Risk reduction strategies for transgender people regarding sexually transmitted diseases and health promotion
Résumé
Objectives
Transgender people are a heterogeneous and growing population in visibility and numbers. They face
documented difficulties in accessing health care systems, mainly based on the lack of training of
professionals and discrimination. In addition, the organization of health care systems is still largely based
on a psychiatric and pathologizing approach that reduces the possibilities of intervention and excludes
people from the health care system as well as research and policy-making. Multiple international studies
document a high prevalence of HIV and other sexually transmitted infections in this population. This work
is based on field initiatives in health promotion and emphasizes the recognition of the expertise of
organizations and field actors with the aim of identifying applicable and acceptable approaches for
intervention.
Methods
We conducted a systematic review of activist literature from European organizations and French local
associations. After analyzing the quality of the included documents, we performed a thematic analysis
aiming at identifying the courses of action and strategies to be used for health promotion interventions
and campaigns.
Results
The results highlight the multiplicity and expertise of associations in the field of harm reduction in sexual
health. Transgender people face specific issues mainly related to social exclusion and inadequate health
care systems. These issues are all the more important when people have a poor experience of medical
services or exist outside of a heterosexual gender binarity.
Conclusions
The implementation of strategies to promote the health of transgender people regarding sexually
transmitted diseases requires major epistemic and social changes. Individuals themselves seem best
equipped to deal with field challenges. Moreover, their concerns are in line with scientific data and policies
promoted by the World Health Organization. The major difficulty seems to be linked to Western care
systems and therefore associations should be put in a decision-making position for public health policies.
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