How minister cut short Audrey Mbugua's dream of fully becoming a woman

By Machua Koinange

Kenya: Doctors were not so compassionate. They warned her she would be arrested if she attempted suicide again.

“I told the doctors if they could not give me what I needed, what did they expect me to do?”

Audrey needed hormones and she needed treatment too - quickly. She had even attempted to develop a method that would allow her to configure her immune system to fight against her male hormones, thinking that would allow her female side to grow. She just did not know how to execute her theory.

So Audrey told doctors her history and struggles with Gender Identity Disorder (GID). It was the first time she was opening up after a long while. The doctors recommended she be referred to Mathari Mental Hospital.” GID is categorised as mental disease by World Health Organisation,” she reveals.

With the help of a generous donation of Sh1,000 from her aunt, who had watched Audrey deteriorate over a period of time, she left for Mathari with her sister Ann Wanjiru.

They arrived at Mathari and saw a female doctor, who was good. She seemed to understand what Audrey was going through. She asked Audrey:” Is this about transsexual disorder?” Audrey answered yes.

She asked Audrey about depression, her emotional battles and her medical history. Audrey poured her heart out about the demons she had been fighting and her journey. She gave Audrey a follow-up date. It was the first time that Audrey learnt she was classified as suffering from GID.

“It was ironic but at Mathari, I got help. They saved my life.”

The doctor put her on anti-depressants and arranged for follow-up treatment that would hopefully lead to a gender operation. The next phase of her treatment had begun. “The problem with the drugs was that they turned me into a zombie.”

She found herself referred to Kenyatta National Hospital (KNH) where a team of doctors ranging from a gynecologist, psychiatrist, urologists and psychologists started to work on her in preparation for her new journey.

She would need an operation that essentially would remove her penis and testicles and insert a vagina. In addition, she could not receive a uterus, so she would never bear children.

Everything was going well. She was already taking estrogen and her voice and body was changing. Her most exciting moment was standing in front of the mirror and watching her breast mature.

“I felt fulfilled.”

Her operation was scheduled for March 2009. Audrey was already active within the transgender movement in Kenya and was working closely with transgender Kenya initiative that had been formed to address the needs of those silently dealing with GID.

“Somebody suggested that we should do a documentary on my operation and we needed permission to film in KNH. Zawadi Nyong’o, a consultant in the social justice movement, suggested she could get permission from her father, Prof Anyang Nyong’o who was Health minister to film in Kenyatta hospital.”

Says Audrey: “Apparently, the minister called the director of KNH and told him he was aware that a gender change operation was scheduled for the following day and advised him against allowing the operation to proceed. I arrived the following morning ready for my operation and my urologist informed me the operation had been cancelled.”

Audrey was in utter disbelief. Her dream had suddenly short-circuited into shocking disappointed. The journey towards becoming fully a complete woman had come to an abrupt halt.

She has written countless letters to the Health minister before he left office to understand why he issued instructions for the operation to be cancelled with no response. But his instructions opened a new battlefront for GID victims, the war to have the right to an operation.

In addition, Audrey’s experience accidentally revealed the complexity of GID treatment with stunning clarity.

Sex change

She says the medical board brought a new dimension to the issue. She learnt to her dismay that according to the medical code of ethics chapter two, gender re-assignment on demand was not permitted.

That a specialist team must be constituted to evaluate each applicant’s situation to reach a decision if an operation was needed, a condition she believes she met. Her attempt to pierce the veil of the medical board in the last four years has been met with soporific silence.

Audrey now combined the battle for her operation with the fight to have other GID victims have the right to sex change if they wanted. “They took me in circles. First, I was told by the medical board I needed my parents consent because they might sue the hospital. But I was over 18, why would an adult need permission?”

“It was very painful.”

Just one operation away from fulfilling her dream of becoming complete as a woman, Audrey now took on the fight not just for herself but for others: “I have received countless offers from people wishing to raise money for me to go and have a gender change operation in Thailand or South Africa.”

“What about the others who want the same? Kenya has very good doctors who can perform the same operation locally. If I don’t do this, no one will ever be able to have this surgery here.”

Audrey has had meetings with the medical board, the preliminary inquiry committee and Kenyatta hospital to have the issue resolved. Their attitude has remained tepid. Despite being bounced around, she is still fighting to date.

“Gender change operation is part of my treatment. It’s the last piece of my treatment as recommended by doctors who saw me. It’s my right.” She has been told that she cannot have the surgery until guidelines have been developed between the medical board and the Attorney General’s office to guide future sex change operations.

This is despite the fact that KNH has conducted sex change operations in the past, the most famous being that of Faith Mueni in 1989.

Looking into the future, Audrey is optimistic she will get her surgery. She is determined to fight and soldier on. Marriage is not in the horizon and she prefers to focus on what she needs to do to get the surgery in Kenya.

Still, her mental state has been anguished and her dreams almost disintegrated. Everyday, she wakes up to deal with her thread of pain. But she says will not capitulate in her quest. Her parents, she says, have accepted her. And though they are abroad, she gets a chance to Skype with them.

“Sometimes when my mum looks at the screen, she will look at my hair and ask me, is that a weave or your natural hair?”

Two of her siblings are abroad, but she has the company of her two other siblings in Kenya, including her sister Wanjiru who has been a source of comfort in her journey.

Moreover, she would like to go back to medical research as a career when the battle has been won. Does she get hit on? A lot. She was reduced to wearing a fake wedding band to ward off men who made passes at her. Most times she will say she is married to keep them at bay.

She has weaved her hair, done manicure, pedicure and has expanded her wardrobe. “I only have two dresses in my wardrobe,” She confesses.

What’s more, her attraction is ironically towards women. Yes, she has been in love before with a woman. “But whoever I am attracted to has nothing to do with my sexual intuition.”

Until the surgery is done, her national ID and passport refer to her as male. It can get complicated for her sometimes dealing with the ambiguities of her status. On a recent visit to Amsterdam, the immigration officer scrutinised her passport, stamped it and looked puzzled.

“He looked at me and told me; madam, do you know that they made an error on your passport? I did not understand.”

He went on: “Your sex reads male. You need to make sure they change it as soon as you arrive back in Kenya.” Audrey recalls.

During the preparation for the 2010 referendum on the new Constitution, Audrey had gone to drop an envelope with her views on transgender issues to the committee offices at a city office. Unfortunately on her way out, she forgot her ID with security downstairs.

She returned the following day to find a stern officer who would not return the ID because it had the name Andrew. She was not Andrew, unless she gave the officer a fake ID. It was a plateful of drama until a legal officer at the office she had visited who knew her situation intervened.

Fighter

Audrey had her identity card changed via a deep poll dropping the name Andrew to read Mbugua Ithibu. She did another deed poll and inserted the name Audrey which is shown on her passport but not on her ID. Her gender, however, remains male.

The unemployed medical biotechnology graduate has become the poster child of the transgender movement in Kenya.

Audrey gets offended by being referred to as a man but her battled and journey towards the identity she has struggled with will end only when she gets her day in the operating theatre at KNH. Stubbornly she soldiers on.

Even so, she believes her fight will open the floodgates for other GID victims who remain silent.

“They are scared to come out. Being denied surgery amounts to discrimination. Our society is still ignorant and intolerant to GID victims.” She says: “I have a tough exterior. Some people may think they can put me down. But I am a fighter. GID does not get the objectivity it deserves.”