Pregnant adolescents do not represent a homogeneous group. Considering differences in how pregnancy and childbearing are conceptualized along developmental, cultural, attitudinal, and experiential lines will strengthen our ability to tailor pregnancy-prevention messages.

This study aims to understand the process by which female-to-male transgender young people come to identify as transgender through in-depth interviews with 13 self-identified female-to-male transgender youth. A grounded theory was created of the process that young people go through in coming to identify as transgender. We identified three stages: (1) a growing sense of gender: school, puberty, sexuality and exposure to diverse gender options impact upon each young person's sense of his own gender; (2) recognition of transgender identity: a young person experiences a growing sense of discomfort with his female birth gender and comes to recognise himself as transgender; and (3) social adjustment: after becoming aware of himself as transgender, a young person adapts to life as a male. Although individual experiences may vary, understanding the typical trajectory of the female-to-male transgender experience can help inform appropriate health care and support services.

Transgender women in Lima, Peru have, until recently, been grouped together with gay and bisexual men in the category MSM, or men who have sex with men, with little consideration of their unique situation and needs. Transgender women, self-identified in Peru as travesti, are a socially vulnerable population with many unmet health needs, including an HIV prevalence of 30%. Understanding specific transgender identities and their contexts will contribute to the improvement and development of HIV prevention programs. Through qualitative open-ended interviews with trans-identified women in Lima, Peru, this study found that the non-normative travesti identity is constructed within a conservative homophobic and heteronormative social context. Participants strive towards appearances and relationships perceived as feminine, seeking out silicone injections and abusive men as social markers of this femininity. Sex work is the primary economic activity available and travestis are often alienated from their families and communities. Work is needed to increase self-esteem and decrease violence, stigma, and discrimination. There is a need for multilevel HIV prevention campaigns prioritising travesti in Lima, utilising a human rights framework.