Transgender women (TGW) face
compounded levels of stigma and discrimination, resulting in multiple health
risks and poor health outcomes. TGW identities are erased by forcing them into
binary sex categories in society or treating them as men who have sex with men
(MSM).
In Malaysia, where both civil and religious law criminalise them for
their identities, many TGW turn to sex work with inconsistent prevention
methods, which increases their health risks. This qualitative study aims to
understand how the identities of TGW sex workers shapes their healthcare
utilisation patterns and harm reduction behaviours. In-depth, semi-structured
interviews were conducted with 21 male-to-female transgender (mak nyah) sex
workers in Malaysia. Interviews were transcribed, translated into English, and
analysed using thematic coding.
Results suggest that TGW identity is shaped at
an early age followed by incorporation into the mak nyah community where TGW
were assisted in gender transition and introduced to sex work. While healthcare
was accessible, it failed to address the multiple healthcare needs of TGW.
Pressure for gender-affirming health procedures and fear of HIV and
sexually transmitted infection screening led to potentially hazardous health
behaviours.
These findings have implications for developing holistic,
culturally sensitive prevention and healthcare services for TGW.
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By:
- 1 Department of Internal Medicine, Section of Infectious Diseases, AIDS Program , Yale School of Medicine , New Haven , CT , USA.
- 2 Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
- 3 Division of Epidemiology of Microbial Diseases , Yale School of Public Health , New Haven , CT , USA.
- Glob Public Health. 2016 Jan 29:1-16
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