TODAY -

Report on Rights of Transgender people and HIV vulnerability

Shobha Shukla *

Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region



A study titled Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region was released in Bangkok to mark the International Day Against Homophobia and Transphobia. According to this research, which was jointly released by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN), transgender persons are among the most socially ostracized in this region and lack fundamental rights, including basic access to health care and social protection schemes. So there is need for concerted action by governments, civil society, development partners and the transgender community itself to design and conduct further research to fill the lack of information about transgender people and their environments.

The report seeks to examine literature on laws, regulations, policies and practices that prompt, reinforce, reflect or express stigma and prejudice towards transgender people. It seeks to identify vulnerabilities to HIV and barriers to access or uptake of HIV related healthcare services, and attempts to establish a research agenda aimed at providing the sort of data that will enable a reduction in future risk, as well as better access to treatment, care and support for transgender people living with HIV.

According to Dr. Sam Winter from the University of Hong Kong, the author of this report and a noted expert on the challenges of transgender people, “For too long, trans people have been lost in transition. Pushed to the social, economic and legal margins in a majority of countries in this region, trans people often suffer from poor emotional health and well-being. Many find themselves involved in risky behaviours and situations, such as unsafe sex and involvement in sex work. Social exclusion, poverty and HIV infection contribute to what we call a ‘stigma-sickness slope’, a downward spiral that is difficult to reverse. We hope that this report will demonstrate the burning need to address a very human crisis, viewed through the prism of HIV, which has taken a devastating toll on millions of our fellow citizens in our region and beyond”.

Although national reported data remains limited, there is growing anecdotal evidence that HIV prevalence rates among transgender people in the region have reached critical levels. These reported numbers commonly exceed the prevalence rates among men who have sex with men, and young transgender women are thought to be at particular risk. Data from one Southeast Asian city suggests that over the four year period from 2003-2007, HIV prevalence among transgender people rose from 25% to 34%.

The Asia-Pacific region is home to a large number of transgender people-- individuals whose gender identity, and/or expression of their gender, differs from social norms related to their gender of birth. Trans women here are birth-assigned males identifying and/or presenting as female, or (in those cultures, where it is accepted that there are more than two genders) as members of another broadly feminised gender. Trans men are birth-assigned females identifying and/or presenting as male or as another broadly masculinised gender. There are possibly 9-9.5 million trans people across this region, but the existing small scale research is largely limited to trans women, an alarming number of who are estimated to be HIV positive, with prevalence rates as high as 49%. There appears to be no data at all on HIV rates among trans men, and the number of trans people of either gender who have died of AIDS is also unknown.

Another challenge is that throughout much of the history of the global HIV response, transgender people have remained invisible and have seldom been properly recognised as a distinct population for purposes of confronting the HIV pandemic. They often find that sexual healthcare services are not suited to their needs and are focused instead on females and on MSMs. Even when it comes to national HIV programming and funding they are usually treated similarly as MSMs. “We are most definitely not MSM,” stressed Prempreeda Pramoj Na Ayutthaya, a noted Thai transgender researcher and activist.

“Many of us are physically very different, either as a result of hormone replacement therapy or other medical procedures. Some of us have had a complete sex change. There is much we still don’t know about our particular vulnerability to HIV, and that needs to change.”

The regional HIV epidemic among transgender people is strongly linked to stigma and prejudice which results in prompting patterns of discrimination, harassment and abuse (verbal, sexual and physical) in the family, at school, in the workplace, in the provision of services (including health) and in society as a whole. Transgender people become marginalized, both socially and economically, with the Asia-Pacific legal environments further failing to offer them sufficient protection against discrimination and serious forms of sexual assault by withholding legal recognition of self-affirmed gender, criminalising their sexual behaviours, and subjecting them to gender-inappropriate detention practices, as well as contributing to police abuses. These experiences can damage their psychological and emotional wellbeing, conspiring with other factors, (such as poverty) to tilt them into situations that put them at risk of HIV as well as risk of other threats to their physical and mental well-being. Unsafe sexual practices appear to be common among them and most of them are quite badly informed about the associated HIV risks. Even the few who are well-informed nevertheless engage in unsafe sexual practices.

Ban Ki Moon, United Nations General Secretary is worried that, “We see a pattern of violence and discrimination directed at people just because they are gay, lesbian, bisexual or transgender. There is widespread bias at jobs, schools and hospitals, and appalling violent attacks, including sexual assault. People have been imprisoned, tortured, even killed. This is a monumental tragedy for those affected – and a stain on our collective conscience. It is also a violation of international law.”

Transgender people approaching any type of health services commonly report that services are often difficult to access. Healthcare providers are uncooperative and respond to them in a gender inappropriate way, adopt a mocking or ridiculing attitude, and withhold/ refuse healthcare. So, some take care of their own healthcare needs as best they can (e.g. getting hormones wherever and whenever they can, and taking them with little or no medical supervision). Those who seek gender affirming surgeries find them to be the extremely expensive procedures. Confidentiality is not always assured, especially in regard to mandatory HIV testing for sex workers, which compounds the problems in accessing appropriate care.

Despite the dismal scenario, the report points out at some encouraging developments too. Among these is a developing transgender identity, a growing pride and an increasing willingness on the part of transgender communities to advocate for increased participation in policy processes and organize peer support services at a national and regional level. The Asia Pacific Transgender Network has been recently established to advocate for the right to access health services, to demand that laws which criminalize transgender people be repealed and to reiterate that vulnerability to HIV is couched within the larger context of human rights.

“The creation of advocacy networks, community-based organisations and non-government organisations devoted to empowering and strengthening our communities is a source of joy. You cannot separate our social well-being and human rights from our efforts to address HIV within our communities. We are pleased that the UNDP report recognizes this.” said Prempreeda.

The report emphasizes that inclusive research, designed and implemented in partnership with the transgender community, is critical to enable governments, community based organisations and supporting organizations to enhance HIV and sexual healthcare services specific to the needs of transgender people, and foster action by governments to adopt more socially equitable policies and practices to protect their rights. (CNS)


* Shobha Shukla - CNS contributes regularly to e-pao.net
The author is the Managing Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also authored a book on childhood TB (2012), co-authored a book (translated in three languages) "Voices from the field on childhood pneumonia" and a report on Hepatitis C and HIV treatment access issues in 2011. Email: shobha(at)citizen-news(dot)org, website: http://www.citizen-news.org
This article was posted on May 28, 2012 .



* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Mera Wayungba #2 : Gallery
  • Ningol Chakouba @Pune : Gallery
  • State Level Basketball : Gallery
  • Sangai Fest : Program Schedule BOAT
  • Sangai Fest : Lamboi Khonangkhong
  • Sangai Fest : Hapta Kangjeibung
  • Sangai Fest : Keibul Lamjao
  • Sangai Fest : Shumang Lila
  • Godhra- Journey of a PM :: Review
  • Combating drug abuse in Manipur
  • Ningol Chakkouba celebrated at Pune
  • Glamour at 55th Naga's Meet 2018, Delhi
  • Myanmarese greeted at Khudengthabi
  • Rejoinder to PRO IGAR(s) statement
  • Quami Ekta Divas
  • Subsuming a smaller tribe
  • Kwatha Festival #2 : Gallery
  • ChingTam Ningol Chakouba @Goa: Gallery
  • Thoudam Kaoba :: Profile of Polo Player
  • The festival of the Inpui Nagas
  • IGAR (s) celebrates Ningol Chakkouba
  • Muslim Org met with Union Minority Minister
  • Thadou Students' condemns Assam Rifles
  • AR condemns the claims of TSA
  • Maintaining traffic regulation is important ..
  • Pony preservation still remains a far cry
  • Hazari/Tombi Polo Tournament : Gallery
  • X-Jam 2018 (Sports) #1 : Gallery
  • Ashok Veilou (Purul) award in Kolkata fest
  • Sanamahism was threat to Hinduism
  • Digital Impact on HR Practice : Review
  • Biodiversity for economic development #1
  • The Visitor :: Poem
  • Ningol Chakouba @ Mysore #2 : Gallery
  • Yoilumba, Chiranglen, Chingjaroi :: eMing
  • Pukning Pothasang: Women Mental Health
  • Scaramouche, Fandango, Galileo, Figaro..
  • A cry for survival: an appeal for unity
  • Who will answer our questions ?
  • Seminar : Challenges in Local Self Govt
  • Tourism and Sangai Festival
  • New leader at MSCW
  • Laija (Film Scenes) #1 :: eRang
  • Ningol Chakouba @ Dubai #2 : Gallery
  • Countdown to Manipur Polo International
  • Education for 21st century jobs
  • The corrupt tiger
  • Can you stop falling rain :: Poem
  • Scholars translate celebrated Nepali..
  • Of harassment at Imphal-Moreh Route
  • Need for a strong Opposition
  • Lamklai Kummoi Maring Fest #2: Gallery
  • National School Games- Fencing: Gallery
  • We want the ring...
  • The Queen's Heart :: Poem
  • Education of heart: Heart of Education
  • Mao - The Revolutionary
  • Discussion on India-Vietnam Relation
  • Sangai of the Sangai festival
  • Jarnail in his element
  • Tough road awaits Sarita in World Boxing
  • ACAUT says NNPGs unable to rein..
  • State has no say in ILP - Conrad
  • Ningol Chakouba @ MBC #2 : Gallery
  • Ningol Chakouba Nga Mela #2 : Gallery
  • Rajkumar Jhaljit : Sahityaratna 2017
  • Gaudiya Vaishnavism in Meitei Nation #2
  • Ningol Chakouba :: Poem
  • World Diabetes Day 2018
  • Bartending as a career option
  • The unintended windfall
  • Issues before the Parliamentary polls
  • Mera Kongchat Mass Rally #3: Gallery
  • Rock Show at X-Jam 2018 : Gallery
  • Bloody Phanek wins at Signs Festival
  • Gender Equality & Development :: Book
  • I am friend of India for life- Japanese PM
  • 2019 Commonwealth Scholarship in UK
  • 55th Nagas' Meet at New Delhi
  • Black money and the dream-merchants
  • What steps to address traffic chaos ?
  • Govt extends ban on seven Meitei groups
  • It won't be easy for Mary Kom - Nieva
  • Ningol Chakouba @ Mysore #1 : Gallery
  • Ningol Chakouba @ Dubai #1 : Gallery
  • Cry of a Dying River - 54 :: Poem
  • Religious education- Part of our life
  • Free Heart Camp at Kakching Bazar
  • Jobs at Gyan Jyoti Foundation
  • Nothing seems change; everything remains
  • Predatory instinct of man: Targeting 'Manipur'
  • Lihaaz- Classical Music at IIT Guwahati
  • Mera Wayungba #1 : Gallery
  • L Modhuchandra : Young Scientist Award
  • Chavang Kut celebrated in Delhi
  • Temple runs for a pilgrim's journey
  • First day of All India Young Writers' Festival
  • Ningol Chakkouba in era of materials
  • Constitutional breakdown in governance
  • Attacked on Environment Defenders
  • Kut festival @ Chandel : Gallery
  • Mega Marathon Manipur #2 : Gallery
  • Karen people's pursuit for survival..
  • Glamorous Maniac & their new single
  • City bus for high end of society- Why not?
  • Youth Leadership Camp at Yairipok
  • Course in Political Science at NEHU
  • Of Indian Constitution
  • Ningol Chakouba @ MBC #1 : Gallery
  • Ningol Chakouba Nga Mela #1 : Gallery
  • NH7 Weekender @Meghalaya #2 : Gallery
  • Gaudiya Vaishnavism in Meitei Nation #1
  • Old Man in the Winter :: Poem
  • Drawing inspiration from Dave Mustaine
  • Condemns attack on Agnes Kharshiing
  • NEUFC Fan Park celebrates
  • Achievement lists of PDA is 'Boring'
  • MPP : Down but not out
  • Ningol - mapam lamdam : Gallery
  • Kwatha Festival #1 : Gallery
  • Ningol Chakkouba: Biggest fest of Manipuri
  • Mizoram Under the British Rule :: Book
  • Dr. Udit Raj: a Crusader
  • Undisclosed #MeToo campaign in Manipur?
  • Drought :: Poem
  • When Money matters, sincerity is out..
  • Detaining two more at Jiribam
  • Ningol Chakkouba : Flash Presentation
  • Ningol Chakkouba Shopping #1: Gallery
  • The Killing Fields 2013-18 : News Timeline
  • Those Sparks and Sounds
  • Manipur from Independence to Merger #2
  • Understanding RSS :: Book Review
  • Cry of a Dying River - 53 :: Poem
  • A take on Freedom of Media
  • Pay of private school teachers
  • Mera Kongchat Mass Rally #2: Gallery
  • Art Festival @ Imphal : Gallery
  • 26 month left to meet AIDS 90-90-90 target
  • Tengnoumanbi- Essential food item ..
  • Dr Abdul Kalam vision of transforming India
  • A Wintry Landscape :: Poem
  • 'Say no to Lead Paints'
  • Completing bigger task
  • Biomedical wastes: Health, ecology at stake
  • NIA files chargesheet against 5 NSCN (K)
  • Ningol Chakouba @ Kolkata : Gallery
  • Mera Houchongba @Konung #3: Gallery
  • Irony of idea of communal harmony
  • Blood Donation at RGU, Arunachal Pradesh
  • Career opportunities in Ecology #2
  • Down the Country Road :: Poem
  • Change of season: Prepare for winter
  • Govt forgotten promises to improve traffic
  • ATC demand: Setback to pluralistic Manipur
  • Mega Marathon Manipur #1 : Gallery
  • Descent & inheritance among Zeliangrong
  • Constituent Assembly Of India & NEFA #3
  • Seminar : Reforming Teaching-Learning
  • Attitude :: Poem
  • Tourism: A key sector in the world
  • NH7 Weekender Meghalaya : Day 2 Report
  • Early solution in Manipur difficult : Army
  • Fabrics of Bangladeshi Manipuri: Download
  • NH7 Weekender @Meghalaya #1 : Gallery
  • Pukning Pothasang: Suicide prevention
  • Where have all the flowers gone? Khurkhul
  • Engaging Failed State :: Book Review
  • eNorth East Award 2018
  • Song of a Tree :: Poem
  • NH7 Weekender 2018 Kicks Off
  • Unsolved case of Pravish Chanam
  • Imphal Jamboree : Gallery
  • Eyek Tamba :: Learn Manipuri script
  • Manipur from Independence to Merger #1
  • A beacon of hope
  • Mishing tribe of Assam
  • Ransomware that made the world cry
  • State Level Painting Competition
  • A suggestion for a strong democracy
  • Issues before Parliamentary polls
  • Kut Festival @ Kangpokpi : Gallery
  • HIV : Gap between research & impact
  • My Tryst With Manipur : A Memoir :: Review
  • Cultural heritage (Kut fete)
  • Bleeding inside Brain treated at SKY
  • Indo-Myanmar Regional Border Meet
  • In Her Arms Of Death :: Poem
  • Pravish Chanam : No Action by CBI
  • Assam Don Bosco : University of the Year
  • NH7 Weekender 2018 in Meghalaya
  • Media that criticize are not your enemy, CM
  • MU limping back to normalcy
  • Mera Kongchat Mass Rally #1: Gallery
  • Happy Kut Wishes :: Flash Presentation
  • November Calendar for Year 2018 :: Tools
  • Weavers training for Mamit , Mizoram
  • Diwali Lagao : Mapugidi Munda
  • Career opportunities in Ecology
  • Jobs at Trueblue, Taxi Service, Imphal
  • CM should not let this opportunity out..
  • Where will Oct 31, 2018 stand ?
  • Mera Houchongba @Konung #2: Gallery
  • Kut Festival :: Series of Articles
  • Comedian Huirem Manglem passed away
  • Constituent Assembly Of India & NEFA #2
  • Naga Peace Process :: News Timeline
  • Chalwa Village in Kangpokpi #3 : Gallery
  • NEROCA Vs East Bengal : Gallery
  • Fashion Show: Lamklai Kummoi: Gallery
  • Mera Houchongba @Konung #1: Gallery
  • Sanjenbam Bhanumati Devi : Kavyabhusan
  • Eepan Thaba #1: Gallery
  • A Road Trip to Myanmar #3
  • Narmada Sougaijam - Natl Konkan Award
  • Bor khoiramba @Hiyangthang #2 : Gallery
  • Mera Houchongba : Unity - hill & valley
  • Khong: significance in Zeliangrong culture-1
  • Manipuri Calendar for 2018 : Download
  • Lamyanba Irabot- Floral Tribute #2: Gallery
  • Mera Chaorel Houba #2 : Gallery
  • Pari Imom (Film Scenes) #1 :: eRang
  • Death Anniv - Bhagyachandra #3 : Gallery
  • Heikru Hidongba #3 : Gallery
  • AMAND Pune: Cultural evening : Gallery
  • Tarpon Sonba : Gallery
  • mtM :: Seireng
  • Front Page Photo 2018 #4: Gallery
  • Inner Line Permit (ILP) Demand :: Timeline
  • Manglandasu Nang - OST :: e-pao Radio
  • Old Manipuri Movie #1 :: eRang Classic
  • SPONSORED ADS