Tranys, Dicks & Fannys

Men Who Have Sex With Both Men & Transgenders

by Jo Alley

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

While many men who have sex with men (M.S.M.) also have sex with transgenders, education strategies to reach these men and to raise the issue of safe sex with transgenders, have not been developed in Sydney. This is surprising as both M.S.M. and transgenders are recognised as important groups in terms of H.I.V. / AIDS education and as seroprevalence amongst both sub-populations is high compared to the Australian population as a whole. This article highlights the social and behavioural risk factors which indicate that educating M.S.M. about safe sex with transgenders should be a priority. M.S.M. research generally should include relevant questions about sex with transgenders.

Transgenders and Safe Sex

Perkins et al. (1994a page 20) give their largest estimate of the number of transgenders living in New South Wales, as 2500, with a high proportion living in Sydney.

As at 30 June 1995, 20 transsexuals were recorded as having been diagnosed as H.I.V. positive in Australia (National Centre in H.I.V. Epidemiology and Clinical Research. October 1995) The Gender Centre had 18 H.I.V. positive transgenders recorded to their files for 1993 - If the Gender Centre figures and the largest estimate for transgenders living in N.S.W. are used, a seroprevalence of 0.7% of transgenders can be estimated. This is nine times the percentage for the Australian population (Perkins et al. 1994a. page 65).

There has been only one major Australian study examining safe sex/needle use issues for transgenders. Of the 113 sexually active transgenders surveyed by Perkins et al. (1994b page 20), 41.6% indicated that they always used condoms for non-sex work relationships, while 27.4% never used condoms for non-sex work relationships. 30% (44) of the transgenders indicated that they were injecting drug users. However, only three had shared needles in the last six months.

Sex work had been practiced by 45% of the 146 transgenders surveyed by Perkins et al. (1994a page 34 & page 37). Only three-quarters of the 66 transgender sex workers used condoms "always". Almost 5% of those engaged in sex work reported rarely or never using condoms. There is an enormous reliance on street work amongst transgender workers, which poses particular pressures in relation to H.I.V. / AIDS.

A range of societal factors may place some transgenders at a disadvantage when trying to negotiate safe sex. Almost all sections of society, discriminate against transgenders. One third of the 146 transgenders surveyed by Perkins et al. (1994 page 58) reported discrimination by government employees, 40% reported discrimination by gays, 39.7% reported discrimination by their own families and 34.2% reported discrimination by Police. According to Perkins et al. (1994b page 18) there is a high incidence of unemployment, drug abuse, involvement in sex work, and suicide amongst transgenders, although considerable numbers of transgenders do nor fit this description, many do face considerable pressures.

Traditionally transgenders have nor been in a strong negotiating position because of loneliness and a need for acceptance and affection. According to Perkins et al. (1994b page 20), "Since finding and keeping a lover is so rare amongst transgenders, he or she who is fortunate enough to acquire a regular sex partner will do almost anything to maintain the relationship". Having high numbers of sex partners for some transgenders may be related to the need for validation in terms of "passing" and desirability. Sexual partners for many transgenders include heterosexual and bisexual members of male groups out on the town for the night, gay men, M.S.M. who are not open about their sexual activities with men, other transgenders and lesbians.

Sex between M.S.M. and Transgenders

A research project conducted across Sydney, Wollongong and Bathurst/Orange suggests chat a significant number of M.S.M. have had sex with transgenders. During the past year, 12% (82) of 682 responders to Bangar (Hood et al. 1994 page 72) had sex with women, transgenders and men. 1.7% (12/682) had sex with transgenders and men. Small numbers of middle Eastern men and Southern European men reported having sex with transgenders.

A substantial number of M.S.M. responding to the Bangar study (Hood et alii 1994 page 38) reported having unsafe sex with their transgender partners. 10.3% (73/698) indicated that they had had unprotected anal or vaginal intercourse the last time they had had sex with a male, the last time they had sex with a female and also the last time they had sex with a transgender partner.

Research

More specific research conduced with transgenders currently being undertaken by the Central Sydney Area Health Service Transgender Project, will provide valuable information about the social and sexual relations of transgenders within a context of discrimination and marginalisation. However, research should also be conducted with gay identified and non-gay identified M.S.M., about the meanings they attach to sex and relationships to transgenders.

M.S.M. research generally does not consider men who have sex with men who also have transgender issues. Yet over half of the 146 respondents to the study by Perkins et al. (1994a page 29) identified as homosexual, gay or bisexual, prior to gender changes. 88.4% (129) of the 146 respondents were born into the male gender.

Cross-cultural studies of men engaging in sex with men may also defy the conceptualization of M.S.M. and transgenders as completely separate groups. Anglo definitions of "transgender" are challenged. For example, in a study conducted in Northern Thailand, Jan W. de Lind van Wijngaarden (1995), outlines twenty-nine concepts/terms that are used to describe men who have sex with men in accordance with varying masculine/feminine traits, desire to change gender, sexual practices and roles.

Other research conducted in Vietnam has found that as some homosexually involved adolescent males move into adulthood, and become aware of their homosexuality and the societal belief that equates it with feminine behaviour; they then restrict their sexual pleasures to the passive role of fellating "masculine" men. Some of these young men move on to full cross-gender behaviour and present themselves in public as women (Carrier et al. 1992 page 547). The impact of these types of social roles on Australian Vietnamese men is currently being studied (McMahon 1996).

Future Directions

In September 1995, a workshop was conducted by The Gender Centre about transgender issues for M.S.M. workers. This was an attempt to familiarize M.S.M. workers with transgender issues, enabling M.S.M. workers to begin to address issues for men who have sex both with men and transgenders.

The workshop was attended by staff from South Eastern Area Health Service, ACON Western Sydney, ACON Hunter and Hunter Area Health Service. The first five recommendations below were formulated by the workshop participants and facilitators:

1. Education strategies for M.S.M. about sex/relationships with transgenders should be included in the ACON M.S.M. strategic plan.
2. A working group involving SWOP, M.S.M. workers, The Gender Centre and ACON venues project should be formed to address M.S.M./transgender issues.
3. Where M.S.M. information and support telephone lines are available, advertisements should be placed in local newspapers targeting men who have sex with men and transgenders.
4. Sex with transgenders should be incorporated in to some M.S.M. literature.
5. The possibility of training transgenders as "barefoot" educators of M.S.M., should be explored.
6. M.S.M. research (particularly metropolitan-based research targeting gay-­identified men or non-gay identified men) should generally include relevant questions about sex with transgenders.
7. There is a need for quality social research which examines different conceptualizations of what the Western world defines as "transgender".

Workshop participants responded with enthusiasm to the issues raised and were interested in incorporating the issues in their work with M.S.M. It is hoped that this will lead to specific initiatives and resources targeting men who have sex with both men and transgenders. As Jill Hooley, from the Transgender Project notes, "There is a need to target M.S.M. The targeting of tranys must be accompanied by targeting of tranys' partners, most of whom are M.S.M."

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.