STUDY: Discrimination to Blame for High HIV Rates, Poor Health Care for Trans People

A new World Health Organization study on transgender people and HIV puts the blame for inadequate health care for the trans population squarely on those who oppose the expression of authentic gender identity.

One sentence near the beginning of the report sums up the situation in dire terms: "Transgender people are often socially, economically, politically and legally marginalized." The result is that transgender women have "just shocking rates" of HIV, study coauthor JoAnne Keatley told National Public Radio this week. "There was a recent meta-analysis demonstrating that a transgender woman was 49 times as likely to be living with HIV [than the general population] in 15 countries in which data was looked at and analyzed."

But it's hard to collect reliable data, as only those 15 countries offered laboratory-proven data on HIV prevalence among transgender people. Not one country in Eastern Europe or Africa could provide such information to the WHO team by the time researchers needed it.

The available information, though, did show a health crisis, and Keatley, who works with the Center for Excellence for Transgender Health at the University of California, San Francisco, and is herself trans, said discrimination is to blame.

"What is driving the epidemic is really the refusal -- I would say -- of governments to pass legislation that allows [transgender people] to function in society, and allows them to participate in the workplace," she told NPR.

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"Trans people struggle in order to obtain identity documents that allow them to participate in the workforce," she continued. "Many trans people are not able to obtain health coverage. All of the ways in which we're denied opportunities to participate in a meaningful way in society then lead us to situations where there is additional risk-taking behavior. Often, for example, trans women have to rely on industries such as the sex work industry. And so that comes along with a lot of additional stigma from criminal justice."

Still, Keatley said she sees some progress. The WHO report, Transgender People and HIV, will help health ministers and governments around the globe better understand the distinct needs of this oppressed minority within a minority, she said.

Click here to read the WHO document, and below listen to NPR's report.