The Regional assessment of HIV, STI and other health needs of transgender people in Asia and the Pacific (jointly developed by the WHO and the Asia Pacific Transgender Network, and the United Nations Development Programme) identifies a clear need to scale up and improve sustained, comprehensive and effective HIV prevention efforts for transgender people (people whose gender identity differs from their biological sex assigned at birth). The assessment reports that ‘HIV prevalence among transgender women in the Region appears to be very high, ranging from 7.5% in Australia, 13.5% in Thailand and 31.6% in Indonesia to 41% in India. Throughout Asia and the Pacific region, transgender people are still very much underserved by health services…, putting them at increased risk for HIV….’
Here is what a few members of this community had to say while talking to CNS at the recent 11th ICAAP held in Bangkok:
Abheena Aher, a transgender (TG) activist and Programme Manager for India HIV/AIDS Alliance endorses what Michel Sidibe, Executive Director of UNAIDS said—HIV is not about the disease, it is actually about the community. Abheena feels that “It is time to look beyond HIV and look into needs of the transgender community. If the community is empowered it will automatically translate into health seeking behaviour. If we have to deal with HIV, we cannot ignore social health of an individual. Social health and wellbeing is the key to open gateway for HIV decrease.”
“The TG/hijra community still does not have acceptance from society and equal access to employment and healthcare. National level data for India shows that HIV prevalence in TGs is 8.8%-- almost double of 4.5% in men who have sex with men. This is because of gender vulnerability—TGs are out and loud there without any support and recognition. This is pushing the community more and more towards HIV risk. We have to deal with stigma at multiple levels—gender issues, sexuality, violence and HIV. If we have empowered communities, access to health will automatically increase, because then you will have more aspirations to live. If you live in precarious conditions you lose the will to live. Also, we have to look into the health of the regular partners too as that is the gateway of spreading the disease from the most at risk populations to the general population. The bigger challenge for India is that most of the money is going for protection and security whereas it should be going for health and education. At the national level TGs are not being given employment, begging is criminalized, sex work is criminalized. There are gaps in national level policies. On one hand you criminalize same sex behaviour and on the other hand you talk of condoms use. So how do we collate them with each other? Interventions will work only in an enabling environment which should be there at national level. We have to have community people on the programme board along with technical experts. We cannot work in isolation.”
Dechen Selden a TG from Thimpu, Bhutan said, “In Bhutan, the government supports us and also the society by far and large. I should say that 90% of the society supports us and just 10% still discriminates. We have never thought ourselves to be different from others in any way but just a normal human being like anyone else. We think we are females and if someone asks us if we are a TG we do not like it—why label us as someone different. But in certain situations we have to be different. But now after attending this conference I can proudly say that I am a TG from Bhutan.”
“In Bhutan identity cards of MSMs have them as males while we register as females. We do not have any problem in accessing health services. In health facilities we are registered as females. Also there are no problems for TGs in getting admission in schools.”
“I run my own beauty parlour. I revealed my TG status in 2008 when I was 16 years old. My family is very supportive of me-- they love me and are very caring for me. Some of my friends faced some problems with their family but later they were accepted by them. In Bhutan we have a national uniform for boys and girls in schools. I have studied till class 9. I wore a boy’s dress till Class 8 and then switched over to a female dress and the school supported me and allowed me to do so.”
“As of now HIV is not an issue with TGs but they have little knowledge about HIV. We do not have a strong network of TGs in Bhutan. But this conference has improved my knowledge about HIV issues in TGs. I will now try to make a network of TGs, especially to give them knowledge about the threat of HIV.”
Joey Joleen Siosaia Mataele, an accomplished singer and Chairperson of the Pacific Sexual Diversity Network, informs that “Like other Polynesian societies, Tonga has a widely accepted third gender subculture of Leitis with a long history. A ‘Leiti’ is a Tongan male who behaves in a relatively effeminate manner. It is an inclusive term that covers the broad range of men who have sex with other men, transgender people, gay and bisexual men. To date, there is no recognition in law for Leitis and by extension cross dressing or same sex relationships.”
“As a Leiti in Tonga I have had to battle against a belief that my behaviour situates me outside the ‘normal’ ‘Anga FakaTonga’ (Tongan ways). In the past I have been called a ‘child of the devil’ who was at-risk, vulnerable, stigmatized and lacking agency. My Leiti status has been equated with having a ‘lack of hope and mobility’ so I was seen as being on a pathway that leads to ‘poverty’ and isolation from normative model and space in Tongan society. But through the TLA we are challenging this prejudiced view with some success.”
The The Tonga Leitis Association (TLA) which was formed in 1992 receives royal patronage and has been active in campaigning in the mainstream community as advocates who also promote HIV/AIDS Awareness to Youth, Family and Tonga’s LGBTI communities. Much recent activism in Tonga has emerged from the TLA. TLA also launched Tonga’s first ever condom and water based lubricant campaign 2007. In 2010 it launched a strategic plan calling for legal recognition of Leitis and their inclusion in all National Human Rights Commissions.”
The 2013 UNAIDS report on the global AIDS epidemic warns that HIV-related stigma and discrimination persist as major obstacles to an effective HIV response in all parts of the world. On this World AIDS Day, 2013 can we as citizens of the world at least pledge to ‘let different flowers bloom in God’s garden’ and not discriminate against anyone of them? If we treat all people with diverse sexual preferences and gender identities with dignity and stop excluding them from mainstream society, it will help accelerate our efforts to have an HIV/AIDS free world.
November 2013
(The author is the Managing Editor of Citizen News Service - CNS. She is a J2J Fellow of National Press Foundation (NPF) USA and received her editing training in Singapore. She has earlier worked with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also co-authored and edited publications on childhood TB, childhood pneumonia, Hepatitis C Virus and HIV, violence against women and girls, and MDR-TB. Email: shobha@citizen-news.org, website: www.citizen-news.org)
