Identity, stigma, and HIV risk among transgender women: a qualitative study in Jiangsu Province, China

Abstract

BackgroundTransgender women have multiple disparities globally, including social rejection and stigma, HIV infection and untreated mental health problems. However, few data on transgender women are available in China. Therefore, this study aimed to explore transgender women’s experiences on gender identity, disclosure, discrimination, transgender-specific medical care, and perceptions of HIV and sexually transmitted infections (STI) risk in China.MethodsA qualitative study was conducted in Nanjing and Suzhou city, China in 2018. Key informant interviews (n = 14) and focus group discussions (n = 2) with diverse transgender women were implemented. Text was transcribed and translated, and Dedoose™ software was used for coding, analysis and interpretation by the research team.ResultsChinese transgender women share experiences with transgender women worldwide, including a long and challenging identity search, stigma and discrimination, poor access to trans-specific services and unmet needs for mental health care. Features unique to them include terms used for self-identification, culturally-shaped expectations for reproduction, and ideals of placing the familial and societal welfare over personal fulfillment. Social networks of this population appear sparse, scattered, and underground. Familial rejection was experienced by nearly all respondents. Perceptions of HIV and STI risk and history of HIV testing were notably low.ConclusionsTransgender women in China face high social rejection and discrimination along with unmet need for various types of healthcare. Scaling up transgender-specific services including gender-affirming medical care, mental health care and HIV/STI prevention are warranted to address the social, medical and mental health of transgender women in China.

Information-Motivation-Behavioral Skills model of consistent condom use among transgender women in Shenyang, China

“…Snowball sampling [30,31] was used for recruitment because TGW in China are hard to reach and hidden due to the universal discrimination [32]. And in the absence of a sampling frame, it was not feasible to perform probability sampling.…”

<p>A Scoping Review of Patient Preferences for HIV Self-Testing Services in the United States: Implications for Harm Reduction</p>

“…34 The option to test privately at times and locations of choice creates the opportunity to reduce stigma, a significant barrier for MSM, [35][36][37][38][39] BMSM, 36,[39][40][41][42] sex workers, 43,44 prisoners, 45,46 and transgender women. 37,39,47 There is also evidence that HIVST may be acceptable for partner-testing by MSM 48 and transgender women 49 including transgender female sex workers. 50 Several systematic or literature reviews discuss conditions for HIVST use among key populations, including one demonstrating that individuals who self-initiate HIVST are those having perception of risk for HIV and knowledge about HIV testing availability.…”

Refinement of recto-sigmoid colon vaginoplasty using a three-dimensional laparoscopic technique

“…Estimates of the proportion of transgender individuals within populations across the world ranged between 0.1% and 1.1% in reproductive-age adults. [ 21 ] A survey of university students reported that gender dysphoria had an incidence of up to 0.8% in Japan [ 22 ] ; however, the incidence and distribution of gender dysphoria in South Korea has rarely been reported. Recently, there has been an increase in the number of individuals with gender dysphoria seeking gender-affirming genital reconstruction.…”