Abstract:

Transgender populations in the United States have been impacted by the HIV/AIDS epidemic. This systematic review estimates the prevalence of HIV infection and risk behaviors of transgender persons. Comprehensive searches of the US-based HIV behavioral prevention literature identified 29 studies focusing on male-to-female (MTF) transgender women; five of these studies also reported data on female-to-male (FTM) transgender men. Using meta-analytic approaches, prevalence rates were estimated by synthesizing weighted means. Meta-analytic findings indicated that 27.7% (95% confidence interval [CI], 24.8–30.6%) of MTFs tested positive for HIV infection (four studies), while 11.8% (95% CI, 10.5–13.2%) of MTFs self-reported being HIVseropositive (18 studies). Higher HIV infection rates were found among African-American MTFs regardless of assessment method (56.3% test result; 30.8% self-report). Large percentages of MTFs (range, 27–48%) reported engaging in risky behaviors (e.g., unprotected receptive anal intercourse, multiple casual partners, sex work). Prevalence rates of HIV and risk behaviors were low among FTMs. Contextual factors potentially related to increased HIV risk include mental health concerns, physical abuse, social isolation, economic marginalization, and unmet transgender-specific healthcare needs. Additional research is needed to explain the causes of HIV risk behavior of transgender persons. These findings should be considered when developing and adapting prevention interventions for transgender populations.

Notes:

"Online First" as an e-publication. Journal publication date unknown.

Abstract:

Born female yet little identified with that gender, these transgender, genderqueer, third gender, and gender variant writers offer personal insights into changing gender identity, dating, workplace issues, and more. This book shines light on those who identify as FTM (female to male) and also illuminates those whose gender is more fluid, proving that biology doesn't control destiny.

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Abstract:

Transgender people are “compromised survivors” who both experience and challenge gender-based oppression. The term “transgender” describes a diverse population of people whose identity does not conform to normative gender expectations. Transgender people experience adverse health outcomes unlikely to be biological in nature, and are best understood in terms of social determinants of health. The social determinants framework contextualizes transgender health outcomes, situating them within a larger social context of discriminatory gender oppression. Life history interviews with 13 transgender people, focus groups with 16 transgender people and 9 in-depth interviews with “key informants” suggest that stress, (lack of) social support, and social exclusion are the primary social determinants of transgender health. Violence-related stress is most pronounced. Violence against transgender people is associated with level of gender variance; transgender people who regularly “pass” as either gender reported lower frequency of violence. Almost all participants reported frequent fear of violence. Hair-trigger violence, or sudden unprovoked aggression, was an important phenomenon among male-to-female (MTF) vector transgender people. Violence is often experienced within sexual relationships or within the context of sex work. Internal gender oppression creates another layer of stress, often manifesting itself through addictions. For some participants, addiction problems were resolved on “transition” from birth to true gender. Social support is weak or absent for many transgender people. Participants experience alienation from families-of-origin, friend networks, and potential romantic partners. Social exclusion of transgender people further compromises their health status. Exclusion from healthcare, education, housing, and employment means that transgender people often lack access to basic resources. Some female-to-male (FTM) participants experience an improvement in social standing if they “pass” as male, but this is tempered with concomitant exposure to gender bias. The demographic factors of SES, race, gender vector (MTF or FTM), and ability to pass as gender normative have an interactive effect with social determinants. A diverse participant pool allows for the observation of gender-related trends across race and class. The approach used to recruit a diverse group of participants from a hard-to-reach population was successful and can serve to inform work with other populations.