LOST IN TRANSITION: UN report highlights lack of research on transgender persons in Asia-Pacific

Thursday, May 17, 2012

Bangkok: A lack of targeted research on transgender persons in Asia and the Pacific is significantly hindering their access to health services and blocking effective responses to HIV, says a groundbreaking study released here today to mark the International Day Against Homophobia and Transphobia.  In this region, where long marginalized sexual minorities are already bearing the brunt of the HIV epidemic, transgender persons are among the most socially ostracized, lacking fundamental rights including basic access to health care and social protection schemes.

‘Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region’ is a comprehensive review of material gathered from across the region over the past 12 years.  This unprecedented research in Asia, jointly released by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN), calls 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.

“Transgender individuals across Asia-Pacific are often highly stigmatized, targets of prejudice, harassment, violence and abuse,” noted Clifton Cortez, Regional Practice Leader on HIV, Health and Development at the UNDP Asia-Pacific Regional Centre in Bangkok. “We urgently need to shed light on their situation to better tailor social and public health responses to protect and empower these communities.”

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.

“For too long, trans people have been lost in transition,” said Dr. Sam Winter from the University of Hong Kong, the author of the report and a noted expert on transgender people and their challenges.  “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. Alarming figures from one Southeast Asian city have suggested that over the four year period from 2003-2007, HIV prevalence among transgender people rose from 25 percent to 34 percent.

“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,” explained Dr. Winter. “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.”

Another challenge is that transgender people are usually treated similarly as men who have sex with men when it comes to national HIV programming and funding.  “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.”

There are encouraging developments, however, as the report points out.  Among these, across much of the region, 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 creation of advocacy networks, community-based organisations and non-government organisations devoted to empowering and strengthening our communities is a source of joy,” said Prempreeda.

The Asia Pacific Transgender Network, for example, 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. Prempreeda continued, “You can’t separate our social well-being and human rights from our efforts to address HIV within our communities.  We’re pleased that the UNDP report recognizes this.” 
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