Ursula M. Abanga

I have learned in many ways over my brief existence that being assigned female at birth could be one of the cruellest jokes nature plays on you. It’s even “funnier” when you’re assigned female at birth but don’t exactly feel like or identify as a woman or are generally masculine presenting. When the body you’ve lived in your whole life is still quite foreign to you, it hits different when people external to that body tell you how to live in it, especially when you’re just learning to make peace with an existence you’ll probably never understand.

Women experience a lot of pain, even during everyday bodily processes like menstruation, and we’ve come to accept some level of pain as normal. Until it exceeds a certain degree, it may not even occur to us that we may be unhealthy. This is part of why I’ve had the most painful periods since I can remember but have brushed them off as normal. I thought my cramps were normal. I thought that extremely painful periods are not that big a deal, even when they render you incapable of functioning.

The systems put in place to care for us reinforce this erroneous belief with how they (fail to) adequately care for us, treating our pain as important only if it threatens the stability of their patriarchal efficiency. You end up having to seek care in unconventional ways from unconventional places. The first time I did psychedelics was because I hoped they’d help with my pain. In some cases, like mine, you give up on finding a solution altogether and resign yourself to a lifetime of pain with the occasional dubious intervention when the pain becomes a little too much to bear.

Sometimes, my pain was nothing but a sharp-toothed toddler gnawing at my body. It was annoying, but not unbearable. Sometimes, it was a full-grown hydra, biting at my abdomen, clawing at my lower back and constricting my hips. I would rarely take painkillers, which barely worked for me anyway, even if I went above the recommended dose.

One month, a couple of years ago, the pain was of the bearable, gnawing-toddler variety. I endured it, as usual, because I knew that in five days when the bleeding stopped, so would the pain. Instead, the pain morphed into an insatiable hydra after my period ended, chewing relentlessly at multiple parts of my body. One of my housemates, Kojo, found me writhing on the floor because I was in so much agony. Not heeding my protests, he physically carried me into an Uber and took me to the hospital. Kojo was alarmed because in the many years he’d known me, he had never known me to complain about physical pain.

My first encounter with medical misogyny

Quite frankly, I had never really faced medical misogyny before then. I hate hospitals. Ghanaian hospitals do not inspire a lot of confidence in the healthcare system. Thankfully, apart from a chronic eye illness that requires the occasional check-up, I rarely fall ill and barely go to the hospital.

I didn’t realize that I had to perform my pain to be taken seriously. The doctor asked me how much pain I felt, on a scale of 1-10.

“About 13,” I responded truthfully.

“That can’t be true. You don’t look like you’re in immense pain.” He had a faint look of amusement when he asked this. He didn’t say it, but I could tell he thought I was exaggerating.

“I usually don’t express pain, especially publicly,” I answered.

“Are you on your period? Could it be cramps?”

“My period ended already. It’s not cramps.”

He proceeded to ask if I could be pregnant, and I told him no. I was certain because I was celibate, which was true. My housemate giggled when the doctor asked me that because he knew there was no way in hell my gay self was pregnant. The doctor ran a pregnancy test anyway without my consent or knowledge. I found out only because the hospital gave me an itemized receipt.

The doctor turned to Kojo and told him it was cramps, and I’d be fine, complete with a dismissive hand gesture. They pumped me full of drugs, and though the pain wasn’t subsiding, I realised that I was quite high. I slept. When I woke up, they discharged me and told me to return if the pain persisted. It did, and so I returned the following day.

I take Kojo with me everywhere because he is the only man on this planet I trust and feel safe around. At the time, I’d had a falling out with my family because they (mostly my mother) didn’t agree with my way of being—my style, my friendships, my choices.

I met a different doctor the next day. He asked me why I had come the previous day. I explained and added that I was back because I was still in a lot of pain. He looked at my history and said I was given tramadol, morphine and ibuprofen. I still couldn’t be in pain after being given those. His tone and expression suggested that I was drug-seeking, which maddened me. I told him I wouldn’t have even come if my housemate hadn’t dragged me there. I hate hospitals and only attend under extreme duress.

I was surprised to find out that these were the medicines I was given, because the previous doctor had never told me. I was also fuming silently because he’d asked me if I had any drug allergies, and I said—like I always do—that I don’t have any allergies I know of, but I have a stomach ulcer and am lactose intolerant. He had gone ahead and given me ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), something you shouldn’t give people who have an ulcer. This had made me ill a few days later, because he’d also given me pills to take for a week that I had no idea were NSAIDs too.

This new doctor recommended an ultrasound scan. I took Kojo with me, but the technician said he had to leave. I protested, saying he was my emotional-support human. The technician said the only way he was staying was if he was family. We’d lied on the hospital forms that he was my cousin. However, he still wasn’t family enough, according to the technician. Unless he was my husband, Kojo had to leave. I found it weird, but I didn’t give it much thought.

At this time, the pain was a very tangible presence on my skin. My abdomen was quite tender, and it hurt when the wand of the machine passed over my belly. I didn’t realize I was wincing or that my features had contorted until the technician said: “Is that how you do your face when you’re [explicit term for orgasm]?”

Wait, what?

I suddenly felt very afraid. I knew I was going to be awake throughout this examination, but I was still afraid that I would become a Twitter thread statistic detailing a medical professional sexually assaulting a female patient. I knew that ultrasounds didn’t need anaesthesia, but I had also never had an ultrasound. What if there was a way to knock me out and do unspeakable things to me while I was incapacitated? Why was this stranger asking me that? The man had the audacity to repeat the question and further ask me to “do your face like you do when you’re [explicit term for orgasm]and lemme see.” And that’s when it clicked that he’d asked my friend to stay out because he wanted to be able to harass me sexually without interference.

I felt violated by his hands on me, even though they were there to investigate the pain that was still persistently plaguing me. It felt that even though he was investigating my illness, he also gained some sort of perverted pleasure from touching me. I zoned out of the entire experience, in too much pain to call him out for being the disgusting creature I thought he was. I couldn’t wait to leave, as I very much wanted to scrub the feel of his hands off my skin, off my back, off my entire existence.

Back in the consulting room, the doctor looked at the results and asked me to go to the dispensary for my drugs. Erm, what? I explicitly asked what was wrong with me, what medicines he was giving me and what they were supposed to do. He seemed annoyed by my questions. “You have a haemorrhagic ovarian cyst, and the meds will take care of it,” he answered impatiently.

I was bleeding inside? Isn’t that what haemorrhage means? Shouldn’t he be more alarmed? He said I had a ruptured cyst, hence the pain. He gave me multiple antibiotics and an antispasmodic medication.

I asked him, out of curiosity, if a hysterectomy was a viable course of treatment. He gave me a strange, confused look and said no. I asked why. I really didn’t want a hysterectomy at the time. I’d known for a very long time that I didn’t want biological kids, but I hadn’t seriously considered removing my uterus.

The doctor looked me dead in the eye and responded, “But what if your husband wants kids?”

I told him that I didn’t have a husband, so that wouldn’t be a problem. Besides, wasn’t his first question supposed to be if I wanted kids, and not if some hypothetical man wanted babies from me? He gave me another look and said, “You’ll be very stubborn. I’ll tell your cousin to watch you.”

I was leaving when it occurred to me to ask if I should come back for a review. He said I could if I wanted. I went home and took my meds religiously. The pain didn’t go away, and I had to deal with the fallout of taking NSAIDs. I went to another hospital after a few days, as I didn’t think the first one was taking me seriously.

At this hospital, things were vastly different. The doctor patiently listened to everything I had to say. He called the gynaecologist, who scanned me and declared I had endometriosis and an endometriotic cyst. He also said I had fibroids. They explained to me with a drawing about the position of the fibroids, etc. I felt some hope. Here, these people seemed interested in what I had to say and what interventions could work. Boy oh boy, was I wrong!

I asked him if this meant I had to live with the pain until menopause or death, whichever came first. He said yes, adding that many women stopped experiencing this pain after childbirth. I told him that I didn’t want kids. I have been certain for a very long time that I don’t want biological children and thus there was no “after childbirth” for me. I asked about a hysterectomy. This time, I wasn’t just curious. I was considering it as a viable course of treatment. If this organ was going to cause me pain for at least the next two decades, I didn’t want it.

“But what if your husband wants kids?” He asked me, just like the other doctor.

“We see a lot of women everyday who want kids but can’t have any. If you can have kids, you should be grateful.”

I told him that I didn’t want kids at all.

But what if your husband wants kids? I remember this like it happened two minutes ago; his expression when he said it and the tone with which he said it. I remember that the rage I felt was so tangible I could taste it.

At this point in the exchange, the doctor turned to the nurse and said, as if I wasn’t in the room, “When they’re saying these things, don’t mind them. They only want these drastic measures because they are in pain. In the future, they will come and worry you and threaten to sue you for doing a procedure they asked for.”

Unimaginable things happened to me

I returned to this hospital twice and was admitted for nearly a week. Unimaginable things happened to me. I was routinely given NSAIDs, even when I protested. The doctor’s response was, “She’s in pain. Give it to her.”

I was there for days, but no further tests were run; I was just given drug after drug after drug. They wouldn’t tell me what they were giving me unless I asked—and when I did, they often patronized me or brushed off my questions. Every time I voiced a concern, they would leave, talk to my (male) housemate in the lobby, and then he would have to come and relay the information to me. A lot of things happened that were a gross disregard for my autonomy, my personhood and my right to know as a patient.

They gave me hormones that stopped my period, and after a few days, an injection in my belly that cost GHS 1,700 (158 USD). Before they gave me progesterone, they explained that it would stop my periods, and I perhaps couldn’t conceive for up to two years if they gave me the shot. The shot in my belly? They didn’t tell me what it was for, only that it was because I was in pain and it would help. (Later on, I found out it’s not a painkiller.) I would ask constantly: Why am I still here? What is wrong with me? Won’t you run other tests? I’m still in pain despite all the things you’re pumping me with. Isn’t that cause for concern? They were happy to send me invoice after invoice though. My ordeal in both hospitals made me at least GHS 10,000 (940 USD) poorer.

I left the hospital at midnight after I’d been there for nearly a week, with no clear indication of what was wrong with me or what was being done to arrest it. I had nowhere else to go, but I knew if I stayed, I would die. My other roommate tried to reason with me, but I was adamant. I was going to leave that hospital that night, even if it meant sleeping by the roadside until it was early enough to get a ride home. I refused to die because some doctor was treating the idea of who I should be, and not who I actually was.

In both hospitals, the idea of being reduced to a vessel for someone else’s offspring made the whole experience feel violently surreal. The misogyny was so casual, I realised these men were used to telling women how to exist in their bodies and getting away with it. As long as my ability to have children wasn’t interfered with, no one cared that I was in excruciating pain.

My people started showing up for me even before I was aware of it.

It started with my boss. She couldn’t stand that I was in pain, and even though she doesn’t live in Ghana, she made calls until she found a hospital that saw me as a whole person, not just as a potential womb for some imagined husband. She found Obaatan Pa Women’s Hospital. The first thing that was different about it was that there wasn’t a male doctor in sight. In fact, I would not encounter a male doctor there until two years later, when I got surgery. He was the anesthetist.

The second different thing was that the doctor didn’t finish my sentences or seem impatient. She listened attentively to everything I had to say. In the middle of my story, she was outraged at what I had been through. I habitually write things down, and I had made a note of every single drug the other hospitals gave me. I had an almost complete history of my treatment, or perhaps the gross lack of it. Thanks to this, I found out from my new doctor that the doctors at the second hospital had induced menopause in me, without my knowledge or consent. The shot in my belly? That was what it was for. For people who were so concerned about preserving my ability to have kids, this was a weird development.

The first thing this doctor told me during the ultrasound was: “You need surgery. The fibroids and cysts are everywhere!” She had me do a more thorough scan and other investigations. I had multi-uterine fibroids, cysts, endometriosis and a distorted myometrium. I was going to need, at the very minimum, a myomectomy. I didn’t bring up a hysterectomy; I had been too traumatized by my last experiences.

I had a definite diagnosis now. I knew what monster it was that was gnawing at my skin with the audacity of a mediocre straight man. The next step would be wrangling the beast. Most people say that naming your demons is the first step to winning against them, but for me, it’s usually the first step into depression and a feigned nonchalance about the issue at hand. Sometimes naming your demons demonstrates how sorely unequipped you are to fight them. At least when you didn’t know what you were fighting, you had the excuse of a lack of knowledge.  Even the Christian god attributes the perishing of his people to the said lack of knowledge. No one can judge you for losing a fight with a nameless foe.

I needed a lot of money if I wanted to excise the cysts and exorcise the demons.  But how does a struggling artist come up with that kind of money in Accra, a city that’s severely overpriced? I went back home and gave up.  I had spent all my savings at the two hospitals before this one, on expensive medicines that treated my symptoms but didn’t take away the cause of the problem. The fact that I even had savings in the first place had been a miracle. Did I already mention that Accra is overpriced, underpaid, and has a barely functional transportation system? My money was gone. By the time I could save up again, the costs would’ve risen. Even though it was a painful existence, I made my peace with it.

It didn’t occur to me that I could turn to my friends for help. I was raised to be self-reliant; it was all I knew. I’d heard of crowdfunding, but I didn’t know how or where to start. And deep down, I doubted I even knew enough people to raise that kind of money.

I didn’t have any pain for some months, thanks to the hormonal treatments I received at the second hospital where they’d stopped my periods. But in January of 2024, my body remembered how to bleed again. I lived with the pain and temporary interventions; overdosing on painkillers, doing (illicit) drugs that would knock me out just to escape the pain for a while.  I was truly resigned to my fate, chale.

The juju that healed me.

It started with a friend sharing a fund for queer people needing money for health interventions. I applied and after a few months of hoping and praying, I received enough funds to pay for half the surgery. However, I first had to prove to them that I could pay or raise enough funds for the other half. Again, into the recesses of despair I went. Relying on the queer fund meant putting all my eggs in one basket. It wasn’t as if I had many baskets to begin with, and this one basket was contingent on my having more eggs. I was hopeful, but also in that weird limbo where hope feels silly.

The juju continued with my partner. At the time of my diagnosis, we were two people who worked together, steadily becoming friends. The only reason she knew I was unwell was because I used to vent about the pain at work. We started going out somewhere in the middle of last year, and she witnessed firsthand how hard it is to exist in my body. She started a GoFundMe page to supplement the queer health fund. We were steadily gathering the eggs, and soon, I would need more baskets than I ever thought possible.

My workplace, Adventures From the Bedrooms of African Women, collaborated with Drama Queens Ghana to host a fundraiser for me. Most people who attended didn’t even know who the funds were for. They only knew they were helping a community member who needed surgery. But people showed up. People gave. And they gave so generously, I wept. Because I didn’t think we’d raise anything substantial. The economy has been in the gutter for years. People have to do a lot with the little they have. Prime example; me. A salaried worker who, after paying the bills and fending for myself, had nothing left over for this vital procedure.

In hindsight, I’m a bit ashamed of myself for believing my people wouldn’t show up for me. Community isn’t something you stumble into. It’s something you build painstakingly, brick by brick. You show up for people in thought and in deed. You party together, you cry together, and you live together.  To build community, you do the important, mundane and annoying things.  For beloved and sometimes annoying people. And they do the same for you, because you too are beloved. I’d done all of this with my people and yet it didn’t occur to me to turn to them for help. I had many friends get cross with me when they found out I’d been needing money for surgery for a while and had never mentioned it.

The juju continued with LGBT Rights Ghana sending me money for the total cost of the surgery. Again, the HR manager at LGBT Rights was cross with me for not saying anything. I’d volunteered with them since 2021, and they couldn’t believe I didn’t reach out when I needed help. They only found out because they saw the link for the GoFundMe page circulating.

Whenever I think about empathy being radical, I think of the Ghanaian queer community, and the many rainbow-infused pockets around the globe that I hear and read about it. This sort of empathy is revolutionary and may be a major contributing factor to us toppling the oppressive systems determined to subjugate and erase our existence as women, nonbinary and queer folk.

The general consensus in Ghana is that people with locs, piercings and tattoos have a hotline straight to the devil. The propaganda is packaged and sold to us subtly at first, and then aggressively. The idea that people who don’t present in conventional, heteronormative ways are bad is an overused and very tired narrative in Ghana. It’s propounded by systems that claim to care for you and have your best interests at heart. I do this, tell you this, because I love you. I want only the best for you. Yet it is these very systems, when we need the most basic care, that turn us away, or at the very least, demand compliance to their warped conditions before our needs are met. Even then, care isn’t given to us in the ways we need, but rather in the way the system deems right for us.

This may sound unhinged, but there is a sacred alchemy that occurs when pariahs band together. Pariah may be a strong word, but I think it serves the purpose here quite beautifully. With the acceptance that you have no one else but one another comes a certain power that defies the very boundaries that society would confine you with. You learn to love each other, care for each other, and collectively navigate systems designed to drive you mad with despair. All the care that is denied us, we give to ourselves and one another in exponential quantities. It is this realization that has kept and still keeps me going.

My own mother has said explicitly and subtly that friendships are fleeting. She says, “You can say that person was my friend.” A lot of her angst stems from the fact that my friends and chosen family are the people that they tell you not to relate with. Men with locs and piercings and tattoos, women who are comfortable in their bodies and flaunt them, fabulous androgynous-presenting people who would make your brain glitch trying to figure out where in the binary to place them. She’s not wrong. Everything is fleeting. Even this life, which we cling to so desperately, is ephemeral. This is what makes the care you receive from your people even more special. We all have limited time and resources on this blue ball, and I am honoured and glad that these people choose, consciously, to share theirs with me.

Queer resistance isn’t always a march or a manifesto. Sometimes, it’s the quiet certainty that you are not alone. This assurance does a lot for your mental health.
In March 2025, I had a myomectomy and endometrial excision. It wasn’t the hysterectomy I wanted, but it was a necessary intervention to make my life easier. I was never alone during my stay at the hospital. My mother visited every day, bringing fruit and medicines and sitting with me.

My apartment is about an hour away from the hospital, and this is on days when traffic isn’t terrible. A friend who lives 20 minutes away from the hospital gave me her apartment to live in.

“You would need to go for reviews. Besides, anything could happen during recovery, and you may need to rush to the hospital.”

I was moved because that hadn’t occurred to me. This proved to be a blessing because I needed to go to the hospital when I suddenly had difficulty breathing in the middle of the night, a few days after I was discharged. Hospital visits became frequent for about a week, and the shorter distance helped.

My friend Rachel moved into the apartment where I was living while I recovered (the owner has two rooms, and she was away during my recovery) so she could take care of me. My mother visited every week with fresh foodstuff, fruit and toiletries.

And oh, did I mention that another friend drove me to and from almost all my hospital visits? My partner was back in the US, where she attends university and so couldn’t be physically present. She gave her car keys to her best friend and this man was my chauffeur till he was certain and satisfied that the surgery site was healed and I could take public transport again. He lived about ten minutes away from where I was staying, which made it easy for him to drive me around at random times. Anytime I wanted to run an errand, he would come pick me up, driving very carefully to ensure that the bumps and potholes in the roads didn’t jiggle us too much. I know this took some effort because Kwadwo doesn’t drive like that. He usually drives like he had to be somewhere yesterday and he’s just now leaving.

A little fun thing about getting surgery in your abdominal region is that you can’t allow yourself to get constipated. It’s fun because a consequence of getting surgery in your abdominal region is that you will get constipated quite often. I would get constipated, take a laxative, run for a few days, get constipated again and thus began a vicious cycle of stomach and anal pain. I eventually figured out the exact amount of milk of magnesia I had to take to ensure that I didn’t run. While I was still caught in the loop, my friend Benewaa showed up with a large bowl of soup, and two big bottles of coconut water. Benewaa has had abdominal surgery and has experienced this cycle firsthand. She brought me exactly what I needed when I needed it, and I didn’t have to ask.

I’m still healing. Some days are hard. Endometriosis doesn’t disappear, and I still live with a lot of pain on most days. I don’t have abdominal pain anymore, but the lower back pain just won’t quit. However, this pain feels significantly reduced because my people showed up for me and I couldn’t be luckier.

Now, I talk about my body with more defiance, clarity, and joy. I tell people openly and freely that I don’t want biological kids. After going through all this pain, I refuse to live as anything but myself. After all, I have people. I may not be everyone’s cup of tea, but I am the exact brew needed to complement the unique flavor palette my community needs to thrive. As cliché as it sounds, I am because we all are. I haven’t given up or thought about giving up anymore, because how dare I give up on myself when my people won’t give up on me?