From the 1970s Groote Schuur has offered an inconsistent psychiatric, surgical and endocrine service to transgender patients. In 2009, a multidisciplinary team was formed in order to offer a more integrated and coordinated service. The team currently comprises three psychiatrists (child and adult), a clinical psychologist, a plastic surgeon, two endocrinologists (paediatric and adult), a family physician, a clinical social worker and sexologist, a general practitioner representing the private sector, and a representative from the NPO ‘GenderdynamiX’. Our team is dedicated to offering gender-affirming care, and we follow the Standards of Care of the World Professional Association for Transgender Health (WPATH- SOC 7).
Dr Kevin Adams
Dr Kevin Adams, a Cape Town-based Plastic and Reconstructive Surgeon, has considerable experience and interest in gender affirming surgery, as well as training and research. He provides outpatient consultation and gender affirming surgery services for Groote Schuur Hospital.
Ronald Addinal is clinical social worker who is further specialised as a sexologist and sex therapist. Currently he is a lecturer in the Department of Social Development at UCT and has also volunteered his expertise in organisations such as Triangle Project (an LGBTQIA NPO) and GenderdynamiX (a Transgender Rights NPO). Ronald is internationally and nationally regarded an expert in the psychosocial healthcare needs of Transgender children, adolescents and adults. He served on the WHO task team for South Africa for the Clinical Utility research on the ICD-11 diagnostic criteria for Gender Incongruence and Paraphilias.
Dr Michelle Carrihill
Dr Michelle Carrihill is a Senior Specialist in the Paediatric Endocrine Diabetes Unit at Red Cross Children’s and Groote Schuur Hospitals.
Dr Elma De Vries
Dr Elma De Vries is a specialist family physician at Heideveld Community Day Centre and a senior lecturer in the Division of Family Medicine at UCT. Dr de Vries provides a link for general practitioners to access advice regarding gender-affirming care.
Gender DynamiX Representative
A member from the GDX management represents the needs and interests of the transgender community.
Dr Adele Marais (Chair of Transgender Clinic)
Dr Adele Marais is a Clinical Psychologist and Senior Lecturer in the Department of Psychiatry and Mental Health at UCT. She co-initiated the Groote Schuur Transgender Clinic with her psychiatry colleague (Dr Wilson) in 2009, and is currently the chair of the clinic. She also sees transgender clients in her after-hours private practice based at Groote Schuur Hospital.
Carol Musikanth is a psychotherapist in private practice. She is a strong advocate for Transgender rights and runs a Transgender parent support group once a month.
Dr Simon Pickstone-Taylor
Dr Simon Pickstone-Taylor is a Child and Adolescent psychiatrist who is an Honorary Senior Lecturer in the UCT Psychiatry department. He has a particular interest in gender identity development in children and adolescents. He runs the Gender Identity Development Service at Red Cross War Memorial Children’s Hospital for youth up to the age of 18 with gender diversity and provides clinical and research supervision for trainees and clinicians. He works in private practice at the Neuro Diversity Centre in the Boland.
A/Prof Ian Ross
A/Prof Ian Ross is an endocrinologist working exclusively in the public sector. The outpatient Endocrinology Clinic at Groote Schuur Hospital provides assessment and advice regarding gender affirming hormonal replacement therapy. Due to the nature of this treatment, careful monitoring is undertaken at each follow-up visit at this clinic. Treatment protocols are based on international guidelines, but they are almost always adapted to the individual who consults us.
Dr Arianne Spitaels
Dr Arianne Spitaels is a Senior Specialist in the Paediatric Endocrine Diabetes Unit at Red Cross Children’s and Groote Schuur Hospitals.
Bev Toker is a medical social worker and counsellor in private practice with years of experience in dealing with assessments, individual and family support and linking clients to the team and hospital services.
Dr Anastacia Tomson
Anastacia is a medical doctor, an author, and an activist in the field of LGBTQIA+, and particularly, transgender rights. She practices as a GP in Sea Point, and also collaborates with public sector entities and NGOs in working towards improved access to healthcare for queer identified folk.
Dr John Torline
Dr John Torline is a privately-practicing general psychiatrist based in Cape Town. After completing his specialist training, he joined the Groote Schuur Transgender Clinic where he consults once a month.
Dr Don Wilson
Dr Don Wilson has been in a member of the UCT Department of Psychiatry since 1983. In 2015 he retired from his position as Head of Clinical Unit at Groote Schuur Hospital. He has been involved in gender affirming care and research at Groote Schuur since the 1990’s and currently attends the Transgender clinic twice a month.
Transgender clinic Groote Schuur Hospital
Our clinic accepts referrals of people (18 years and older) who experience that the sex they were assigned at birth is not congruent with their experienced gender identity. We can assist with assessment of gender dysphoria, including assessment of identities across the spectrum of gender diversity, and we facilitate access and make referrals to other gender affirming services.
A GP or another health professional can refer a client directly to the Transgender Clinic by completing the referral form, and sending it to: GSH.PsychOPD@westerncape.gov.za.
Please note: we do not accept referrals for people with psychosexual issues in the absence of gender identity concerns. If a client seeks gender affirming surgery, Groote Schuur Hospital has a very long waiting list for these procedures, and therefore these procedures can only be undertaken many years after initially being referred.
A client’s first appointment at the Groote Schuur Transgender Clinic will be at the Psychiatry Outpatient Department (OPD), where Dr Marais (clinical psychologist) and either Dr Wilson or Dr Torline (adult psychiatrists) will see them. The assessment and a client’s need for gender affirming interventions will inform referrals to the Endocrine and Plastic Surgery department.
Endocrinology OPD does not contact clients telephonically to inform them of their appointment dates. Following the appointment at Psychiatry OPD, we advise clients to wait 2-3 weeks, and then contact Mrs Fredoline Lincoln, on 021 404 6151 or firstname.lastname@example.org to assess the progress with arranging an appointment. Clients should provide their name and Groote Schuur Hospital (GSH) folder number, and ask her to check the date of their scheduled appointment in the Endocrine new patient clinic. The hospital will also send clients a SMS two weeks prior to their appointment with confirmation of the date.
After the initial appointment at Psychiatry J2 OPD clients will be referred on the same day to the Plastic Surgery booking office, on F-floor (Room 14) to obtain a date for a future appointment with the plastic surgeon.
Psychiatry and Mental Health
The first appointment at the clinic (at Psychiatry OPD) will involve a comprehensive assessment of the client’s gender dysphoria, as well as a mental health assessment, to determine if there are any mental health concerns with which we can assist. If a mental health condition is diagnosed, and treatment is started, the client will be given follow-up appointments at Psychiatry OPD in order to monitor progress. In most cases, this will be done in parallel to facilitating access to other gender affirming interventions.
Referral to gender-affirming services
Once seen by the mental health team at Psychiatry OPD, clients will be referred to the Endocrine and Plastic Surgery services.
The Endocrine clinic provides transgender hormone therapy to reduce the differences between your body and your gender identity, while monitoring for side effects and using the principal that the lowest effective dose should be used to limit side-effects where possible. One should always bear in mind that the rate of progression differs from person to person and treatment is always individualised. While acknowledging that this form of treatment is relatively safe, there are potentially very serious side effects. Your consultant will take your general health, your risk factors for certain side effects, and your current medications into consideration. On average, we evaluate patients initially at 3 monthly intervals, and it may be reduced to 6 monthly appointments. A series of blood tests are usually requested prior to each appointment.
There are unfortunately limited resources at Groote Schuur Hospital when it comes to psychotherapy and counselling services. The mental health team will refer clients to other available counselling services, which may include the counselling services at Triangle Project or practitioners in private practice.
How to find us
Psychiatry Out Patient Department (J2 OPD). We are on the H-floor of the Out-patient Building at Groote Schuur Hospital. Our contact number is 021 404 2151.
Changing an appointment
Please note that each clinic (Psychiatry, Endocrine, Plastic Surgery) manages their bookings separately. To cancel or reschedule an appointment, please liaise directly with the relevant clinic.
Psychiatry OPD: please contact Linda Newman on 021 404 2151; GSH.PsychOPD@westerncape.gov.za.
Endocrine clinic: please contact Fredoline Lincoln on 021 404 6151; email@example.com.
Information and support
Our team is available to provide consultation and support to other clinicians wanting to offer gender-affirming services.
For general queries about gender dysphoria, and local resources, please contact GenderdynamiX:
021 447 4797 firstname.lastname@example.org
For specific queries related to the GSH Transgender Clinic, please contact Dr Adele Marais: email@example.com
For queries related to hormone and GP support, please contact Dr Elma De Vries: Elma.deVries@westerncape.gov.za
General practitioners - please have a look at the following resource: https://www.genderdynamix.org.za/general-practitioners
The practitioners on the team can assist clients with the application for changing their gender marker on their ID. The application at Home Affairs requires letters from two practitioners.
Legal Resources Centre (LRC) is a law clinic that uses law as an instrument of justice for vulnerable and marginalised persons in South Africa. In promoting/advancing the rights of transgender persons, the LRC provides legal assistance with Act 49 related cases, difficulties in accessing care through medical aids as well as legal assistance related to various cases where transgender persons are discriminated against.
To make an appointment, call 021 481 3000. Website: www.lrc.org.za; firstname.lastname@example.org
Support Groups and Organisations
Unit 21, Collingwood Building, 10 Anson Street, Observatory, Cape Town
021 447 4797
Triangle Project has a clinical services programme with volunteer healthcare practitioners and LGBTQIA positive therapists offering specialized expertise in LGBTQIA care. Transgender persons can access individual counselling, relationship counseling, family counseling, 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.
Parent Support Group/Parent Counselling:
The parent support group is facilitated by a psychotherapist (Carol Musikanth) who herself is a mother of a transmale young adult. The group takes place once a month on a Tuesday evening. There is no cost involved.
8 Chilworth Road, Camps Bay, Cape Town
(Office) 021 438 8989
Bev Toker medical social worker and counsellor in private practice with years of experience in dealing with assessments, individual and family support and linking clients to the team and hospital services.
32 Oceanhurst, Sea Point, Cape Town
072 132 6197
Compliments, complaints, concerns
We welcome your feedback. Please forward it to GSH.PsychOPD@westerncape.gov.za.