1. What does transgender mean?

Transgender refers to people whose gender identity does not align with their biological sex. For example, a person could have been born with a penis, but at their core, they feel like they are female.

2. What is the difference between transgender, transsexual, and transvestite?

These terms are often confused but precise definitions can be tricky because the concepts are not fixed and the answer to this question will depend on who you ask. If you are unsure of how to refer to someone, the best thing is usually to ask them how they would identify themselves. But in general:

  • Transgender refers to individuals who feel a lack of fit between their biological sex and which gender they identify with. It can also be used as an umbrella term for transgender people, transsexuals and transvestites.
  • Transsexual is a person who would like, or has already, undergone gender affirming surgery (sometimes called re-assignment surety) to match their body’s appearance to their gender identity.
  • A transvestite is a person who dresses as the opposite sex, for personal reasons or for entertainment reasons (drag queens or kings). This does not necessarily reflect the person’s sexual orientation or gender identity.
3. What’s the deal with bisexual people? Have they just not made their mind up yet?

No. Bisexuality is a legitimate sexual orientation, just like heterosexuality and homosexuality. Bisexual people feel a romantic and physical attraction to both men and women, often to varying degrees. It is not a reflection on their ability to stay faithful to their partner, the number of sex partners they might have or their ability to make decisions about their love and sex life.

4. How do lesbians have sex?

Let us count the ways! One should try to remember that there is no such thing as ‘gay sex’, ‘lesbian sex’, or ‘straight sex’. Rather, two or more bodies come together to provide sexual stimulation, be that orally, vaginally, anally, or by touch only.

That said, lesbians often enjoy cunninglingus (sexual stimulation of the clitoris or vagina with another person’s tongue), fingering (inserting the finger into the vagina), making use of sex toys, or other activities which both people involved might enjoy. One’s sex life is limited only by your imagination.

5. What are MSM?

MSM means Men who have Sex with Men. It is a term that is often used in public health and recognises that not all men who have sex with men identify as bisexual or gay. They might be in prison or other settings where they don’t have access to women, they might not feel comfortable describing themselves as gay or bi or they may just enjoy sex on a purely physical level with another man, but feel romantically and/or physically attracted to women.

6. Why are gay men so effeminate? Why are lesbians so butch?

We should be careful not to generalise, and not to confuse gender identity with sexual orientation. Some men may seem more effeminate, but identify as straight, and some men may seem more masculine, but identify as gay. Everybody should be allowed to express who they are, be it feminine or masculine or androgynous (neither feminine nor masculine), regardless of their biological sex or orientation.

Anyway, what is considered ‘feminine’ and ‘masculine’ is largely socially constructed.

7. Do gay men want to be women?

No they do not – they are men who are sexually and/or romantically attracted to other men. Also not all gay men behave in what society would consider to be a ‘feminine’ way. Some identify as masculine and act according to the societal expectations of what is masculine. The same goes for lesbians. They do not want to be the opposite sex, but because they identify as more masculine they act appropriately according to society norms.

8. How does religion play a role within LGBTI lives?

Many LGBTI people are religious and spiritual because religion and spirituality is personal and the connection that any person has with their deity is their own.

9. How are sexual orientation and gender identity determined?

No one knows exactly how sexual orientation and gender identity are determined. Scientists agree that it is a complicated matter of genetics, biology, psychological and social factors. For most people, sexual orientation and gender identity are shaped at any early age. While research has not determined a cause, homosexuality and gender variance are not the result of any one factor like parenting or past experiences. It is never anyone’s ‘fault’ if they or their loved one grows up to be LGBT, nor is it a defect, disease or something that needs to be ‘cured’.

Human beings are vastly diverse – that’s what makes us such interesting creatures – and so there is no ‘normal’ or ‘abnormal’ when it comes to sexual attraction and love.

10. Is it possible to change a person’s sexual orientation and gender identity?

No. A person’s sexual orientation and/or gender identity cannot be changed. What must change are the negative social attitudes that stigmatize LGBT people and contribute to violence and discrimination against them. Attempts to change someone’s sexual orientation often involve human rights violations and can cause severe trauma. Examples include forced psychiatric therapies intended to “cure” individuals of their same-sex attraction, as well as the so-called “corrective” rape of lesbians perpetrated with the declared aim of “turning them straight.”

Coming Out

Want to come out but don’t know where to start? Here are a few things to think about before you take your first steps out of the closet.

Be comfortable in your sexual orientation

It can sometimes be a shock for friends and family so make sure you are 100% comfortable in your orientation. They will want to know that you are sure before they are willing to accept the idea that you are LGBT.

There may be a sense of wish fulfilment too: “maybe if he’s not really sure, he isn’t really gay.” It’s okay to be confused but make sure you talk to people, read up more, reflect on your feelings and how your body responds sexually around different types of attractive people, and try to be aware of who and what you are. Then, when it comes to coming out, you can explain it all to your loved-ones clearly and confidently.

Consider the timing

You may want to assess your financial position. Are you dependent on your family? Is there a risk that they might cut you off financially if they disapprove of your sexuality? Ask yourself if it might be wiser to wait until you are fully independent before you tell your family.

Test the attitude of your friends and family towards LGBT people

Do your friends and/or family make disparaging remarks about LGBT people? Do they express disapproval in any way? By asking yourself these questions, hopefully you will be able to gauge better what they reactions might be, and therefore how you can cope with those reactions.

Remember, though, that people sometimes express homophobic views without really thinking about what it means (‘that’s so gay’ is an example) and may have a very different attitude if they understand it better and it is someone they love. You may be pleasantly surprised with acceptance!

What if they react badly?

The most common reaction is probably denial but in some cases family and friends will react very badly and may say and do things that hurt you. Do you have a social support system besides immediate family and friends that you can lean on? Find out about the local LGBT rights organisation in your neighbourhood. If worse comes to worst, and you are left without a home, contact Pride Shelter Trust in Cape Town, who can give you temporary accommodation until you are back on your feet.

With time comes understanding

Remember, if your family and friends react badly initially, don’t lose hope. It took a lifetime of conditioning for them to arrive at their current ideas about LGBT people. It most likely took you at least several years to come to terms with your sexuality. As much as you might want their immediate acceptance, this is not always a realistic expectation. Offer to answer any of their questions, even if they might be naive or even homophobic, and try to provide them with as much factual information as possible.

Don’t lose your cool

Things might get heated. Your loved ones may become upset, use abusive language, and in worst cases, become violent. Remove yourself from any physical threat, and if possible, arrange with a friend beforehand who would be willing to let you spend the night if it is necessary. Try to stay rational, take deep breaths and tell your truth.

Safer Sex

Does anal sex hurt?

It shouldn’t hurt if care is taken and both people want to do it. Many people immediately associate anal sex with men who have sex with men. But research shows that 1 out of every 6 heterosexual couples have practiced anal sex, or practice anal sex regularly. In addition, some men who have sex with women enjoy having their anus stimulated. Like vaginal sex, anal sex can be painful if it is forced or there isn’t enough lubrication. But with the right type of preparation and plenty of lube, the experience can be enjoyable.

Is it true that most gay men have AIDS?

No but they can be more at risk of becoming infected with HIV because of a number of social, economic, biological, and political factors. Some health providers in South Africa deny MSM health care because of homophobia, leading them to not knowing their HIV status, or how to take care of their sexual health. Not all MSM have access to condoms and lubricants. Anal sex is a much riskier sexual behaviour in terms of HIV than other forms of penetration, especially for the partner that is being penetrated. Few MSM are aware of the risks associated with unprotected anal sex.

Why are MSM so promiscuous?

Not all straight, gay or bisexual men have multiple sex partners. Yes, some men (and women!) have sex with a large number of partners but sexual orientation has very little to do with this. What’s important is not how many people you have sex with, but rather that you always use a condom and lube.

Can lesbians also contract HIV and sexually transmitted infections (STIs)?

Yes. Not all women who have sex with women (WSW) have sex only with female partners. They might be having sex with men, too. In addition, if WSW don’t clean and a put a condom on any sex toys they might be using, they are at risk of contracting certain STIs. And some STIs can be transmitted through oral sex.

Good luck, and remember, we have an open door policy at all times!

HIV – testing / treatment / care / support


Get tested to know your status. Knowing your status helps you to protect yourself and your sexual partner/s.

If you test positive and your CD 4 count is 500 and below you can start with Antiretroviral Therapy (ART).

ART is fast tracked for:

  • – HIV positive women who are pregnant or breastfeeding OR…
  • – Patients with a CD4 count below 200 OR…
  • – Patients with stage 4 irrespective of CD4 count OR…
  • – Patients with TB/HIV co morbidity with a CD4 count below 50

If you are not yet eligible for ART (CD4 count above 500)

  • – Go for regular follow-ups & repeat 6 monthly CD4 testing
  • – Stay healthy
  • – Protect yourself and your partner by practicing safe sex

As of 1 January 2015 all patients with a CD4 count of 500 or less will be eligible to commence on ART.

ART is a LIFE LONG commitment and you should be aware of the follwing

  • – The importance of ART
  • – Compliance to treatment
  • – Adherence counselling (AT EVERY CLINIC VISIT)
  • – Consequences of non-compliance/defaulting
  • – Possible side effects
  • – Importance of taking treatment correctly, consistently & on time
  • – Importance of regular clinic visits, care & support
  • – Counselling re general lifestyle (healthy lifestyle, nutrition, exercise, stress etc.)
Gender Based Violence

Gender-based violence refers to violence that targets individuals or groups on the basis of their gender. This includes acts that inflict physical, mental or sexual harm or suffering, the threat of such acts and coercion.

Sexual Violence

Sexual violence includes sexual exploitation and sexual abuse. It refers to any act, attempt, or threat of a sexual nature that result, or is likely to result in, physical, psychological and emotional harm. Sexual violence is a form of gender-based violence.


Sex is defined as “biological characteristics of males and females. The characteristics are congenital and their differences are limited to physiological reproductive functions”.


Gender is the term used to denote the social characteristics assigned to men and women. These social characteristics are constructed on the basis of different factors, such as age, religion, national, ethnic and social origin. They differ both within and between cultures and define identities, status, roles, responsibilities and power relations among the members of any culture or society.


Violence is a means of control and oppression that can include emotional social or economic force, coercion or pressure, as well as physical harm. It can be overt, in the form of physical assault or threatening someone with a weapon; it can also be covert, in the form of intimidation, threats, persecution deception or other forms of psychological or social pressure.


Abuse is the misuse of power through which the perpetrator gains control or advantage of the abused, using and causing physical or psychological harm or inflicting or inciting fear of that harm. Abuse prevents persons from making free decisions and forces them to behave against their will.