Answer to a question from a reader

How can I get on the waiting list for gender reassignment surgery?

The short answer

You would start by getting a referral from a doctor to the Transgender Clinic at Groote Schuur.

The whole question

Dear Athalie

I am transgender. How can I apply to have gender reassignment surgery done?

The long answer

If you are 18 years old, you can begin the process of transitioning. You would start by getting a referral from a doctor to the Transgender Clinic at Groote Schuur. The Transgender Clinic was started in 2009 with a multidisciplinary team including plastic surgeons, psychologists, endocrinologists and social workers. It is seen as the best unit of its kind in the country and is one of the only healthcare centres dedicated to the needs of transgender patients.

The doctor can make the referral by completing the referral form and sending it to

Your first appointment at the Transgender Clinic would be at the Psychiatry Outpatient Department (OPD), where Dr Marais (clinical psychologist) and either Dr Wilson or Dr Torline (adult psychiatrists) will see you for a comprehensive assessment. Depending on their assessment of your need for gender-affirming interventions, you will be referred to the Endocrine and Plastic Surgery department.

The Psychiatry Out Patient Department (J2 OPD) is on the H-floor of the Out-Patient Building at Groote Schuur Hospital. The contact number is 021 404 2151.

It’s not very difficult to access hormone therapy to begin transitioning, but there is an extremely long waiting list for transgender surgery. People have to wait for over twenty years for surgery because there are only four days a year allotted to transgender surgeries, and each operation takes a day to perform – so only four surgeries a year are performed at Groote Schuur. 

Since Covid, no transgender surgeries have been performed and so the waiting list is even longer.

The Transgender Clinic applied to government four years ago to be recognised as a “quaternary level service” (meaning it does uncommon or experimental surgical procedures). If they got this recognition, it would mean that the national government would fund the clinic rather than the provincial government. Dr Kevin Adams, a surgeon at the Clinic said that the clinic could then employ nurses who just did gender reassignment and the surgeons could open more theatres and work till midnight instead of having to finish work at 4 pm. In that way, the waiting list could be dramatically shortened.

Also, if the national government funded the clinic, people from all over South Africa could use its services, not just the Western Cape. 

Medical aids see transgender surgery as “cosmetic” and only one medical aid, called Bankmed, has funded the surgery. Private transgender surgery costs between R450,000 and R600,000, which very few people can afford. 

If you are in the Western Cape, you should get started by getting a referral to the Transgender Clinic. They also provide a list of organisations that provide support and counselling to transgender people:

  • Gender Dynamix
    Unit 21, Collingwood Building, 10 Anson Street, Observatory, Cape Town
    021 447 4797

  • Triangle Project

Triangle Project has a clinical services programme with volunteer healthcare practitioners and LGBTQIA positive therapists offering specialised expertise in LGBTQIA care. Transgender persons can access individual counselling, relationship counselling, family counselling, support with negotiating social transition at school, college, university or the workplace. Depending on your financial circumstances, services can be free or on a sliding scale.

2nd Floor, Leadership  House, Corner Burg and Shortmarket Streets, Greenmarket Square, Cape Town 
081 257 6693

There is a monthly transgender support group on a Saturday morning at Triangle Project (in Shortmarket Street, Cape Town). It’s facilitated by a clinical social worker, Ron Addinall. Visit the website or call Heather Adonis at Triangle Project for more information - 021 422 0255.

Wishing you the best,

Answered on March 3, 2022, 3:51 p.m.

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