Transgender sexual health in China: a cross-sectional online survey in China

Zhang, Ye; Best, John; Tang, Weiming; Tso, Lai Sze; Liu, Fengying; Huang, Shujie; Zheng, Heping; Yang, Bin; Wei, Chongyi; Tucker, Joseph D.

doi:10.1136/sextrans-2015-052350

Cited by 20 publications

(12 citation statements)

References 17 publications

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“…IPV from a male sexual partner (or IPV victimization) was measured by 25 items soliciting lifetime experience of physical, sexual, psychological, deprivation or neglect, and other violence from a male partner. These items were developed in accordance with the definition and typology of violence of the World Health Organization (18), the construction of items used in the WHO Multi-country Study on Women's Health and Domestic Violence against Women (19), with some having previously been validated in the study of IPV and sexual behaviors among MSM in Shanghai and in the nationwide online survey of sexual health among MSM in China (16,20). These 25 forced-choice items cover five domains: physical violence (7 items), sexual violence (3 items), psychological violence (5 items), deprivation or neglect violence (7 items), and other violence such as having ever been threatened to reveal their sexuality (3 items).…”

Section: Behavioral Measuresmentioning

confidence: 99%

Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China

Liu

Zhang²,

Zhang

et al. 2018

BST

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Intimate partner violence (IPV) and its association with HIV infection among men who have sex men (MSM) in China are not understood. In this study, 732 MSM recruited from Shanghai, China between March and August 2015 were administered with a questionnaire survey and HIV blood testing. IPV victimization was measured by 25 forced-choice items capturing lifetime experience of physical, sexual, psychological, deprivation or neglect, and other forms of violence. Of them, 179 (24.3%) reported having experienced at least one type of IPV victimization. In separate multivariable analyses, sexual violence was associated with age over 35 years (AOR = 0.26, 95% CI: 0.07-1.02), ever had male-to-male commercial sex (AOR = 2.53, 95%CI: 1.19-5.39), and diagnosis of a sexually transmitted infection (STI) (AOR = 2.14, 95%CI: 0.98-4.66). Both psychological violence (AOR = 2.53, 95%CI: 1.25-5.12)and deprivation or neglect violence (AOR = 1.75, 95%CI: 1.14-2.68) were associated with ever had sex with a casual male partner(s). Having experienced at least one type of IPV victimization was significantly associated with ever had sex with a causal partner(s) (AOR = 1.72, 95%CI: 1.15-2.57) and ever had a diagnosis of a STI (AOR = 1.80, 95% CI: 1.12-2.88). HIV infection was marginally associated with having experienced any form of IPV victimization. IPV victimization is common among MSM, especially young MSM, in China, although its association with HIV infection is not conclusive in our sample. Nonetheless, our findings highlight the importance of the needs of individualized IPV interventions for certain target risk groups of MSM.

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Section: Behavioral Measuresmentioning

confidence: 99%

Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China

Liu

Zhang²,

Zhang

et al. 2018

BST

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“…Social rejection and stigma are very common experiences for transgender women. Numerous studies have documented that transgender women experience intimate partner violence, physical abuse, rejection by parents and family, harassment or violence from police officers, and negative attitudes from service providers due to their gender identity or expression [12–14]. Transgender-specific care and support are also insufficient, contributing to significant health disparities [15, 16], particularly for mental health [13, 17].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…There are~4 million transgender individuals living in China, where 8-17% are living with HIV, 56% have lifetime suicidal ideation, and 75% have experienced serious social discrimination. [1][2][3][4][5][6] These conditions reflect severe unmet health needs, which might further impede HIV control and other public health efforts. To fill the gaps, we put forward several recommendations that researchers, community members, clinicians, and policymakers can work together to implement.…”

Section: Introductionmentioning

confidence: 99%

Addressing unmet health needs among Chinese transgender individuals

Tang

Dong

Huang³

2021

Sex. Health

Self Cite

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Chinese transgender individuals encounter significant barriers to accessing health care. In this letter we summarise the main health issues among Chinese transgender individuals and propose several recommendations to address these challenges. These recommendations include, but are not limited to, improving access to HIV prevention services, mental health services, and access to sex reassignment surgery and gender-affirming hormone therapy services. We anticipate that these measures will promote physical and mental health for transgender individuals in China.

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Transgender sexual health in China: a cross-sectional online survey in China

Cited by 20 publications

References 17 publications

Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China

Intimate partner violence victimization and HIV infection among men who have sex with men in Shanghai, China

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

Addressing unmet health needs among Chinese transgender individuals

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