“Just shocking rates,” JoAnne Keatly, commented. “There was a recent meta-analysis demonstrating that a transgender woman was 49 times as likely to be living with HIV [than the general population] in 15 countries.”
Keatly is one author of a recent World Health Organization report that addresses the inadequate healthcare provided for transgender women. In addition to the general population, the HIV prevalence among transgender women sex workers is nine times greater than the prevalence among non-transgender female sex workers. Transgender women also have high rates of substance use, depression, and suicide. But what is to blame for these concerning statistics?
The recent report states that “structural and social inequalities, such as widespread stigma and discrimination” are at the root of inhibiting the prevention and treatment of illnesses. In most countries, transgender people are unable to obtain gender-appropriate legal identification or must undergo costly genital surgery to receive documentation. Without gender-congruent documents, many transgender people cannot receive healthcare, education, employment or voting rights. The lack of protection from such discrimination increases HIV vulnerability by limiting prevention, treatment and economic opportunities.
However, many countries are taking positive steps toward improving the quality of life for transgender people. A 2009 law in Uruguay allows people over the age of 18 to change their names and sex on official documents. In 2012, the Argentinian senate also unanimously enacted the Gender Identity Law, which makes gender-affirming procedures a legal right. Furthermore, the law allows transgender people to change their birth certificates, national ID cards and passports without a requirement for any diagnoses.
While systemic barriers to transgender people’s health have somewhat improved, stigma is often a harder issue to tackle. The bias against transgender people can contribute to mental health problems and often deters people from getting tested and treated for HIV. Stigma is often the direct cause of poor health outcomes, violence, and death. To combat the stigma surrounding transgender individuals, young people in Asia started the popular video campaign, “Loud and Proud.” A trans-specific HIV testing and psychosocial support program in Thailand, called Sisters, also increased HIV testing among transgender individuals by 25%.
These dedicated individuals should inspire us all to stand up against discrimination. Together, we can improve healthcare for transgender people and for all people worldwide. The challenge is far from over, but also far from impossible.