Candid give-and-take with Dr Sex

In her new book Tlaleng Mofokeng, South Africa’s sex-talk expert, deals directly with decriminalising sex workers, the National Health Insurance Bill and the importance of sexual pleasure. 

Her experience with gender-based violence fuelled her activism on women rights and sexual and reproductive health, but the principles of sisterhood instilled by her family encouraged “sex doctor” Tlaleng Mofokeng, 37, to become a trailblazer in her field.

Since obtaining her medical degree in 2007, Mofokeng, who hails from the Free State, has taken part in a number of panel discussions about health. She’s also been involved in social and advocacy work, appeared on radio, written numerous columns for different media platforms, and has now written a book – Dr T: A Guide to Sexual Health and Pleasure.

The root of campaigning for change, however, started in 2010 when she was working in the outer reaches of the city of Johannesburg. There she realised the dearth of candid talk about sex between health care practitioners and their patients. This type of focus would include educating the young on issues of reproduction, sexual pleasure and general sexual health.

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Sitting in Moja Love studios in Braamfontein dressed in a royal blue tulle skirt paired with a white T-shirt and a red beaded Xhosa traditional doek, she chats about her activism, changing existing systems and fighting stigmas. 

Before applying prominent red lipstick, Mofokeng explains how, over the years, she touched people’s lives through her radio talks as a sexual health and reproduction contributor on radio stations such as KayaFM, 5FM, Metro FM and Radio 702. “That’s where I got the name ‘Dr Sex’,” she chuckles.    

31 July 2019: Medical doctor Tlaleng Mofokeng, affectionately known as Dr Sex, explores the subjects of sex, sexual pleasure and sexually-transmitted diseases

What people need

“I’ve always had something to say, but I wanted to say the things that people wanted [to know about].” She says the positive response she has received from listeners and readers was followed by requests to do presentations in schools and in other countries. It was also the kind of boosting feedback that fuelled her to write a book.

Mofokeng says that when Macmillan approached her to write the book, launched on 7 August, she gave it some thought and told them she wanted it to have three parts: on sexual health, sexual pleasure and sexual rights. “I hope to get people to learn about their bodies and health conditions without realising that it is that deep and they are learning that much,” she says.

She explains that it is for pupils, teachers, the older generation, women, men and the queer community. “I think we are so disconnected [with our bodies], and I hope the book can really show people why sexual pleasure and sexual energy is inherently good, pure and beautiful. And how we can try and get to that place, and normalise healthy sexual behaviour and relationships.” 

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In October 2018, Mofokeng was part of the Johannesburg-based My Body My Choice campaign, where women and men marched for safe accessible abortion. She says that addressing a dialogue on abortion and the systematic stigma that surrounds it starts with the understanding that all people have the right to make decisions about their bodies, regardless of their age or where they are in terms of development. 

“People need to understand that an abortion is a medical procedure … [and] that those who do need it must be able to access it safely. Those who want information should be able to get information that is non-judgemental and not obstructive. People who are trained like nurses and doctors shouldn’t have a choice whether they want to learn or not,” she says. 

Patients’ rights

Mofokeng further accentuates the importance of healthcare practitioners being activists and advocating patients’ rights. “If you go to a clinic or a hospital, and you hear or you see that someone is being obstructed from getting a service, or they’re being discriminated against in some way because they are asking about abortion, you should stand up and immediately say something. But if we health workers, nurses and doctors don’t say anything, [it sets a tone]. 

“It is the health professionals themselves who need to lead the destigmatisation of abortion. It is us who are experts in this,” she says.

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Mofokeng agrees that South Africa has one of the most progressive policies in the world on the termination of pregnancy, which is stated in the Constitution. Furthermore, the Choice of Termination of Pregnancy Act of 1996 details the right to terminate pregnancy. But, she adds, those policies fail to influence programmes ensuring health care services are available for women.   

She ponders why, 25 years after apartheid, “most abortions in South Africa are happening outside of a health facility if we have a policy like the Choice of Termination of Pregnancy Act of 1996”. 

If the policy does not influence programming and available healthcare services to the people, it means nothing, she argues. Then it’s just something written on paper. “We need to demand accountability now as South Africans because we don’t have a policy problem, we have an implementation problem. There are of course global legal frameworks that are restrictive,” she continues.  

31 July 2019: Tlaleng Mofokeng believes “people need to understand that an abortion is a medical procedure … [and] that those who do need it must be able to access it safely.”

The thorny NHI question

On 8 August, Minister of Health Zweli Mkhize released the National Health Insurance Bill, which claims to provide affordable health care services to all South Africans and documented migrants. 

But, says Mofokeng, the Bill has major loopholes, because some areas of health remain unaddressed. She says issues around decriminalising sex work, the inherent stigma around abortion and the culture of antichoice in the health system still remain unregarded. 

“The marginalised will still face the stigma because no one is doing the work,” she says. “If you look at people who are transgender who need to transition, NHI is still not mentioning that hormonal therapy is more than just contraception. It is still not talking about procurement of generics that can make medicine cheaper.

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“Just because you are giving it a different name, it will not just suddenly change anything if there is no budget for it, and the thinking is still limited. For example, if I am a menopausal woman and I need hormone replacement therapy, but the public health system still only speaks about hormones as contraception, this is a problem because it means my needs as a menopausal woman are still not being taken care of.”

Mofokeng says the current problems in the health system can be resolved without the Bill. She questions how NHI will successfully work if the country’s current leadership is not committed to fixing long-term systemic problems.

Leadership, not money

“The problem is not money but leadership; we spend more on health than a first world country. It’s not money we need, [it is] leadership. We need to stop outsourcing government programming into non-governmental organisations, no one knows what culture exists in those NGOs,” she continues. 

For many years Mofokeng has been vocal about the decriminalising sex work through her work at the Sexual and Reproductive Justice Coalition, and she has taken part in debates around the topic. She says discriminalising sex work means that adults will not be jailed for engaging in consensual sex and negotiating how they want to have that sex.

“The law reform we are asking is decriminalisation, not legalisation. We just want them to remove the penalty that currently exists. South African criminalisation makes [sex workers] the target of more violence, [as well as profiling] what a person wears, whether one is a sex worker or not.”

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She says the current health system only talks about sex work as an HIV and Aids-related topic, and not as a human rights issue. “The health system is an example of how stigma can be structural and systematic … The focus on sex work in relation to sexually transmitted diseases is stigmatising. So many choose to not use condoms, that’s still their choice, just like the general population. Safe sex is not a sex worker thing,” Mofokeng adds. 

Apart from launching her book and partnering with colleagues globally, Mofokeng was invited by the Bill and Melinda Gates Foundation in Seattle in the United States of America to be a keynote speaker there in May and to share her story with 1 600 employees. 

A few months later, on 1 August, President Cyril Ramaphosa appointed Mofokeng as a permanent member of the Commission for Gender Equality. The commission is designed to attain and promote gender equality through public education, research and policy legislative initiatives and so is well aligned with many of Mofokeng’s own interests.

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