The Star (Nairobi)

27 November 2012

Kenya: Gender Identity - The Other Sex

The Transgender day of Rememberance is marked annually on November 20. It is a day to memorialise those who have been killed as a result oftransphobia-which is the hatred or fear of transgender and gender non-conforming people. This is first of a three-part series into the lives of the Kenyan transgender society.

The confident Audrey Mbugua, 28, kicks off our interview by taking a bite of her fries and sandwich. "I didn't get a chance to eat last night, was busy working on a paper," she says.

She pushes back her glasses to sit more securely on the bridge of her nose before she rubs her hands, covered in gloves that have the tips cut off.

She has this daft punk look going, if you met her on the streets, you would probably think she had her own band. Far from it, Audrey is actually an aspiring biomedical scientist.

"I am searching for masters scholarships; I want to do virology and molecular biology. I have always been fascinated by viruses. Look at the HIV, it is one complex retro-virus. Its genetic material codes for a paltry nine proteins yet we have spent millions of dollars trying to tame it. They are resilient and versatile, much better than humans in my opinion. I admire that and the fact there is no cure for any viral disease," she tells me as she stares at me intently as if deciding whether she can trust me or not. After a long pause in between bites of her food, she shares her story.

Five years ago, Audrey had gotten her degree in Biomedical Sciences from Maseno University. Fresh out of campus, she was a few weeks into her first job with an agricultural research institute.

Like she had every morning since the beginning of June that year, she got up early and prepared for work, straightened her long hair and brushed her teeth, wore her slacks and boots and headed off to work.

Unknown to Audrey, this would turn out to be one of the darkest moments of her life. Soon as she got to office, word reached her that her colleagues were blaming her for the failed bounty wheat harvest that they had been expecting.

"I heard one of them whispering to another, "She came in June, then we had healthy crop, but by the end of July the wheat has failed." They implied that I was some sort of abomination or a jinn (evil spirit) and because of what I was and they having associated with me, their crops had failed, Audrey says as she gives a weak smile, trying to hide the pain in her voice.

Despite the fact that this accusation hit her hard, Audrey was no stranger to snide remarks from her workmates. She recounts how one of the lab technicians once told his friends that whenever he saw her first thing when he arrived in office, his day would be ruined.

"He said that on seeing me, his experiments of the day would all turn out wrong, or he would be a totally klutz and end up breaking his equipment." Her workmates and neighbours' aversion for Audrey stem from the fact that she is a transsexual/transgender woman.

Transgender persons are those whose gender identity, gender expression, or behaviour does not conform to that typically associated with the sex to which they were assigned at birth and seek a sex transition.

Audrey's sex on her birth certificate is male but she has an internal sense of being female, thus she identifies as a trans-woman and is seeking sex change therapy.

Audrey has adopted a social and personal identity that corresponds to her gender identity/psychological sex. Audrey is one of the first transgender women in Kenya who has publicly declared her identity.

Apart from discrimination from some of her workmates, using the bathroom was a trip. "It was pretty tough because when it came to using the bathroom, I had to use the gents and it got to a point I decided that I would just hold my pee or whatever till I got home.

One of my workmates I remembered told me, "If you were my child, I would really beat you." His statement really angered me and I retorted, "If I was your child, I would have probably killed myself by now." That hushed him up.

"Then there was a group of guys who tried to strip me in Nakuru, lucky for me I got away before they did. A person can only be subjected to so much hate before you start spewing it too."

After the whole debacle of the failed crop, Audrey was let go by the organisation and she got another job (volunteer) with an NGO working on diabetes.

"My new boss was really understanding and she tried to help me cope." However, following her bouts of manic depression, Audrey admits that she was on a path of self-destruction and even tried to take her life by overdosing on medication to "black out".

"The NGO had to let me go because I wasn't pulling my weight and that is when I decided to set up an organisation that would deal with the problems of transgender/transsexual people in Kenya. A colleague - Samantha King'ori - joined in and another journey begun."

Audrey is now the programmes manager for Transgender Education and Advocacy (TEA). This is a human rights organisation working towards defending the human rights of transgender people in Kenya.

TEA was established in December 2008 and it works with transgender people from all over the country. "We are about 40 members.

The members range between 18 and 45 years. We don't allow anyone who is less than 18 years old in the group. But we do assist such clients with information, legal aid and referrals to doctors," said Audrey.

Audrey's Story:

"I was born completely male and was brought up as such but I was never comfortable in my own skin; my mind and everything else within me knew that I was female.

I started my transition around 2004 when I was going to college; I decided to plait my hair." Her father was furious but there was no deterring Audrey. "When I first started transitioning, I used to get threats, people trying to get me to move out of my home but I held my ground."

Most of her family and relatives stopped speaking to her and her friends did not want to be associated with her. " They started excluding me from family functions and when I did attend, they said some really spiteful stuff behind my back.

I remember one of my aunties actually told me never to speak to her if I decided I wanted to live as Audrey. It would have been easier to conform but this not something that you can just bury or hope it goes away."

In college her hopes to be incognito and just breeze through class were nothing but a pipe dream. For years she was the butt of jokes because her fellow students could not understand why she chose to live the way she did.

"I was an introvert and everyone used to avoid me." In class whenever a lecturer would ask a question and I put my hand up, he would go, "Yes, lady at the back. And the whole class would burst out laughing."

He would then ask why they were laughing and they would go like, "she's a he or he's a she." Then the whole issue of who I was would come up. It was cruel. They used to call me Barbara or Patricia; I think it was based on some soap opera character.

At the end of my third year in campus. I was really depressed and stressed out and I wanted to quit but if I did then it would have meant that all my hard work had been for nothing and I couldn't have that."

By the time Audrey was graduating, she was battling depression and had to get some help. "I remember, I asked my sister to take me to a psychiatrist and we went to Mathare Mental Hospital, Kenya's only referral psychiatric hospital.

We were broke and I remember an aunty gave me Sh1,000 and told me to go get help. We got there and they opened a file under my former names Andrew Mbugua. When it was our turn to get in, the nurse called my name and my sister and I both went in.

The doctor then asked us who Andrew was. She was very stern and he thought we were just mucking about because we both looked like girls.

Initially I wanted to leave but the psychiatrist figured it was a case of gender identity. I was admitted for a psych evaluation for two days but it helped me because I was really depressed and I got some medication to deal with that.

Those doctors saved my life. After that treatment, I got transferred to Kenyatta hospital and they did a total mental and physical evaluation."

After certifying that she was indeed sane, Audrey was released and began working with a psychologist who prescribed some anti-depressants for her.

"The psychologist talks to you about your medical history, before they start you off on hormonal therapy, they try to find out what your condition means to you and what your hopes are if you do make the switch. I was in therapy for about three to four months.

Then I had to do what is known as the real-life test. This involves living as your preferred gender for about a year, before you are eligible for a sex-change surgery.

Then there is the modulates of after surgery, follow-ups, hormone therapy. I was prepared for all of this and I became more comfortable with myself."

Audrey began making steps to get a sex reassignment surgery. Sex reassignment surgery, also known as SRS, is the surgical procedures by which a person's biological sex is altered to resemble that of the other sex.

It is part of a treatment for gender identity disorder/gender dysphoria (GID) in transsexual people. "In March 2009 after a series of evaluations from a number of doctors, I was supposed to get the sex reassignment surgery. On the day of my surgery, March 17, the then KNH Director Dr Jonathan Micheni said he had received a call from the Minister of Health Dr Anyang' Nyong'o to hold off the surgery. When I asked why, he said that the minister had cited a case from 1989 where the parents of a transgender lady who had received the surgery gave the state a lot of grief following her surgery.

"The director then set up a committee of doctors to review my case but I think it was just a façade - the whole system kept moving goal posts. I tried to talk to them when they asked me to come before the board. They wanted me to bring in my parents to give their consent, which is ridiculous because I am an adult and I am not mentally incapacitated.

"So anyway, I spoke to my mother and asked her. Her response was, 'I don't know if you are crazy or what but it's not our job to give you our consent, you are an adult and you understand these things better than us. I will not give you my consent and I will not speak to your psychiatrist for a consent'.

I could sense their ambivalence about the surgery. I remember my mother reminding me that if I went through with the surgery, I would not be able to bear her grandchildren.

When I told my doctor this, I think it sounded like I hadn't got their consent, but it didn't matter because I am an adult and they had no legal argument for refusing to let me have the surgery .

It was a wild goose chase. The committee did a report that I never got. I got no feedback." Following this incident, Audrey wrote a number of complaints to the medical board and was then referred to a doctor with the public health and fitness committee. "I met the doctor there who asked me a series of questions and nothing came of it.

I tried to see the director of medical services without much success. After about a year of this constant back and forth from all possible outlets, I decided to go directly to the director's office without an appointment, of course he wouldn't see me but I kept coming back."

After a number of fruitless visits to the director of medical services, Audrey decided to write a letter to the Minister of Health Dr Anyang' Nyongo' in 2011."Surprisingly I got a call from Kenyatta National Hospital. The minister had forwarded my matter to Kenyatta Hospital and told them to look into it.

I received a call from the office of the deputy director of clinical services. They asked whether I used to be a patient and asked me to come in and speak to the deputy director.

I thought my breakthrough was finally here. When I met him, he asked what had happened. He said he would follow up the matter.

I waited, made calls. Then I was told my file was misplaced and they said that they needed time to find it," she says a little exasperated.

"Then they said management had changed. In October I walked to the director's office. He was able to see me and once again, I had to explain my situation. He scheduled a meeting with my doctors for 2pm on November 3, 2011."

On the day of the meeting, a hopeful Audrey went to make her petition but was surprised when the director asked her why she hadn't been accompanied by her parents.

"I remember I told him he hadn't asked me to. Then he took my parents and siblings numbers and requested we move the meeting for another two weeks to November 17, 2011.

Two weeks later I was told the doctors were not ready. I discovered it was a lost cause when KNH's legal officer told me she had to consult with the attorney general on the legal framework on sex change in Kenya.

Still determined, Audrey waited another two weeks before calling for a follow-up. "When I did make the call, I was told that the doctors had already submitted their reports but they were waiting on the legal officer's input.

So in December I called again and I was told that the doctors were on strike and that they could only attend to my matter after the strike."

What followed was an agonizing three months of calling and following up without much success. On one occasion when she insistently called Kenyatta Hospital and asked the operator to link her with the chief executive's office, her call was redirected to the mortuary to deter her from pestering them.

"In March 2012 I was referred to another legal officer because the other was bereaved. She called the doctors and they told me I could not get the surgical procedure because my younger sisters felt I should not have the surgery.

I then asked her to put it to me in writing. She asked me to write a request for it which I did but then I never got a reply from her.

I wrote to her, Dr Anyang Nyong'o, the medical board, Commission on Administrative Justice and got no response. The CAJ "response" jolted me into the realisation that most commissions in Kenya are either useless or a pain in the neck.

The last meeting I had with one of their legal officers (Ruth Emanikor) and their deputy chairperson (Dr Regina Mwatha) on June 26, 2012 elicited a spark of hope.

I loved the fire in Dr Mwatha, an educated commissioner who ended our conversation with 'hata mnyonge ana haki' ( even the weak have rights)...those doctors will get it'.

I reminded her that I had nothing against those doctors and I would not be alive wasn't it for those doctors. The problem lay in Afya House and the Director of Kenyatta National Hospital.

On September 4, 2012, I called Ruth Emanikor at around 10am. I was told to call after five minutes. She told me that she and Dr Mwatha had decided not to follow up on my case since I was a transsexual and not a hermaphrodite.

"Laws are made to protect minorities from the tyranny of the majority. Thus when that doesn't seem to be the case, it feels frustrating and heartbreaking.

It would be easier to just try and get the surgery abroad but its very expensive and its not fair that as a transsexual, you can't get the same service as the normal public because we are seen as being different."

Listening to her speak about becoming self-aware of herself and the hurdles that transgender Kenyans are currently going through, reminded me of a movie I had watched years ago about Renee Richards, a professional tennis player from the 1970s.

She is the world's most famous transsexual athlete. Richards, who was born Richard Raskind, and managed to create a new life for herself as a woman after a sex change operation in 1975.

In 1976, she took the US State Tennis Association to court for banning her from playing in women's events at the US Open as she was a transsexual. She won and became known as a pioneer for transsexual rights. Unlike Renee, however, Audrey's battle it seems has only just began...

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