The Obstacles and Overcoming the Challenges that Transgender Women who have HIV Encounter in Jamaica

Opinion

Knowledge about people who oppose the binary system of gender identity is an under-researched area. There is enormous social pressure to conform to religious expectations about masculinity and femininity. It is extremely difficult to manage and negotiate a gendered self-concept that is oppositional to your sex. This paper explores the importance of confronting the denial of health rights to transgender women in Jamaica. Although transgender women are disproportionately affected by the HIV pandemic there is ignorance about their negative experiences of HIV testing. A social-ecological theoretical approach examines the overrepresentation of transgender women among individuals suffering from HIV in Jamaica. This intersectional method analyses HIV testing, healthcare, personal beliefs, cultural norms and relationships. A community-based qualitative research project with people who are living with HIV (PLHIV), women who have sex with women (WSW), men who have sex with men (MSM), bisexual and transgender organizations in Kingston was conducted. 1 focus group with 8 transgender women and in-depth semi-structured interviews with 20 transgender women between the ages of 18 and 30 years old was studied. The focus group and interviews were recorded, transcribed and analysed with a thematic approach.

The transgender women come from diverse ideological and socio-economic backgrounds. They share the conditions of HIV related stigma, discrimination and mistreatment from healthcare workers that reflect Jamaican values and makes them often conceal their gender identities. Among the interviewees 75 % had received an HIV test. Of these 25% were HIV positive (Logie, et al. [1]). In Jamaica there are extremely high levels of homophobia, lesbophobia, biphobia and transphobia that are frequently fatal. Cross-dressing is a matter of life or death. This is demonstrated by the heinous killing of Dwayne Jones. In 2013 the 16 year old Jones attended a party dressed in women’s clothes. When a woman at the party who knew Dwayne informed men that Jones was cross-dressing s/he was murdered by an angry mob [2-5]. It was transphobic overkill as the gender-non-conforming youth was perceived as provoking attack by deceiving the men who s/he danced with. Dwayne was beaten, chopped, stabbed, shot and run over with a car. There was outraged international media coverage of the killing that demonstrated the lack of LGBT rights in Jamaica. There was little local concern or media attention of the hate crime. As usual in these executions the perpetrators were not caught. The terrible nature of Dwayne’s murder makes one question the psychological disturbance of the killers. What types of people would respond in such a savage and tragic manner to cross-dressing? What does the lack of Jamaican social condemnation suggest about the population?

The transformation of policies, practices and provisions are vital to reduce prejudice, harassment and violence. Radical interventions are necessary to oppose transphobia and improve access to HIV prevention services. There is little information about the HIV prevention requirements of transgender people. The problems of gaining access to HIV testing is due to mistreatment by medical staff who are vehemently opposed to caring for Lesbians, Gays, Bisexuals and Transgender (LGBT) people and (PLHIV). These stereotypical and non-confidential issues contribute to huge mistrust and fear. Many healthcare workers urgently require correct information about HIV transmission that negates their transphobia. Transgender women are encouraged to get HIV testing when they have social support and the benefits of knowledge [6-9]. The political will to decriminalize The Buggery Law has the potential to greatly reduce bigotry, brutality and trauma but it can also create a backlash. It is crucial that transgender women deal with their unique concerns such as survival challenges and HIV risks that are connected to discrimination in education, employment and social services. This is essential to foster equity, improve sexual health and protect the rights of transgender women.

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