Transgender women in Malaysia: Helping each other

Michelle Nor Ismat, is the manager of the PT Foundation drop-in centre for sex workers in Kuala Lumpur. Like the majority of the centre’s clients Michelle is a transgender woman. “We face many levels of discrimination. We will have a male name on our identity card but we are female, and if you ask a clinic to call you a different name they won’t. It’s very rare for a hospital to show you this respect”.

In Malaysia, it is estimated that there are about 20,000 transgender people. They experience extreme stigma and discrimination within Malaysian society and have an HIV prevalence rate of 9.7% (compared to 0.5% in the general adult population). Many transgender women turn to sex work as a way of making money because of employment discrimination and a lack of educational opportunities.

In Malaysia, it is estimated there are about 20,000 transgender people.

PT Foundation is an implementing partner of the Malaysia AIDS Council, the Alliance’s Linking Organisation in Malaysia. They have an extensive outreach programme with communities most at risk of HIV, including sex workers and transgender people. Although the PT Foundation centre caters for female and transgender sex workers, most of those who use the services are transgender. The centre offers a wide range of programmes for sex workers including referrals for voluntary counselling and testing, HIV treatment, as well as hepatitis, TB and STI diagnostic and treatment referrals.

Many of the centre’s outreach workers are former or current sex workers. “The advantage of having active sex workers as outreach workers is you have better access; not only do you get to know the clients’ problems on the field, you get to know other issues stemming from the customers as well” says Michelle.

nullFighting stigma

“One of the challenges, apart from funding, is support [from the wider community],” explains Michelle. “People see us giving condoms and the first impression they have in their mind is that we are encouraging sex worker whereas we are trying to reduce the risk of HIV being transmitted through sexual activities.

“To reduce stigma in the wider community and society we need to have a lot of collaboration. I am currently working with HUKM [the hospital of the University of Malaysia], we are thinking of having a public health forum with medical practitioners on the need to provide health services to most at risk populations.”

At risk of losing out

In Malaysia, civil society organisations operate the vast majority of HIV prevention programmes involving most at risk populations: people who use drugs, men who have sex with men, transgender people and sex workers. Despite the excellent work of centres like the one run by PT Foundation, funding is sporadic and reaching out to these populations remains a significant challenge for both the Government and civil society.

While donors continue to withdraw development financing from middle-income countries like Malaysia, and key populations such as transgender women are discriminated against, stigmatised and criminalised, achieving a sustained response to HIV will continue to be a challenge.