The Queue

My private funds were exhausted. The “car crash” economy of my life meant I could no longer afford the privacy of Dr. Venter’s quiet consulting rooms in the east of Pretoria. To continue my transition, I had to enter the machinery of the state. I was referred to the Steve Biko Academic Hospital, a massive, brutalist institution of public health.

I learned quickly that the poor and the marginalized do not sleep. To get a place in the queue, I had to leave home at 04:30 AM. I arrived at the hospital at 05:00, standing in the dark with the sick and the desperate. This was the great leveler. In the eyes of the state, we were all just file numbers waiting to be called.

The Prayer

The sun rose, and the bureaucracy woke up. I made my way to the Endocrine Clinic on the third floor. I was dressed as Juanita, feminine, anxious, trying to project a reality that my ID book contradicted.

When the administration office finally opened, a man stood up behind the counter.

“Everyone please stand and pray,” he commanded.

It was a public hospital in a secular democracy, yet here was the religious hegemony asserting its dominance. The state and the church were holding hands over the files of the sick. I remained seated. I refused to bow my head. I was angry at the God who had made me this way, angry at the church that had exorcised me, and angry at a medical system that pathologized me. My refusal to stand was a small, silent act of epistemic disobedience. I was done performing piety for a system that regarded me as an abomination.

Window 3

After the “prayer and reflection,” the machinery of the state resumed.

“Dawie van Zyl to window 3!”

The name boomed across the silent waiting room. I was dressed as Juanita. The name “Dawie” was a weapon. It stripped away my presentation and “outed” me to every stranger in the room.

I walked to the window, my mouth dry. The administrator looked at me, a woman standing in front of him, and then looked at the file.

“Sir, do you have an appointment?” he asked.

The word “Sir” cut through the noise. I tried to explain that Dr. Venter had referred me, that I was a transfer patient.

“Sorry, Sir. I can’t help you without an appointment.”

This was administrative violence. It is the moment where the state’s record-keeping refuses to acknowledge the reality of the human standing in front of it. I stood there, humiliated, my gender presentation clashing violently with his “Sir,” while a room full of strangers watched. I was not a patient seeking care; I was a bureaucratic anomaly causing a delay.

I refused to leave. I waited for Dr. Venter to arrive. When she finally appeared hours later, she greeted me with a hug in the corridor. “It is wonderful to meet the real Juanita,” she said. Her recognition saved me. She navigated the administration for me, forcing the system to open a file for “Juanita” even while the computer screen insisted on “Dawie”.

The Letter

While waiting to be seen by the psychiatrist, Dr. Steyn, I opened the referral letter Dr. Venter had given me. I sat in the plastic chair, surrounded by the noise of the hospital, reading the medical definition of my existence.

“Ms Van Zyl (Dawie) was possibly born with Disorder of Sex Development... From scarring found between her legs, we think she might have received corrective surgery at some stage in her life.”

I stared at the paper. Disorder of Sex Development (DSD).

For years, the church had called me a sinner. The school had called me a moffie. Now, medicine called me a “Disorder.” It was a moment of epistemic collision. On one hand, it was vindication, proof that the “hernia” operation was a lie, proof that my body was indeed different. On the other hand, it was pathologizing. My existence was framed as a biological error that needed to be categorized. I realized then that to the medical establishment, I was not a person; I was a fascinating case study.

I folded the letter. I wiped my tears. I was ready to face the psychiatrists. I knew what I had to do: I had to perform “sanity” to get the hormones I needed to survive.