The Impact of Policies, Ecological Factors and Laws on Transgender Health

A panel comprised of six transgender activists from Thailand, Nepal, Argentina and the U.S. spoke about the various factors impacting transgender health, and how those put transgender communities at risk for HIV. The panel started with a video recording sent by Kartiny, a trans activist from the Philippines; she was scheduled to present on HIV prevalence amongst transgender communities in Asia and Indonesia, but did not make it to the IAC due to U.S. laws prohibiting sex workers from visiting the country. Kartiny stressed that transgender groups face many structural and societal factors impacting their capacity to advocate, educate, and mobilize trans people for health equity. The groups often lack access to funding for programs and disagree about how funds should be used; as such, the groups are not sustainable. In addition, they are not registered, lack technical assistance and organizational development skills (e.g., grant writing, leadership development), and are often misperceived as MSM by health providers and the society at large.
JoAnne Keatley of the Center for Excellence for Transgender Health (UCSF) stressed the lack of data collection and population based studies regarding the trans community. That lack of data impacts development of interventions that are not only culturally appropriate but that can address the realities and needs of trans people. On the most basic level, “there is a lack of gender variance variables on health surveys,” stated Ms. Keatley. As per policy barriers, the activist mentioned the absence of name change, non-discrimination and immigration policies that protect trans people rights. “A person without identification ceases to exist,” said Marcela Romero from Argentina.
Panelist, Cecilia Chung, San Francisco’s Health Commissioner, said migration around the world is another factor impacting trans communities’ human rights. Transgender individuals migrate due to persecution, social pressure, lack of jobs, the political climate (in their countries of origin), to escape poverty, and to have access to community. “Some positive outcomes of migration are more opportunities such as income, social support, belonging, and finding love. On the other hand, negative results can be homelessness, discrimination, physical and sexual abuse, poverty, low wages, addiction, HIV/HCV, violence and deportation,” said Chung. Without a doubt, HIV prevention efforts for trans people need to look beyond access and condom use. Being stig;matized, deprived of their basic rights, not included in decision making groups, nor consulted on resources allocation, planning and program design are just some of the ways that they are excluded from meaningful participation in the field. “The best way to create trans interventions is hiring trans people, we are hirable!” said JoAnne Keatley.

Written by Yanira Arias

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