Forms of Safety and Their Impact on Health: An Exploration of HIV/AIDS-Related Risk and Resilience Among Trans Women in Lebanon

Abstract

Using minority stress theory, the authors investigated risk behaviors of transgender women (trans women) in Lebanon. Using semistructured interviews, the authors explored six areas: relationships with family and friends; openness about gender and sexuality; experiences with stigma; sexual behavior; attitudes and behaviors regarding HIV testing; and perceived HIV-related norms among transgender peers. Participants voiced the importance of different forms of safety: social/emotional, physical, sexual, and financial. Strategies for obtaining safety were negotiated differently depending on social, behavioral, and structural factors in the environment. In this article, we provide study findings from the perspectives of trans women, their exposure to stigma, and the necessary navigation of environments characterized by transphobia.

Suicide risk factors among trans feminine individuals in Lebanon

“…Because of the stigma and discrimination that trans feminine individuals experience in Lebanon (Kaplan et al, 2014), we anticipated that recruitment would pose considerable challenges. However, given the total population size of Lebanon (approximately 4 million) and the estimates of the prevalence of male-to-female transgenderism in other countries of 1:11,900 to 1:45,000 (WPATH, 2012), our sample size of 54 in fact represents a sizable proportion of likely 88 to 336 trans feminine individuals country-wide.…”

“…Formative work (Kaplan et al, 2014) that engaged the community was conducted prior to the implementation of this study. Long chain referral sampling was used to recruit the sample between May and December of 2012.…”

“…One of the only existing studies found that transgender women in Lebanon experience threats to their emotional safety due to lack of support from family, friends, and community (Kaplan et al, 2014), as is the case, but perhaps to a lesser or different degree, in other settings. A recent Human Rights Watch report details the abuses that transgender women suffer in Kuwait at the hands of police (2012).…”

“…Conflicting reports exist about the legality of obtaining gender confirmation surgery in Lebanon (Anderson, 2011; Saleh & Qubaia, 2015); however, it is established that genital surgery is the only way for transgender people to be able to change their legal identification cards in the region (Anderson, 2011). Transgender women experience tremendous difficulty finding employment in Lebanon due in part to physical appearance not matching their legal documentation (El Feki, 2013; Kaplan et al, 2014). Although being transgender is not illegal in Lebanon per se , transgender women face discrimination, harassment, and violence in school, work, and while navigating public spaces (Kaplan et al,2014; Anderson, 2011; Saleh & Qubaia, 2015).…”

“…Transgender women experience tremendous difficulty finding employment in Lebanon due in part to physical appearance not matching their legal documentation (El Feki, 2013; Kaplan et al, 2014). Although being transgender is not illegal in Lebanon per se , transgender women face discrimination, harassment, and violence in school, work, and while navigating public spaces (Kaplan et al,2014; Anderson, 2011; Saleh & Qubaia, 2015). Given this complex context that prioritizes male privilege (El Feki, 2013), it is important to examine the factors that threaten the mental health of transgender women in Lebanon.…”