“I’m scared of the nurses telling other people I am a transwoman”: Disclosure and nondisclosure of gender identity among trans women in Ghana’s urban slums– BSGH010

Abstract

Abstract Background: Trans women in Ghana and SSA face dilemmas regarding the disclosureof their gender identities due to potential discrimination they may face during visits to health facilities. This study investigates the experiences of trans women living in urban slums in Ghana and explores factors influencing their decisions to disclose or withhold their gender identities while seeking healthcare. Design: We used purposive and snowball sampling techniques to recruit 20 trans women from slums in Ghana’s Greater Accra Metropolitan Area and conducted in-depth qualitative interviews to gather data. Data was analyzed using Nvivo and coded to arrive at our results. Results: Our study revealed four reasons why trans women concealed their gender identities when seeking healthcare: (a) Gossiping among healthcare professionals, (b) Rude and unwelcoming gestures from health workers, (c) Avoidance of probing questions from health workers, and (d) Delayed treatment and unsatisfactory services by health professionals. The study also found two reasons for trans women to disclose their gender identity while seeking healthcare: (a) LGBTQ-friendly facilities as a reason for disclosure and (b) Intrusive questioning. Conclusion: These findings contribute to the experiences of trans women living in deprived communities such as urban slums, contributing to the existing literature on challenges associated with the disclosure and nondisclosure of gender identity when accessing healthcare in these communities. Additionally, our results underscore the urgent need for reevaluating health policies and implementing targeted training and practices for healthcare professionals dealing with trans women in Ghana.