Gender identity, healthcare access, and risk reduction among Malaysia's mak nyah community.
Gender identity, healthcare access, and risk reduction among Malaysia's mak nyah community.
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DOI：
10.1080/17441692.2015.1134614
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发表时间：
2016-08
影响因子：
3.3
通讯作者：
Altice FL
中科院分区：
文献类型：
--
作者：
Gibson BA;Brown SE;Rutledge R;Wickersham JA;Kamarulzaman A;Altice FL
跨性别妇女（TGW）面临着复杂程度的耻辱和歧视，导致多种健康风险和不良的健康结果。TGW的身份被抹去，迫使他们在社会中进入二元性别类别，或将他们视为男男性行为者（MSM）。在马来西亚，民法和宗教法都因其身份而将其定为犯罪，许多TGW转向性工作，但预防方法不一致，这增加了他们的健康风险。这项定性研究旨在了解TGW性工作者的身份如何塑造他们的医疗保健利用模式和减少伤害的行为。深入，半结构化的采访进行了21男到女的变性（mak nyah）性工作者在马来西亚。访谈记录，翻译成英文，并使用专题编码进行分析。结果表明，TGW的身份是在很小的时候就形成的，然后被纳入Mak nyah社区，TGW在那里得到了性别转变的援助，并被介绍给性工作。虽然医疗保健是可以获得的，但它未能解决TGW的多种医疗保健需求。对性别平等保健程序的压力以及对艾滋病毒和性传播感染检查的恐惧导致了潜在的有害健康行为。这些发现对发展TGW的整体，文化敏感的预防和医疗保健服务具有影响。
Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalize them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilization patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally-sensitive prevention and healthcare services for TGW.