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Violence, social exclusion, limited access to opportunities and the systematic violations of their human rights, make transgender people one of the populations most affected by the HIV epidemic. The chance of acquiring HIV is up to 49 times higher in transgender women than for all adults of reproductive age (Baral et al, 2013). 

There have been positive moves and actions being undertaken to address the urgent needs of transgender women. The Asia-Pacific Transgender Network (APTN), founded in 2009, advocates for the improvement of transgender health, wellbeing and overall quality of life, including through the protection of their human rights. Under the umbrella of APTN, national networks and grassroots communities of transgender populations are coming together in the region, bringing visibility to the lives and needs of transgender people.

"We are visible yet remain invisible in the mainstream advocacy", says Kate Montecarlo Cordova, Co-Chair of APTN and founding Chair of the Association of Transgender People in the Philippines (ATP). “We, transwomen, have been addressed as men despite of our female gender-identity and social presentation. We are not men. We are women of transgender experience.”

Since its foundation, APTN has done significant works to highlight the ways in which transgender people are marginalized, discriminated and violated. Through documenting the lived experiences of their members, they have been able to attest that such discrimination and violence acts are barriers to access to health care, especially HIV, and sexual and reproductive health related services and commodities. Many health workers are unprepared to address the health needs of transgender people, either because they have negative attitudes towards transgender people or are unfamiliar with the transgender population’s unique health needs.

“The health needs of transgender people in Asia and the Pacific are largely neglected. Very few countries in the region have access to hormonal therapy for gender affirmation procedures; those without often times resort to self-medication. Some buy their hormones on the Internet. For these people, there is no way of knowing the quality of the hormones and counseling methods, to monitor the progress of the gender affirmation process”, says Montecarlo.

Along with a general lack of access to health services, APTN members have given personal testament to how “homophobia and transphobia has pushed transgender people into poverty, facing frequent unemployment due to discrimination based on their gender identity and gender expression”, says Abheena Aher, Chair of APTN and transgender human rights activist from India. Indeed, social exclusion has driven many transgender persons to engage in sex work as a means to survive, increasing their risk of acquiring HIV and being subject to violence.

In the face of these challenges, APTN’s programmes include sensitizing doctors and committing policy makers to the needs of the transgender on a local level. Today, the network has a long term goal of creating large scale policy change, especially with respect to gender and sexuality laws, and mobilizing more transgender organizations to do the same in an effort towards equal opportunities for transgender people. The network, led by and for transgender people, has created an important space for this community to unite and have a voice on a regional and global scale.

As highlighted in the recently launched UNAIDS Gap Report given the central role that the community engagement plays in ensuring safe access to HIV services, transgender-led organizations need technical and financial support.

GCWA joins APTN in calling for increased investment in transgender community leadership; recognition of the rights of transgender people and ensure freedom from violence; improved access to comprehensive, integrated quality health services, including HIV services that respond to transgender people needs and expanded quantitative and qualitative research on transgender women and men with transgender peoples meaningful involvement.

For more information on the Asia Pacific Transgender Network, visit http://unaids-ap.org/tag/aptn/

(1) Baral SD, Poteat T, Strömdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22. doi:10.1016/S1473-3099(12)70315-8.