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Area of Response to HIV: Key Populations—Transgender
Interview was originally published in the May 2015 newsletter.
Doi Nakpor is the director of Sisters, a transgender-focused community-based organization in Thailand that has provided health, education, and support services to the transgender community in Pattaya, Thailand since 2004. Sisters employs social marketing outreach to reach members of this community, and offers them a friendly and supportive space. The organization also encourages preventive behaviors, including HIV testing and counseling and screening for other sexually transmitted infections.
HIV Policy and Advocacy Monitor: Tell us about Sisters' mission and its work.
Our mission at Sisters is to promote sexual health and human rights for transgender women in Pattaya, Thailand. Sisters has a drop-in center where women can receive health services, as well as an outreach team to reach women throughout the city. Of the 5,000 transgender women estimated to live in Pattaya, Sisters reaches 2,300. This estimation is derived from our work over the last 10 years, but the population is very mobile, with higher numbers during the tourist season. Due to police harassment, the political climate in Thailand surrounding transgender women, and decreasing tourism, the population may be in decline.
HIV Policy and Advocacy Monitor: What are the main policy priorities in Thailand for you and your organization?
I think the first issue for Sisters is achievement of gender recognition for transgender people. As the minority of a minority (among the broader LGBTI community), transgender women experience employment difficulties, limited reproductive and sexual health information, lower incomes, limited access to social welfare, and harassment from the police. In order to truly improve the quality of life for this community, Sisters needs to look beyond HIV to ensure that our work addresses these difficult conditions. However, even when the gender recognition law is in place, our society as a whole must learn to recognize our gender, be more accepting, and realize that trans rights are human rights. Transgender people want more than a supportive document; we want the people's support. This will require more than just policy—it will require continuous advocacy efforts.
HIV Policy and Advocacy Monitor: What are some of Sisters' policy and advocacy activities?
We partner with the Thailand Asia Regional Office of the CDC (Thai CDC) to estimate HIV prevalence among transgender people. In recognition of our work, Thai CDC invited us to stakeholder meetings to develop a sexual and reproductive health guideline for transgender people, where we advocated for more comprehensive sexual healthcare for this population. While Thailand already has a national HIV guideline developed by the Ministry of Public Health, we need more comprehensive guidelines that address HIV in tandem with other health issues relevant to transgender women, including reproductive health. Sisters is currently developing these guidelines in cooperation with Thai CDC and the Red Cross.
Sisters also conducts human rights work. In cooperation with the Thai Transgender Alliance, we promote equal rights for trans people in Thailand. In Pattaya, which has one of the highest populations of transgender women, Sisters supports the Alliance's gender recognition advocacy project. Sisters also provided input and development support to the Alliance's recently released legal review of gender recognition and assessment of the current gender situation in Thailand.
HIV Policy and Advocacy Monitor: What led you to become involved in policy and advocacy work?
Because I am trans, I have seen and experienced many of the problems faced by my community. It's about more than work for me; it's about life. When our efforts succeed, I benefit as a member of the community, but the entire transgender community benefits as well. I have faced discrimination daily and have struggled to enter the workforce. As one of two transgender siblings, I struggle to talk to my parents about being trans and the issues I face. These experiences are not unique to me, so what Sisters does is not about work—it's about life.
HIV Policy and Advocacy Monitor: How is social marketing an important strategy in the response to HIV?
Social marketing is important in getting the transgender community's attention. While we have a strong condom distribution project, the distribution of safe sex commodities to transgender sex workers is not sufficient to change their behavior—that's where social marketing comes in. Incorporating social marketing in our programs helps us analyze a product, determine the best way to draw attention to it from members of the transgender community, and then link it to HIV prevention. For example, we provide beauty services (e.g., facial massages, lessons on make-up use) to transgender women, using the time to introduce them to the center and its services, and to discuss HIV prevention. We are currently holding a promotion for members who get tested at the center with their partner, offering them a gift bag with body lotion and additional beauty products.