This paper places barriers to access to health care by adult transgender and gender diverse Africans under a human rights spotlight. It has three main objectives. First, it identifies the main barriers to accessing gender-affirming care in selected  African countries, namely, Kenya, Malawi, Nigeria, Senegal, Uganda and Zimbabwe. Second, it applies a human rights framework to address the barriers with an ultimate focus on overcoming barriers to contraception and abortion. Third, it integrates an African-centrered approach as an intersectional method for ensuring that the lived experiences and needs of Africans are placed at the centre for any normative framework.