First published in the Daily Maverick 168 weekly newspaper.

There is something enthralling about listening to Anastacia Tomson-Myburgh talk. She seems to have instant access to all the knowledge she’s accumulated in her life and can weave together clean, precise, lucid answers to almost any question, whether it is of an existential, factual, philosophical, sociological, medical or political nature.

This talent is one of the reasons she became what she calls “a reluctant leader”. The other is her fairly unique identity of being a trans doctor.

Tomson-Myburgh, author of Always Anastacia: A Transgender Life In South Africa, has been included in the Mail & Guardian 200 Young South Africans (Health category), The Young Independents Top 100 (Disruptor category) and the Republic of South Africa Women of Fortitude lists.

Her activism spans a number of ongoing advocacy and education programmes. She does research and contributes to policy analysis in the field of gender, sexual and reproductive justice, health, rights and care. She also teaches the understanding of gender within a healthcare setting to third- and fifth-year medical students at the University of Cape Town as part of the women’s health block and gynaecology rotations.

Her day job is working as a general practitioner, but on the day she’s available for an interview, she is on duty, as she always is on Wednesdays, at an NGO healthcare clinic. She has also been involved in volunteering that has little to do with her public identity as a queer activist: working as a crew member on a tree-planting and eco preservation programme.

None of these things seem to have been part of her life plan, which, as a child, extended only as far as pouring “most of the emotional, physical and mental resources I had into staying under the radar”.

“I’ve always been an introvert, but whether I’ve wanted to or not, I’ve found myself in the role of the reluctant leader enough times in my life to realise that people see something in me that I don’t always see in myself.

“Coming out, I faced my own challenges interacting with healthcare professionals who, at the same time as being my peers and colleagues, were often also toxic, condescending and even abusive towards me.

“If I had to go through that – me with my white, upper-middle class university education and medical degree – what chance does the average trans person have in the world? What can I do to take the trauma I’ve experienced and make good out of it, make things easier for people who don’t have all the resources I did?

“What I went through was horrifying and it’s nowhere near the worst that people have been through. It was that sense of imperative that forced me into activism.”

She never saw herself in the role of activist. All she wanted was to be comfortable in her own skin, to live her life in peace and to practise her craft.

“Before I knew it, I was being called an activist. I wrestled with that for a while, wondering whether I’d earned this moniker people had started applying to me. You know, there’s this concept when it comes to queer identity and activism that we define our own credibility by the trauma that we’ve endured.

“Of course, I did reflect on the trauma and I realised, well if I have to earn my stripes that way, I’ve certainly earned them. But it’s such a terrible thing that unless we’ve suffered, we don’t feel like we’re queer enough or trans enough. No one should have to go through that.

“I quickly came to understand that I was at a unique intersection of being a qualified medical doctor who identified as trans and who was living out and open in the world.”

Tomson-Myburgh grew up as an only child in a secular Jewish family, though she had two half-brothers a decade older than she was. She went to an orthodox Jewish school and grew up with fairly conservative values in comparison to those she holds now.

Although her politics were left and queer, she never identified as queer until her late twenties. “I understood from an early age that I was different to most of the people around me but not how or why or what the axis of that difference was. A big reason for that was because we didn’t have representation, we didn’t have the vocabulary, we didn’t have education on matters of identity in the same way that we have now.”

A lot has changed in the five-and-a-half years since she was outed while working as a GP in Norwood, Johannesburg. She’d been “accumulating pieces of evidence” about how she didn’t fit in with mainstream ideas about masculinity in a world in which she read as male.

“It’s almost like stashing clutter away in a closet and eventually the door won’t hold any more. I’d held myself to this narrative that I was exceedingly liberal and an ally to queer and trans people but that it wasn’t my own lived experience. And then one day I looked in the mirror and had to start asking myself, ‘Well, what if this is?’

“Once you know this about yourself, the next thing you have to ask is what you’re going to do about it. Am I going to keep this close to my chest for the rest of my life or am I going to come out and risk losing everything: career, friends, family? If I do decide to pursue medical intervention, what kind of life am I going to have? What am I going to look like? What will people think of me? What will I think of me? The burden of that is overwhelming. These are not things most people have to think about.”

She was still in the middle of this self-interrogation when she was outed. “I hadn’t yet decided if or when or how I was going to come out in a public sense, or even if I was going to do that, and then the agency to make that decision was taken away from me.”

It was having had her story wrenched from her that propelled her from a shy child with no close confidants to a woman who can address large crowds without breaking a sweat, in spite of how this puts her front and centre of the firing line when it comes to rude, inappropriate and abusive questions.

“People spin a narrative when you’re a nice, Jewish doctor working in a Norwood practice. It was a huge skandaal. If I was going to take the agency of my own narrative back, I had to tell the story in my own voice.” The skandaal at Norwood and coming out left Tomson-Myburgh “unemployable” for about two years “because you come out of university with a degree certificate and an HPCSA [Health Professions Council of South Africa] registration that are tied to your legal name and your ID number”.

It took almost a year to get her ID document sorted out, after which she could begin to update all her degree certificates and registration. In that time, she wrote her book and began delivering educational workshops and public speaking engagements that included sensitisation and competency training, skills development and awareness campaigns for LGBTQIA+ rights in South Africa.

She also worked as a junior registrar in clinical pathology for the National Health Laboratory Service and as research clinician at Task Applied Science, a social enterprise that develops and tests medicines, vaccines and diagnostics.

It is clear from her CV that professional development and activism have run alongside one another consistently for the five-and-a-half years since she transitioned.

There is something steely and focused about Tomson-Myburgh, the kind of a toughness, coolness and resourcefulness usually seen in people who have been in the fray of activism for many more years than she has.

“A lot of activists,” she says, “are militant and combative and confrontational, but that’s not my nature. I realised early that the actual weapon in the armoury for me is vulnerability and the ability to share. When you put all of this stuff about yourself out there, you deweaponise it. It can’t be used against you when you’re the one telling the story.

“The other side to that is that it enables you to connect with people on a very frank level. When you start sharing the awkward and intimate truths about yourself, it really disarms people and breaks down barriers …but it does come at a cost.”

Her wife provides a safe harbour from the abuse and the trolls and the ever-present threat of burn-out. And she has what many call the “chosen family” network of friends, allies and colleagues that provide a sense of belonging and community that is often absent before a coming out. Things have eased somewhat for queer-identifying people in South Africa and around the world in the past five years and public feeling has become less rigid and more open than it used to be.

Tomson-Myburgh has been blown away by the acceptance from the patients and community where she now practises in Sea Point in Cape Town. Whether they are trans or queer people or straight millennials seeking medical help, they are appreciative of what she represents as a trans doctor, she says.

She has the trans, queer and asexual flags on her desk and her keyboard all decked out in trans colours. It’s really something to them, she says, to find an intake form that asks about preferred pronouns and names, which represents progressive values.

As a doctor who only once in all her years of study at the University of Pretoria was exposed to one sentence about trans people, she now treats a number of trans people who are also medical students, so it won’t be long before being an openly trans doctor is no longer unique.

“It was my guiding principle, in many ways, to become the doctor that I had needed back then. I’m not sure if pursuing surgery, as I’d intended initially, is still something I might consider in the future. I’d love to be out there creating brand-new penises and vaginas for trans people, but without access for trans people to basic, informed primary healthcare, what would be the point?”

She tells people in the queer community that they don’t have a responsibility to be an activist. “But, on the other hand, every breath you draw in this queerphobic, homophobic, transphobic society, that would sooner see you dead than alive, is a radical act of defiance against an oppressive system. That in itself is activism.” DM168

Five Questions

What’s the image on your phone’s home screen?

Right now, it’s an animated starry sky. I’m a geek for all things stellar.

What would you spend your last R100 on?

Dogecoin

What’s the worst piece of advice you ever took?

My mom advised me to watch The Hangover and for some or other reason, I did. 100 minutes of my life wasted, and lasting psychological scarring.

The one thing you wish you had learnt earlier on in life?

That to be different does not necessarily mean to be broken.

Three books that have changed your life?

The Tamir Triad, by Lynn Flewelling; The Left Hand of Darkness, by Ursula K. LeGuin; Lilith’s Brood, by Octavia Butler

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for free to Pick n Pay Smart Shoppers at these Pick n Pay stores.