abstract Research conducted among transgender women in South Africa shows a marked tendency toward health disparities and poor access to appropriate mental, sexual and reproductive health services. Little is known about the socio-economic conditions underlying the health of transgender women in the country. A study was conducted to examine the cost of being a transgender woman in South Africa, in relation to physical, psychological, economic and social well-being, and vulnerability to gender-based violence. Among other disparities, the findings revealed a high level of substance abuse and poor access to hormones for gender affirmation. These findings are consistent with already published literature on stigma, discrimination and poor health outcomes among transgender women. This paper draws on the findings to report on the socio-economic determinants of health for transgender women in the South African healthcare context. It argues that efforts must address the intersections of transgender women’s lives, such as economic, health and educational status, and geographic location, to ensure comprehensive health and human rights services reach transgender women. It also proposes that further research is needed to understand the forces that shape the public health landscape for transgender women in South Africa.

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南非跨性别女性健康的社会经济决定因素：混合方法研究的结果

摘要 在南非跨性别女性中进行的研究表明，健康差异明显且难以获得适当的精神、性和生殖健康服务。关于该国跨性别女性健康背后的社会经济条件知之甚少。进行了一项研究，以检查在南非成为跨性别女性的成本，与身体、心理、经济和社会福祉以及易受基于性别的暴力的脆弱性有关。除其他差异外，调查结果显示，药物滥用程度很高，而且很难获得用于性别肯定的激素。这些发现与已经发表的关于跨性别女性的耻辱、歧视和不良健康结果的文献一致。本文利用研究结果报告南非医疗保健背景下跨性别女性健康的社会经济决定因素。它认为，必须努力解决跨性别女性生活的交叉点，例如经济、健康和教育状况以及地理位置，以确保全面的健康和人权服务能够惠及跨性别女性。它还建议需要进一步研究以了解塑造南非跨性别女性公共卫生格局的力量。