The United Nations Development Programme report, Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region, was written by Dr Sam Winter, a professor of transgender studies at Hong Kong University whose position is currently under threat.
The information for the report was gathered from existing literature. The figure of 49 percent of transgender women being HIV positive was found in Delhi, according to a UN report. The report found a HIV prevalence rate of 37% among transgender women in Phnom Penh and 22-34% in Jakarta. The report says these exceeded the rate for MSM [men who have sex with men] ‘sometimes substantially so’.
There’s evidence these figures are rising in a study that showed a 9% rise in HIV prevalence among transgender women in Jakarta from 2003 to 2007.
The report attributes the high prevalence of HIV in transgender women in Asia to a ’stigma sickness slope’, where they are bullied and marginalised at school, so drop out, discriminated against when seeking employment, failed by the legal system and police and end up relying on sex work for money, sometimes to fund gender transition surgery.
Dr Winter told Gay Star News that the most important thing that needs to be done to halt the neglect of trans people in health research is to ‘stop invisibilising’ them.
‘Trans women having sex with men are so often conflated with MSM,’ said Dr Winter. ‘It reinforces the idea that trans women are in fact men, and therefore resoundingly undermines their claim for recognition as women (socially, in health systems and in law). It also perhaps has the sad side effect of invisibilising trans men altogether (that is a whole other problem).’
The report says that there’s so little research on transgender men and HIV prevalence, that it could not present findings in that area. But it says: ‘it is likely trans* men also do sex work, providing services as female sex workers (FSWs) or as male sex workers (MSWs). In each case (trans* women and trans* men) the numbers of trans* sex workers (TSWs) remain uncertain.’
The report puts the number of trans people in the Asia Pacific region at 9 to 9.5million, based on an informed assumption that they make up 0.3% of the population.
The report recommends that HIV-related research looks at trans people as distinct from other at-risk groups, so that their health vulnerabilities can be understood and addressed. Trans people need research that ‘recognises them as a distinct set of communities, treats them with respect, and involves them as partners’ said Dr Winter.
Download the report here.