In Zimbabwe, intersex children face painful, unaffordable journeys to specialist care, while some young mothers confront superstition, violence and rejection.
By Tendai Makaripe
At school, Tapiwa sometimes suppresses the urge to pass urine; not because there is no toilet, but because using it can bring intense pain and unwanted attention.
“I sometimes fear going to the toilet because the pain can be too much,” he said.
“I try to suppress it so that I appear strong. Our school toilets usually have people around, so there is no way I can go there without being noticed.”
At 13, Tapiwa is learning to conceal both pain and vulnerability.
He was born with variations in sex characteristics, often described by the umbrella term intersex.
There are more than 30 different intersex variations.
Such variations may involve a person’s anatomy, reproductive organs, hormones or chromosomes and may not fit typical definitions of male or female bodies.
To protect his privacy, Tapiwa is a pseudonym, while his village and school have been withheld.
Tapiwa’s experience exposes the gap at the centre of Zimbabwe’s emerging debate over intersex rights.
Even as a High Court case seeks legal recognition and protection, children such as Tapiwa can struggle to reach specialist care, remain in school and obtain protection from ridicule and abuse.
Interviews with mothers of intersex children in Buhera, Wedza and Mutare show how distant referrals, unaffordable medical investigations and poor information can shift the cost and coordination of care from public institutions to families least able to carry that burden.
Tapiwa’s experience also echoes wider research.
A peer-reviewed study by Pearl Gambiza and Hellen Venganai, based on interviews with Zimbabwean intersex children aged 8 to 16, found that legal invisibility and cultural and religious beliefs threatened their education, bodily autonomy and health rights.
For Tapiwa, the gap between recognition and care opened at birth.
Seen, but not told
Tapiwa’s mother said nurses at Buhera Rural Hospital gathered around her newborn and called colleagues to see him.
No one explained their interest before she left the hospital the following day.
Three days later, the baby cried continuously and struggled to pass urine.
When she returned, a senior nurse told her that staff had noticed the child’s sex characteristics at birth but feared she was too young to accept the news, the mother said.
The hospital referred Tapiwa to Murambinda Mission Hospital, where medication and injections enabled him to urinate, according to his mother.
Doctors later advised her to seek specialist care at Sally Mugabe Central Hospital in Harare, but neither parent had formal employment, and she could not initially afford the journey.
“At one point, I went back to Murambinda Hospital but failed to get help,” she said. “They argued I was being hard-headed because I had not taken the child where I had been referred.”
She eventually reached Sally Mugabe Hospital, where she remembers being told that doctors could assess which organs functioned and consider an operation after Tapiwa turned 12.
A Mutare mother who spoke to the reporter described a similar referral chain involving her 3-year-old child.
She said Mutare Provincial Hospital referred the child to Parirenyatwa Group of Hospitals, which then referred the family to Sally Mugabe Hospital.
The mother said clinicians told her that tests had identified ovaries internally, while the child had external sex characteristics she understood as both male and female.
“We need money for the operation, and the hospital requires US$235, which I do not have,” she said.
These cases show that the children came from different communities, but their accounts reveal the same weakness: hospitals issued specialist referrals without a coordinated system to help them afford transport, investigations, treatment and follow-up care.
A referral told them where to go; it did not make care accessible.
A urologist, who requested anonymity because his employer bars staff from speaking to the media, said there is no medically significant birthday at which surgery automatically becomes appropriate.
“Turning 12, for example, is not itself an indication,” he said.
Gumisai Bonzo, director of TransSmart Trust, an organisation supporting transgender and intersex people, said families seeking its assistance can face more than US$300 in diagnostic costs before doctors determine whether a procedure is necessary.
TransSmart Trust sometimes helps families raise the money, but that assistance also exposes a larger failure: access to essential care remains dependent on charity instead of a publicly funded route from diagnosis to continuing care.
When mothers carry the blame
The consequences of fragmented care do not end at the hospital.
Bonzo said children referred to the organisation come from communities including Buhera, Wedza and Mutare.
Some have young mothers who married or eloped into families they believed would provide financial security, only to find themselves carrying responsibility for the child’s care with little support.
In one Buhera case, paternal relatives accused the child’s mother and her family of witchcraft, subjected her to physical and emotional abuse and eventually forced her out, Bonzo said.
In Wedza, relatives expelled another mother after her husband relocated to South Africa, according to Bonzo.
Overwhelmed and without support, the woman left her child at a clinic, but nurses later returned the child to her care, Bonzo said.
Another Wedza woman described how her husband pressured her to terminate a second pregnancy because he feared they would have another intersex child.
“I bled heavily after this because traditional methods were used for the abortion. I later required medical treatment for heavy bleeding,” she said.
These cases illustrate the gaps in medical information, financial support and continuing care that can compound gender-based violence.
When institutions fail to explain a child’s needs or make care accessible, the burden and blame can fall on the least powerful person in the household: a young mother.
In that vacuum, poverty is recast as disobedience and medical uncertainty as witchcraft.
Hellen Venganai, director of the Gender and Diversity Centre at Women’s University in Africa and co-author of the study cited earlier, said legal invisibility allows intersex children’s needs to be overlooked across health and child-protection systems.
“Recognition must be matched by action,” Venganai said.
She called for specialised psychosocial support for intersex children and their families, better training for health workers and support systems developed with the affected children.
“Most importantly, intersex children should be consulted to come up with child-centred support systems,” Venganai said. “Their voices matter.”
Pain enters the classroom
The consequences of delayed care follow Tapiwa into the classroom.
“I am closest to my mother because people at school often laugh at me,” he said.
He also relies on a friend who lives near his home.
“He understands me. He shares books with me when I fail to go to school because of ill health,” Tapiwa said.
“Sometimes the pain is so intense in the area below the belly button that I struggle to go to school.”
The support Tapiwa described receiving during those absences came from another child.
Other pupils have called him ngochani, a Shona slur commonly directed at gay people.
The insults have also left him uncertain about how widely his condition has been discussed among pupils.
“My confidence has been ruined because I do not know what has or has not been said about me,” he said.
Rotina Mafume Musara, a women’s rights activist, said the slur reflected a fundamental misunderstanding.
“Intersex is about biological sex characteristics, not sexual orientation,” she said.
“Our research found that stigma and inadequate support from school authorities contributed to some intersex children leaving school, harmed their mental well-being and created barriers to obtaining appropriate assistance,” she said.
Zimbabwe’s School Health Policy commits the country to equitable health services for learners and stronger coordination between health and education.
Tapiwa’s experience exposes the distance between that promise and a child who misses lessons because of pain, depends on a friend for books and faces ridicule when he returns.
She called for teacher training on diversity and inclusion, confidential support services and school facilities and policies that protect intersex learners’ dignity and privacy.
For Tapiwa, those protections would be concrete: using a school toilet without unwanted attention, receiving support when pain keeps him home and returning to class without ridicule.
Recognition without care
Zimbabwe is debating legal recognition amid a basic information gap: A review by the reporter found no published national count of intersex people in the country.
The United Nations human rights office says experts estimate that up to 1.7% of people are born with intersex traits, although the broad estimate includes variations that may not be visible at birth or require medical intervention.
Kenya offers a regional precedent.
Its 2019 census recorded 1,524 intersex people, a count, not an estimate of prevalence, and its 2022 Children Act expressly protects intersex children’s dignity and rights to appropriate medical treatment, care, education and freedom from discrimination.
In 2023, the African Commission on Human and Peoples’ Rights called on states to prohibit non-consensual genital-normalisation practices, train health workers and provide counselling to intersex children and their families.
Women’s rights activist Rotina Mafume Musara said such protections need not come at the expense of culture.
“Sometimes the law has to catch up with human reality, not because culture does not matter, but because culture, like law, must be capable of protecting human beings,” she said.
That debate has now moved into Zimbabwe’s courts and government.
In August 2026, the Justice Ministry convened ministers, experts and people with lived experience following a September 2025 High Court application, HCH4743/25, by seven individuals, including two minors, alongside two organisations.
The applicants seek legal recognition, appropriate identity documents and protection from non-consensual, non-essential surgery.
Dorcas Chitiyo, a justice, gender and social inclusion specialist, said the applicants want the law to recognise intersex as a distinct category and make an “I” marker available on identity documents.
Public Service, Labour and Social Welfare Minister Edgar Moyo acknowledged that child protection falls within his ministry’s mandate.
“The way forward is legislation to address this gap, as well as awareness campaigns,” he said.
Yet future legislation is only part of the answer.
The ministry’s website says its National Case Management System already provides comprehensive child-protection services through social workers and community child care workers.
Tapiwa’s mother, however, said no social worker or community child care worker connected the family to continuing medical care, counselling or school support.
A protection system cannot coordinate care for a child it never reaches.
Legal recognition could help resolve damaging contradictions in identity documents.
It cannot, by itself, bring specialist care closer to Buhera, cover the Mutare child’s reported US$235 bill or protect a mother accused of witchcraft.
For years, other people have interpreted Tapiwa’s body: nurses, relatives, doctors, classmates and, now, policymakers.
He is no longer the newborn around whom adults can speak as though he is absent.
“I wish people understood my condition,” he said. “I also wish that those with the power and resources to help would assist me.”
Zimbabwe’s policy debate may eventually change laws and identity documents.
Tapiwa cannot live only in that future.
For now, even an ordinary visit to the school toilet can force him to choose between enduring pain and risking unwanted attention.
