Includes bibliographical references / The purpose of this study was to understand the life-world of transsexual women in relation to their awareness of their unique health needs as a direct result of sexual realignment treatment, and their health-seeking behaviours, practices and experiences of responses in negotiating health care for their transgender-related health needs in the healthcare system. The overarching question asked in this research was: What are the lived experiences, and meaning of these experiences, for transsexual women during the sexual-realignment process when negotiating health care for their transgender-related healthcare needs in the healthcare system? Participants in this study were selected through purposive and snowball sampling. In-depth interviews were conducted with ten participants selected from urban, peri-urban, and rural areas of the Western Cape. Theoretical saturation was reached with the tenth participant, and further selection of participants was ceased. The data was viewed through a trans-inclusive feminist lens with a concurrent collection and analysis process as guided by the steps of analysis of Interpretative Phenomenological Analysis (IPA), as developed by Smith (2010). IPA is a modern qualitative approach to research inquiry which harnesses the strengths of phenomenology, hermeneutics, and ideography. The analysed data were illustrated in a master theme graphic which contained one superordinate theme, two subordinate themes and various categories. The superordinate theme of this study was named "Towards organic Womanhood", while the two subordinate themes were coined "Embracing Womanhood", and "Facing the Giant in order to Become". The subordinate theme Embracing Womanhood gives insight into aspects of transsexual women's journey of moving towards a state of organic womanhood, whereas the subordinate theme Facing the Giant in order to Become maps out powers in the healthcare system which prevent transsexual women from having a smooth transition journey. This study illustrates that transsexual women have a need to align their bodies with their gender identities, but even though South Africa has legislation which protects the health and rights of transsexual women, transsexual women find it challenging to make the transition. Health practitioners are ill-equipped to manage transsexual women, the care which they receive in the government-funded healthcare system is of a poor standard, and they are4subjected to extremely long waiting periods to have access to surgical sexual realignment services. Recommendations are made for the healthcare system, policy makers and educational institutions in order to stimulate the South African healthcare system to become inclusive and affirming to the needs of transsexual women. Furthermore, recommendations for researchers are made to stimulate the debate around transsexual health care in the scientific literature.

La presente investigación tiene como objetivo explorar y describir cómo contribuye la relación de pareja en la satisfacción de necesidades psicológicas básicas (NPB) en un grupo de mujeres transexuales de Lima. Se abordó las NPB mediante un estudio cualitativo con diseño fenomenológico en seis casos de estudio. Se realizó una entrevista a semi estructurada por cada una de las seis mujeres transexuales residentes en Lima Metropolitana de nivel socioeconómico B y C que oscilaban entre los 26 y 61 años de edad. Los resultados indicaron que la relación de pareja logra tanto satisfacer como frustrar las NBP de las practicantes. Se concluyó que los procesos de satisfacción o frustración de las NBP de estas mujeres transexuales además de ser el resultado de una conducta de sus parejas, también pueden darse de forma combinada, creándose redes complejas donde la satisfacción de una necesidad puede llevar o esconde la frustración de otra u ocurrir de manera inversa. / The objective of this research is to explore and describe how couple’s relationship contributes to the satisfaction of psychological basic needs (PBN) on a group of transsexual women of Lima. PBN were approached through a qualitative study with phenomenological design in sex case studies. A semi-structured interview was conducted by each of the six transsexual residents of Metropolitan Lima of socioeconomic level B and C, who ranged between 26 and 61 years old. The results indicated that couple’s relationship achieves both satisfy and thwart the PBN of the participants. It was concluded that the process of satisfaction or thwart of the PBN of these transsexual women besides being the result of a behavior of their partners, can also occur in a combined way, creating complex networks where the satisfaction of a need can carry or hide the frustration of another or occur in reverse. / Tesis