian. Jon Qwelane guilty of hate speech. Mail & Guardian. 2011 May 31. https://mg.co.za/article/2011-05-31-jon-qwelane-guilty-of-hate-speech/. Accessed 14 Apr 2021.

  5. Meer T, Müller A. “They treat us like we’re not there”: queer bodies and the social production of healthcare spaces. Health Place. 2017;45:92–8. https://doi.org/10.1016/j.healthplace.2017.03.010.

    Article  PubMed  Google Scholar 

  6. Müller A. Beyond ‘invisibility’: queer intelligibility and symbolic annihilation in healthcare. Cult Health Sex. 2018;20(1):14–27. https://doi.org/10.1080/13691058.2017.1322715.

    Article  PubMed  Google Scholar 

  7. Nath D. ‘We’ll show you you’re a woman’ – violence and discrimination against black lesbians and transgender men in South Africa. New York: Human Rights Watch; 2011. https://www.hrw.org/reports/southafrica1211ForUpload_0.pdf. Accessed 09.07.2022.

    Google Scholar 

  8. Müller A, Daskilewicz K, Southern and East African Research Collective on Health. Are we doing alright? Realities of violence, mental health, and access to healthcare related to sexual orientation and gender identity and expression in South Africa: research report based on a community-led study in nine countries. Amsterdam: COC Netherlands; 2019.

    Google Scholar 

  9. Jewkes R, Abrahams N. The epidemiology of rape and sexual coercion in South Africa: an overview. Soc Sci Med. 2002;55(7):1231–44. https://doi.org/10.1016/S0277-9536(01)00242-8.

    Article  PubMed  Google Scholar 

  10. Swarr AL. Sex in transition: remaking gender and race in South Africa. Albany: SUNY Press; 2012.

    Google Scholar 

  11. Msibi T. ‘I’m used to it now’: experiences of homophobia among queer youth in South African township schools. Gend Educ. 2012;24(5):515–33. https://doi.org/10.1080/09540253.2011.645021.

    Article  Google Scholar 

  12. Francis DA. Homophobia and sexuality diversity in South African schools: a review. J LGBT Youth. 2017;14(4):359–79. https://doi.org/10.1080/19361653.2017.1326868.

    Article  Google Scholar 

  13. Mayosi BM, Benatar SR. Health and health care in South Africa--20 years after Mandela. N Engl J Med. 2014;371(14):1344–53. https://doi.org/10.1056/NEJMsr1405012.

    Article  CAS  PubMed  Google Scholar 

  14. Breier M. The shortage of medical doctors in South Africa: scarce and critical skills research project. Cape Town: Department of Labour South Africa; 2008.

    Google Scholar 

  15. Van Dyk J. Fears as Durban loses last state cancer specialist. Mail & Guardian. 2017 June 9. Available at https://mg.co.za/article/2017-06-09-00-durban-cancer-services-shut-down-as-last-public-sector-oncologist-leaves/. Accessed 14 Apr 2021.

  16. Kutzin J, Barnum H. How health insurance affects the delivery of health care in developing countries. Policy Research Working Paper Series 852.

    Google Scholar 

  17. Meade C, Wells K, Arevalo M. Lay navigator model for impacting cancer health disparities. J Cancer Educ. 2014;29:449–57. https://doi.org/10.1007/s13187-014-0640-z.

    Article  PubMed  PubMed Central  Google Scholar 

  18. National Department of Health. National health insurance – white paper. Pretoria: Department of Health, Republic of South Africa; 2017.

    Google Scholar 

  19. Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa: historical roots of current public health challenges. Lancet. 2009;374(9692):817–34. https://doi.org/10.1016/S0140-6736(09)60951-X.

    Article  PubMed  Google Scholar 

  20. Müller A. Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa. BMC Int Health Hum Rights. 2017;17(1):16. https://doi.org/10.1186/s12914-017-0124-4.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Newman-Valentine D, Duma S. Injustice to transsexual women in a hetero-normative healthcare system. Afr J Prim Health Care Fam Med. 2014;6(1):E1–5. https://doi.org/10.4102/phcfm.v6i1.574.

    Article  PubMed  Google Scholar 

  22. Wood K, Jewkes R. Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa. Reprod Health Matters. 2006;14(27):109–18. https://doi.org/10.1016/S0968-8080(06)27231-8.

    Article  PubMed  Google Scholar 

  23. Von Holdt K, Murphy M. Public hospitals in South Africa: stressed institutions, disempowered management. In: Buhlungu S, Daniel J, Southall R, editors. State of the nation: South Africa 2007. Cape Town: HSRC Press; 2007.

    Google Scholar 

  24. Lubuzo B, Ginindza T, Hlongwana K. Exploring barriers to lung cancer patient access, diagnosis, referral and treatment in Kwazulu-Natal, South Africa: the health providers’ perspectives. Transl Lung Cancer Res. 2019;8(4):380–91. https://doi.org/10.21037/tlcr.2019.08.17.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Pretorius L. Cancer care in South Africa. Lancet Oncol. 2012;13(8):e325. https://doi.org/10.1016/S1470-2045(12)70332-7.

    Article  PubMed  Google Scholar 

  26. National Cancer Registry SA. Ekurhuleni population-based cancer registry annual 2018 report. 2020.

    Google Scholar 

  27. Spencer S, Meer T, Müller A. “The care is the best you can give at the time”: health care professionals’ experiences in providing gender affirming care in South Africa. PLoS One. 2017:1–18. https://doi.org/10.1371/journal.pone.0181132.

  28. Nkoana T, Nduna M. Engaging primary health care providers in transgender community health care: observations from the field. New Voices Psychol. 2012;8(2):120–9.

    Google Scholar 

  29. Müller A, Daskilewicz K. ‘These are the topics you cannot run away from’: teaching lesbian, gay, bisexual and transgender health in health professions education in Malawi and South Africa. Amsterdam: COC Netherlands; 2018.

    Google Scholar 

  30. Müller A. Health for all? Sexual orientation, gender identity, and the implementation of the right to access to health care in South Africa. Health Hum Rights. 2016;18(2):195–208.

    PubMed  PubMed Central  Google Scholar 

  31. Smith R. Healthcare experiences of lesbian and bisexual women in Cape Town, South Africa. Cult Health Sex. 2014;7(2):180–93. https://doi.org/10.1080/13691058.2014.961033.

    Article  Google Scholar 

  32. Müller A. Teaching lesbian, gay, bisexual and transgender health in a South African health sciences faculty: addressing the gap. BMC Med Educ. 2013;13:174. https://doi.org/10.1186/1472-6920-13-174.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Müller A, Meer T, Haji M. Quality through inclusion? Community-led healthcare delivery, training and advocacy related to sexual and reproductive health of lesbian, gay, bisexual and transgender people in South Africa. Amsterdam: COC Netherlands; 2020.

    Google Scholar 

  34. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.

    Article  PubMed  Google Scholar 

  35. Mbulawa ZZA, Marais DJ, Johnson LF, Coetzee D, Williamson A-L. Impact of human immunodeficiency virus on the natural history of human papillomavirus genital infection in South African men and women. J Infect. 2012;206(1):15–27. https://doi.org/10.1093/infdis/jis299.

    Article  Google Scholar 

  36. Joint United Nations Programme on HIV/AIDS (UNAIDS). Country fact sheet: South Africa | 2019. Geneva; 2019.

    Google Scholar 

  37. Cloete A, Simbayi L, Rehle T, Jooste S, Mabaso M, Townsend L, et al. The South African Marang Men’s Project: HIV bio-behavioural surveys using respondent-driven sampling conducted among men who have sex with men in Cape Town, Durban and Johannesburg. Cape Town: HSRC Press; 2014.

    Google Scholar 

  38. Müller EE, Rebe K, Chirwa TF, Struthers H, McIntyre J, Lewis DA. The prevalence of human papillomavirus infections and associated risk factors in men-who-have-sex-with-men in Cape Town, South Africa. BMC Infect Dis. 2016;16(1):440. https://doi.org/10.1186/s12879-016-1706-9.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Cloete A, Wabiri N, Savva H, van der Merwe L-A, Simbayi LC. The Botshelo Ba Trans study: results of the first HIV prevalence survey conducted amongst transgender women (TGW) in South Africa. In: 9th South Africa AIDS Conference. Durban; 2019.

    Google Scholar 

  40. Sandfort TGM, Baumann LRM, Matebeni Z, Reddy V, Southey-Swartz I. Forced sexual experiences as risk factor for self-reported HIV infection among southern African lesbian and bisexual women. PLoS One. 2013;8(1):e53552. https://doi.org/10.1371/journal.pone.0053552.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  Google Scholar 

  42. Reddy P, Zuma K, Shisana O, Jonas K, Sewpaul R. Prevalence of tobacco use among adults in South Africa: results from the first South African National Health and Nutrition Examination Survey. S Afr Med J. 2015;105(8):648–55. https://doi.org/10.7196/SAMJnew.7932.

    Article  PubMed  Google Scholar 

  43. Peltzer K, Davids A, Njuho P. Alcohol use and problem drinking in South Africa: findings from a national population-based survey. Afr J Psychiatry. 2011;14:30–7.

    Article  CAS  Google Scholar 

  44. Evans MGB, Cloete A, Zungu N, Simbayi LC. HIV risk among men who have sex with men, women who have sex with women, lesbian, gay, bisexual and transgender populations in South Africa: a mini-review. Open AIDS J. 2016;10:49–64. https://doi.org/10.2174/1874613601610010049.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Allan B, Marais DJ, Hoffmann M, Shapiro S, Williamson A. Cervical human papillomavirus (HPV) infection in South African women: implications for HPV screening and vaccine strategies. J Clin Microbiol. 2008;46(2):740–2. https://doi.org/10.1128/JCM.01981-07.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alex Müller .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Müller, A. (2022). Sexual Orientation, Gender Identity and Cancer in South Africa. In: Boehmer, U., Dennert, G. (eds) LGBT Populations and Cancer in the Global Context. Springer, Cham. https://doi.org/10.1007/978-3-031-06585-9_4

Download citation

Publish with us

Policies and ethics