Trans-People In The Asia-Pacific Region – Part 1

When we think of the oppression of trans-people we usually are North American centered in our thinking, but trans-people are in every country and on every continent. I came across a report on transgender people in the Asia-Pacific region on the WPATH eList that shows that our struggle for human rights is global.

The report is by the UNDP (United Nations Development Programme) Asia-Pacific Regional Centre and the NGO (Non-Governmental Organization) Asia Pacific Transgender Network (APTN) titled “Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region”

The Asia-Pacific region is home to a large number of trans* people; individuals whose gender identity, and/or expression of their gender, differs from social norms related to their gender of birth. Across the region it can be speculated that there are possibly 9-9.5 million trans* people, though existing research is scattered and small-scale, and is largely limited to trans* women. Asia-Pacific research, again scattered and small-scale, indicates alarming numbers of trans* women are HIV positive, with prevalence rates as high as 49 percent. There appear to be no data at all on HIV rates among trans* men, an emerging identity group. The number of trans* people of either gender who have died of AIDS, or what proportion they represent of overall AIDS-related deaths, is unknown.

In order to effectively study AIDS/HIV you must study the transgender population. However, when we were trying to survey the trans-community in the Hartford CT area one of the difficulties that we faced is that it is hard to find members of an oppressed community and the same holds true for the Asia-Pacific trans-communities. You have to earn the co-operation of the community in order to begin to make connections within it.

Research on Asia-Pacific trans* people, scattered and often small-scale, has tended to focus on young and urban communities of trans* women, and has neglected the elderly and rural, as well as trans* men. That said, the research indicates that stigma and prejudice are major problems for trans* people, and are rooted in a range of beliefs (either traditional or modern, depending on the culture concerned) about sexuality and gender norms and nonconformity. The stigma and prejudice appear to put large numbers of trans* people onto a slope (a ‘stigma-sickness slope’), prompting patterns of discrimination, harassment and abuse (verbal, sexual and physical) in the family, at school, in the workplace, in the
provision of services (including health) and in society more broadly (including in the law and law enforcement).

We not only face repression from society in general, but also from those that are there to protect and care for us. I know of several trans-people who have received discrimination from healthcare professionals. One trans-woman that I know slipped and fell on some ice and they brought her to the emergency room of a hospital here in Connecticut. When the staff found out that she is trans, they sent her home without examining her. The next day when she was still in pain she went to another hospital and they found out that she had broken her back in several places. This type of treatment or lack of treatment is found world-wide. The report goes on to state…

Across the region, there are numerous reports documenting problems in healthcare for trans* women - whether for general, transition or sexual health. The challenges facing trans* men remain severely under-researched. Trans* people approaching health services commonly report that providers are uncooperative or hostile with staff addressing or responding to the trans* person in a gender inappropriate way, adopting a mocking or ridiculing attitude, withholding or refusing healthcare, or even offering ‘reparative’ treatments. Providers may lack competence in regard to trans* health care.

It is hard enough trying to educate healthcare and service providers here in the U.S., but it must be hundreds of time harder to try to do that around the Pacific Rim countries. You have so many different cultures that require a different approach in education that it will require individual strategies for each culture.

Next in Part 2, the results of the report.