“I deserve to live. I deserve to breathe. I deserve to be here.”
It is a humid Cape Town day, and Siv Greyson is standing in front of a crowd at the Faculty of Health Sciences exactly 32 years since the first South African pride march was held.
They are wearing a lab coat that reads, written on the back, ‘a healthcare professional who knows nothing about LGBTQI+ life is a [healthcare professional] who’s unfit for the purpose of healing.’
Siv, who works at the Faculty of Health Sciences (FHS), has called upon LGBTQ+ and ally staff and students to come to the grounds for a pride march.
“My name is Siv Greyson. I am a black transgender autistic artist, activist and academic. And I am the Faculty of Health Sciences’ gender and sexual diversity advocate. In fact, I am the first.”
Siv brings the energy of the crowd together with a powerful acknowledgement of the date: 13 October. The date that, in 1990, Bev Ditsie and Simon Nkoli organised the first pride march in our country, which was also an anti-apartheid march.
“The reason why we are able to be here- the reason why I am able to stand here shirtless and not have stones thrown at me, and not have a bullet to my head, is because of people like Simon Nkoli and Bev, who came before us and paved the way.”
Siv has a talent for both gripping listeners extremely quickly with their words, and having the intention and ability to see the people they are engaging with. This is an important thing to them, truly being seen.
“Seeing is not just about someone witnessing you being there, your tangibility. Seeing is about witnessing you with all your complexity. Seeing is about trying to understand where your troubles come from, what sparks you joy,” they say.
Siv is there, standing in the quad of the FHS on a Thursday afternoon, in one of many efforts to bring attention to the dangers of the healthcare system for queer and trans people, and why the fixing of this system needs to be prioritised.
“We are terrified of going into a doctor’s room and immediately being met by violence at our most vulnerable,” Siv explains of both them and their friends when experiencing illness.
Historicising medical violence:
Siv, who is an experienced educator, takes a moment to simply explain some concepts that may feel academic but are important in our basic understanding of the healthcare system.
They go on to reference four important concepts: eugenics, ableism, hysteria and conversion therapy. Understanding examples of these concepts help us get an idea of how the medical field has previously been violent.
Eugenics, as Siv puts it, was when “people decided to use science in order to prove that black people were lesser than.” Although the science was eventually disproved, this is a frightening and real way that people used a widely trusted field to justify harmful treatment of others.
Ableism is still obvious in the world today. A clear example of ableism in medicine is the misinformed notion that giving a child a vaccine will result in them being autistic. This is not only incorrect, but also fosters the idea that autism is a bad thing.
Going a bit further back, hysteria was a common label given to women who had a thought that went against the systems set in place. Feeling frustrated or upset was invalidated by way of medical professionals deeming these women as ‘crazy.’
Lastly, conversion therapy is another destructive act that has its roots in the medical field. Nowadays, conversion therapy is not always an obvious, physical system, Siv explains.
“It can sometimes form itself in the way that you do not allow someone to feel safe enough to be themselves, and therefore they are having to hide themselves.”
“As you can see, the medical sciences is not benign. It is subjective. It has history. There are powers involved in how medical science, and health sciences, extends itself as the knower of all bodies, of all sickness, of all health.”
Harmful medical concepts:
Siv goes on to talk about three other words that are important to know in the context of the healthcare system: positivism, biological essentialism and medicalisation.
Positivism, Siv explains, is the idea that you can take something complex and make it definite. It results in looking at the relationship between various things as if they’re in a vacuum. For example, it puts a circle around ‘homophobia’ and says ‘this is what it is and nothing else.’
It also assumes that everything that happens is something you can see or hear or smell, but excludes the things that “we don’t feel with our fingers, the things that are internal.”
Biological essentialism acts to assume that we are only our biological selves and nothing more. That what our bodies look like defines us as people. Siv reminds us that this idea “completely obliterates our subjectivity, who we are, and takes it down into simply our physical, corporeal being.”
The final concept they discuss is medicalisation. This is the process of making everything medical, and brings about the idea that there is a ‘normal, right and healthy’ way to be a human being. Which, equally, decides that there are opposites and that these are the ‘abnormal, wrong and unhealthy’ ways to exist.
These opposites most often include being black, fat, a woman, trans or queer.
Statistics:
The effects of these concepts, that are implemented in how many healthcare professionals behave, result in very real and horrifying consequences.
Siv mentions how there is an assumption amongst people that unless you have a very set number to tell you how people are harmed, that it is not actually happening.
They then give the harrowing information that the statistics about how many trans people are getting ill are inaccurate because a lot of trans people die before they can be counted.
Siv’s healthcare experiences:
Siv, whose identity places them in a vulnerable position when interacting with healthcare professionals, details some of the experiences they’ve had.
When going to a doctor for a treatment of tonsillitis, the doctor told them that they are “such a lovely black person.” He continued to say that they are “so articulate” and have “such a great command of English.”
Why is this an issue? The comments assume that Siv is particularly exceptional for being able to speak English, implying that black people are less inclined to be able to speak English or are unintelligent. As Siv says, “it also assumes that English is the only way to be affluent.”
A dentist Siv was with to get a root canal done, abruptly confronted them during the procedure – one in which it is difficult to speak during – with the question of what it actually means to be trans. Siv was expected to do the educating in a position where they were there to be a patient.
Another common experience in every day life for trans people, but is especially triggering in a healthcare space, is the act of misgendering. It is easy to ask rather than just assuming and causing harm.
“I think we need to think very carefully about what it does in that moment when you use particular language to name someone without their permission.”
Siv details their experiences as they “wanted to use these examples to illustrate to you that it’s not just theory, that it affects LGBTQ+ people on a daily basis.”
Positive healthcare experiences:
Having positive healthcare experiences can literally save lives. Siv speaks from experience as they say their therapist saved their own life.
An educated therapist, for example, can then also assist trans and queer people in finding more helpful healthcare professionals for other needs.
Healthcare professionals who are either queer or who have enough of an understanding of queer life make an enormously important impact on the quality of care for LGBTQ+ patients.
“That’s what we’re trying to do here at the Faculty of Health Sciences, we’re trying to build and grow knowledge and people who are able to effectively respond to an incredibly ill world.”
Trans people and healthcare:
There is a lot of talk in the healthcare space of trans people getting healthcare, and a discussion around whether it should be allowed. A lot of people are worried that trans people getting surgeries will regret them, and that the fault will then be that of the healthcare worker.
But, as Siv says, regret exists in many spaces without affecting future actions. People may regret having children yet pregnancy care hasn’t stopped.
People may regret tattoos they have, but “if there is an infection from the tattoo the hospital doesn’t go ‘no sorry, you decided to have a tattoo, that’s not our problem’.”
“I actually don’t think it’s about whether or not we’re going to regret it. I don’t think people really care about us that much at all. I think it’s about the body and ownership. I think people are really upset that trans people have the nerve to change their body, to align themselves with who they are, and to push against these ideas that the body must be in a particular way.”
“The health sciences are incredibly beholden to this idea that they are the only ones who know a body. When in actuality, what the health sciences know is illness. What the health sciences know is curative care.”
Siv’s experience at FHS:
Siv explains that within their work, they are constantly having to find hope, and that it can often feel as though they’re moving around in circles.
They bring up the important question of “what does it mean to have change?”, which they say they realise happens in a mixture of all at once and over a long period of time.
“It was uSteve Biko who talked about black consciousness, and talked about the importance of black people being able to go into themselves and undo the mechanisms of oppression that had them telling their own selves that they were not human,” Siv explains on the change that happens within ourselves.
“There are many ways in which we end up being violent towards people because that’s what we’ve learnt. And it’s hard to undo the violence that’s inside of you. But you have to do it if you’re wanting to be the kind of healthcare professional who can actually be present, and that healing point for all of your patients.”
Going forward:
Siv mentions that they have witnessed friends in various states of illness, suffer at home because they are too scared of the treatment they will receive in the healthcare system, if they can even receive treatment.
“I know that there are a lot of difficulties in the healthcare system, and I know you are busy, I see it. But I’m begging, I’m seriously begging,” Siv says explaining that at some stage it will get to the point where their friends might need to go to a hospital, and they don’t know what they will do.
“There are so many ways of being ill. And on top of that, you have a healthcare system that is so burdened, there are so many silk folk who cannot get access.”
Healthcare professionals are the ones that can really implement a changed, more educated system.
“You need to ask yourself ‘what ideas about gender have I inherited? What ideas of gender are actually mine? Who do I want to be? And who am I?'”
Pride marches:
Despite the scary and honest information that Siv spoke about, they bring their speech back to the reason the crowd has gathered: a pride march.
“What I love about pride is that it has always been political. It has not just been about being shirtless, wearing tutus and dancing. It has always been about fighting for LGBTQI+ rights to access, rights to life, rights to joy, rights to love, rights to be who you are.”
The content they spoke about was devastating but wildly important in the context of why pride marches even exist, and why there is still fighting that needs to be done.
“We have still lost so many LGBTQ+ youth and elders because of the ever-present oppression that is homo-transphobia and cisgender-heterosexual patriarchy and normativity. In other words, because we live in a world that does not recognise LGBTQ+ people unless there is a big rainbow on our forehead. Because we do not walk around like that, people assume we do not exist.”
Siv wants this gathering to focus on creating a space in which everyone could heal. They explain that as trauma lives in our body, healing can come about by doing something with your body that makes you feel safe.
They go on to say that instead of marching, a dance-in will take place. Like a sit-in, but dancing.
“You do not have to know how to dance. You do not have to be ‘good’ at dancing. All you need to do is move your body where it wants to go. Just be you. That’s all pride is about.”
The Sun is shining harshly through the clouds near Groote Schuur Hospital, and a small crowd of people in both rainbow getup and earthy tones, watch as Siv braces to step down off of the chair in front of them.
“Let’s dance. Shall we?”
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Picture: capeetc
