Speaking at a workshop this morning, five AIDS 2012 panelists examined problems transgender people face in various countries, particularly in the U.S. Focusing on the prevalence of HIV in the transgender community and the related risks, JoAnne Keatley, director of the University of California, San Francisco (UCSF) Center of Excellence for Transgender Health, covered several of the factors contributing to transgender people's higher risk of acquiring HIV. For example, she said, transgender people face relatively greater degrees of dicscrimination in employment, housing and health care, as well as marginalization, or, in some countries, criminalization of people who do not conform to gender norms.
Because of fears of discrimination or mistreatment, she said, many transgender people avoid needed medical attention or reporting crimes to police. Employment discrimination may also lead transgender people into survival sex work. Other factors include intravenous drug use or injecting themselves with silicon or hormones without the guidance of medical professionals.
Because of these very community-specific problems, Keatley said, transgender people cannot simply be classified as "men who have sex with men" (MSM) in anti-HIV efforts, but need a distinct category with outreach and prevention strategies specially tailored.
Marcela Romero, a Colombian-born transgender activist, said that governments are complicit in the challenges faced by trasngender communities. Marginalization and a lack of resources to address health and well-being contribute to a higher incidence of HIV and sexually transmitted infections, and lower life expectancy among transgender people.
"A person without an identity ceases to exist," Romero said of governments who ignore transgender citizens.
Manisha Dhakal, a Nepalese activist with the Blue Diamond Society, added that even when transgender communities mobilize, they often lack the capacity and skills needed for efforts like proposal writing, and have fewer resources to lobby international organizations or governmental bodies for funding.
Keatley reiterated the importance of employment as the key to solving many of the problems facing transgender people. Gainful employment (as well as protections against discriminatory hiring and firing), she said, is what is needed for transgender people to access insurance, health care, better educational opportunities and housing.