Transgender AND MSM:

Trans masculine people who have sex

with men claiming our place in the global
HIV response

Weareagroupofgay,bisexual,queer,
andothertransmasculinepeople*whohave
sexwithmen(transMSM)andallies,and
weareinvolvedintheglobalHIV/AIDS
responseasadvocates,researchers,and
serviceproviders.Weareissuingthiscallto
actionfollowingthe2016InternationalAIDS
ConferenceinDurban,SouthAfrica.Trans
menwhohavesexwithmenarerecognized
bytheWorldHealthOrganization[1]asa
keypopulationatincreasedHIV
vulnerability.Despitethis,AIDS2016
receivedonlythreeresearchabstractsand
threeprogrammingsubmissionsspecificto
transMSM,ofwhichonlyoneabstractand
oneprogramsubmissionwereacceptedto
themainconference.Thisinvisibilitymust
end.
Firstandforemost,werecognizethe
disproportionateimpactthatHIVepidemics
havehadonourtransfemininesisters.We
wholeheartedlyandactivelysupporttheir
callsforascaled-up,fully-funded,and
community-ledresponsetoHIVamong
transwomen.
*Transpeopleassignedfemaleatbirth,whomay
identifyasmen,transmen,transmasculine,gender
non-binary,TwoSpirit,Brotherboy,orother
identitiesthatdifferfromourbirth-assignedsex.

Inissuingthisstatement,werejectthenotion
thatwemustcompeteamongstourselvesfor
resources.
Structural,culturalandsocialdevaluation
andthecriminalisationoftranslivesarethe
primarydriversofHIVvulnerabilityintrans
communities,andtheprimaryobstaclestoa
robustresponse.Wearestrongerwhenwe
challengethesebarrierstogether,whilenot
obscuringtheparticularlydevastatingimpact
thatHIVcontinuestohavefortransfeminine
people.
TranswomenhavelongcalledforHIV
research,funding,andinterventionsthatdo
notlumpthemintothecategoryofmen
whohavesexwithmen(MSM).Weconcur
thatdoingsoisinvalidating,violent,and
counter-productive,andarepleasedtosee
thatorganizationsareincreasingly
recognizingtheneedforadistinctresponse
fortranswomen.Ontheotherhand,weare
troubledbyblanketstatementsthatdivide
transgenderpeoplefromMSM,because
suchstatementserasetransmenwhohave
sexwithmenandjustifyourcontinued
exclusionfromMSMHIVprograms.

Ineffect,thisrhetoriccontributestous
fallingbetweenthecracksofa(nascentand
stillunder-resourced)HIVresponsefortrans
women,andtheMSMHIVresponse.
Verylimiteddataareavailableto
characterizetheHIVburdenandprevention
ortreatmentneedsoftransMSM,
particularlyoutsideofCanadaandthe
UnitedStates[2].Inaddition,untilquite
recently,transmenhadbeenexcludedfrom
alltrialsofbiomedicalHIVpreventiontools.
Paradoxically,basedontheassumptionthat
transmasculinepeopleareatlowriskfor
HIV,weareexcludedfromresearchthat
couldrefuteorsubstantiatethisassumption.
Theabsenceofevidenceisnotevidenceof
absence.
Ourexclusionisalsobasedonassumptions
aboutthekindsofsexwehaveandwho
wehavesexwith.Infact,transmencan
anddohaveallkindsofsexwithpartners
ofallgendersandsexualities.Forexample,
someofusexclusivelyengageinanalsex
withcisgender(non-trans)gayandbisexual
men,andsomeofusaresexworkers.In
addition,wesometimesexperiencesexual
assaultwithinandbeyondgaycommunities,
increasingourriskforHIV.Thus,evenif
HIVprevalenceamongtransMSMtrulyis
lowrelativetotranswomenandcisgender
MSM,preventioneffortswillbenecessary
toavoidincreasingHIVincidenceinour
communities.Wehaveobservedthatin
somecities,transMSMareincreasingly
partofgay/MSMsexualculturesand
communities.Wecelebrateandaffirmthese
spaces.Atthesametime,recognizethat
thisshiftmayincreaseourriskforHIV,
particularlyifweareexcludedfromHIV
preventioninitiatives.

Whileweurgentlyneedtoenhancedata
collectionontransmasculinepeopleand
HIV,wedonotneedtowaitforsuchdata
tobeginincludingtransMSMintheHIV
response.Therefore,wecallonall
stakeholdersintheHIVresponsetorecognize
andaffirmthattransmasculineMSMare
MSM.ThismeansincludingtransMSMin
HIVresearch,programming,andpolicy
documentsrelatedtoMSMinconsultation
withlocaltransmasculinecommunities.Keep
inmindthatthesecommunitiesmayidentify
withIndigenousandotherculturally-specific
genderdiverseidentitiesthatarenot
reducibleto"transMSM",andtaketheir
leadonhowbesttorespectfullyand
meaningfullyinvolvethemintheHIV
response.Itmeansanendtotheconflationof
transgenderpeoplewithtransgender
women.
OrganizationsbyandfortransMSMexist
andareavailabletoprovideguidanceon
howbesttoincludeusandreflectourdiverse
identities,bodies,andexperiences.Wehave
providedalistbelow,whichunfortunately
onlyincludesformalorganizationsbasedin
high-incomecountries.Wehopetobeable
toexpandthislistinthenearfuture,andwe
callonorganizationsanddonorstoinvestin
communitymobilizationfortransMSM
globally.
PeerAdvocacyNetworkfortheSexual
HealthofTransMasculinities(PASH.tm),
Australia
www.facebook.com/pashtm
tm4m,Asian&PacificIslanderWellness
Center,SanFrancisco,USA
http://apiwellness.org/site/tm4m/
TransMensWorkingGroup,OntarioGay
MensSexualHealthAlliance,Canada
www.queertransmen.org

References
1.WorldHealthOrganization.ConsolidatedguidelinesonHIVprevention,diagnosis,treatment
andcareforkeypopulations.Geneva;2014.Availableat:
http://www.who.int/hiv/pub/guidelines/keypopulations/en/
2.ReisnerSL,MurchisonGR.AglobalresearchsynthesisofHIVandSTIbiobehaviouralrisksin
female-to-maletransgenderadults.GlobalPublicHealth.2016;11(7-8):86687.
3.IRGT:AGlobalNetworkofTransWomenandHIV.Countingtranspeoplein:Advancing
globaldatacollectionontranspeopleandHIV.Oakland,USA;2016.Availableat
http://transglobalactivism.org.
4.PASH.tm.Positionstatement:datacollection.December2015.Availableat:
https://www.facebook.com/notes/pashtm/pashtm-position-statement-datacollection/1220634297957157

Signed (in alphabetical order):

NoahAdams,co-chair,Gay/Bi/Queer
TransMensWorkingGroup,OntarioGay
MensSexualHealthAlliance
Canada

AramHosie,PASH.tm&BoardDirector,
VictorianAIDSCouncil
Australia

RonnyArnephy,Director,LGBTISey.
Seychelles

TshepoRickiKgositau,Director,Gender
Dynamix
SouthAfrica

MauroCabral,Co-Director,GlobalAction
forTrans*Equality
Argentina

NikoKowell,tm4m,AsianandPacific
IslanderWellnessCenter
UnitedStates

LawrenceChipili,Director,Trans,Intersex
andLesbianMalawi(TILMA)
Malawi

JamesMcKye,Coordonnateur,ASTT(e)Q:
ActionSantTravesti(e)set
Transsexuel(le)sduQubec,projetde
CACTUSMontral
Canada

TedCook,PASH.tm
Australia
MasenDavis,Co-Director,GlobalActionfor
Trans*Equality
UnitedStates
PintyDludlu,ProjectOfficer,RockofHope
Swaziland
JustusEisfeld,IndependentConsultant
UnitedStates
UwimanaEnide,Directeur
Executif/ExecutiveDirector,Transgender
IntersexeInAction(TIA)
Burundi
BrandynGallagher,OutshineNW
UnitedStates
ChanGrey,Director,TransBantuZambia
(TBZ)
Zambia
LaurieHopkins,PASH.tm
Australia

MarvellousMoffat,Director,Houseof
EmpowermentandAwarenessinTanzania
Tanzania
TamposeMothopeng,Director,ThePeople's
Matrix
Lesotho
BarbraMuruga,Director,EastAfricanTrans
HealthandAdvocacy
Network(EATHAN)
Kenya
RickyNathanson,Director,Trans*Research,
Education,Advocacy&Training(TREAT)
Zimbabwe
DeyonceNorris,Coordinator,Trans
MovementofNamibia(TAMON)
Namibia
DaniyarOrsekov,Director,KyrgyzIndigo
Kyrgyzstan

Signed (in alphabetical order):

JezPez,PASH.tm
Australia
SariReisner,ScD,AssistantProfessor,
HarvardMedicalSchool
UnitedStates
CiannB.Russell,HumanRights&
AdvocacyOfficer,AsiaPacificTransgender
Network
Thailand
AydenScheim,PhDCandidate,
EpidemiologyandBiostatistics,Western
University
Canada
JoshuaSehoole,RegionalManager:
Iranti-org
SouthAfrica
AdamSmiley,HealthOfficer,Transgender
Europe(TGEU)
Germany
SouthernAfricaTransForum(SATF)
MphoTekanyo,Director,Health
EmpowermentandRights(HER)
Botswana
JholerinaTimbo,Director,WingsTo
Transcend
Namibia

ApakoWilliams,Coordinator,Uganda
NetworkforTransandGNC(UNTGNC)
Uganda
AedanJ.Wolton,Director,cliniQ
UnitedKingdom
JoeWong,ProgramManager,AsiaPacific
TransgenderNetwork
Thailand
JolXavier,co-prsident/co-chair,
Gay/Bi/QueerTransMensWorkingGroup,
OntarioGayMensSexualHealthAlliance
Canada