Seroprevalence amongst trans women
cross posted at Harlot’s Parlour
Since yesterday was World AIDS day I thought I’d drop some stats about seroprevalance amongst trans women, especially sex workers, worldwide.
Studies about HIV infection rates amongst trans women populations overall:
* 14% amongst trans women in Puerto Rico (Rodriguez-Madera and Toro-Alfonso 2005) and Chicago (Kenargy and Boswick 2005)
* 21% in Sydney (Alan et al 2005)
* 24% in Amsterdam (Gras et al 1997)
* 25% in Houston (Risser et al 2005)
* 35% in San Francisco (Clements-Nolle 2001)
Specifics (transsexual unless noted, some included transvestite or travesti sex workers)
* 63% of trans women of colour in San Francisco indicated HIV positive (Clements 2001)
* 74% in Rome among transsexual and travesti who use drugs. Most notably, the same study found 100% seroprevalence of people who had been in the same milieu for more than four years (Gattari et al 1992).
Rates amongst trans sex workers
* 46% in Lisbon (Bernardo et al 1998)
* 68% in Atlanta (Elifson et al 1993)
* 63.8% in Rio de Janiero (Surratt et al 1996)
* 62% amongst transsexual and travesti sex workers in Bueno Aires (Berkins and Fernandez 2005)
All of these statistics have been taken from Viviane Namaste’s recent research paper “Undoing Theory: ‘The Transgender Question’ and the Epistemic Violence of Anglo-American Feminist Theory” (Hypatia journal, vol 24, no. 3, summer 2009) where she argues that a feminist emphasis on what transsexual and transgender bodies mean has neglected the very real crises of violence and HIV infection amongst our communities. Namaste argues compellingly that HIV has ravaged communities of transsexual women worldwide, a “lost generation” whose disappearance has largely gone unnoticed. Looking at these statistics, I can’t say I disagree with her.
Very interesting, especially the comment about relating this to cisfeminism; it seems that if we don’t have cis people actively trying to murder us, we have HIV/AIDS amongst a large population of us to worry and fight about as well.
z
2 Dec 09 at 1:20 am
The same “going unnoticed” applies to many political attempts, too. I’m afraid the proposals for gender identity protections tend to obfuscate the issue: trans women don’t get murdered because of their identities (the attackers hardly ask them “How do you identify as?” before attacking) – we get assaulted and murdered because of the way we look or are perceived to be by others. Protection for gender identity -based discrimination neatly shoves the very real violence under the table. Not that I mind gender identities being protected against discrimination, but violence perpetrated against people perceived to be trans, esp. trans women is thus yet again pushed to the background. The problem isn’t anyone’s gender identity, or their gender presentation – the problem is the violence against people who look different, not the people who look different, or their looks, or why the look the way they do, or their motivations, or, in fact, anything with them. It’s the violence, and the agency for that lies squarely with the perpetrators, not with the victims.
Carto
2 Dec 09 at 1:39 am
Vivian Namaste’s article is available here.
Lisa Harney
2 Dec 09 at 6:26 am
Ah, that’s just what I was going to ask. Thanks for the link, Lisa.
Rachel_in_WY
2 Dec 09 at 8:26 am
“The problem isn’t anyone’s gender identity, or their gender presentation – the problem is the violence against people who look different”
That’s why the Trans Alliance Society’s petition to the BC Legislature last year aked for protection on the grounds of gender identity AND gender expression. It’s no good without that “and”.
Note that this also protcts gays who present outside the gender binary: butch lesbians and femme gays, who would otherwise be at risk. Too bad HRC and the assimilationist gay men who have been trying to throw us under the bus yet again can’t seem to realise this.
Jessica
2 Dec 09 at 9:42 am
While I don’t want to minimize the importance of seroprevalence in the trans community, I just want to mention there is reason to doubt some of the accuracy in those San Francisco statistics (where I live). The chosen sampling in these studies is crucial (this study was done by the SF Public Health Department and CAPS–the Center for AIDS Prevention Studies). They were primarily taken at public health centers and trans-service agencies in the Tenderloin, which is the lowest income area in downtown SF and in a small section of the Inner Mission District. It’s also where most of the street trans sex workers are. This study wasn’t intended to study the ‘entire transgender population’ (not that the study ever properly defined what that consists of) but to study the population in the tenderloin (and compare it to a very vague sampling of other transpeople taken from people in a couple of organizations. Unfortunately, the statistics of the study have been frequently repeated and misquoted to state how it somehow represents the seropositivity of the entire trans population of the city… which it doesn’t and didn’t purport to do. Again, the message of what you’ve said is right, just the framing of what the numbers of the study actually represent is off. It doesn’t change the central issue of how seriously HIV has impacted transwomen, especially transwomen of color.
Gina Morvay
2 Dec 09 at 10:26 am
It’s the violence, and the agency for that lies squarely with the perpetrators, not with the victims.
This is absolutely true. But to be fair to the academic feminists (like Butler) that Namaste is critiquing, I don’t think they’ve ever claimed that the problem is with the victims. I think their view is that violence and other social injustices like AIDS infection rates and mental illness and high suicide rates among the trans population arises from their marginalization which is rooted in the conceptual framework that’s so prevalent in our culture in which trans people are aberrant, creepy, pervy, less-than, etc. In this view it’s this marginalization which gives rise to and allows for the perpetrator’s mentality (and the ridiculous way the violence is then handled by the police, media, and courts) to begin with. This cultural worldview is what marginalizes trans people and causes or contributes to their high-risk, vulnerable status, so it’s this whole big causal chain that begins with the dominant conceptual framework that people like Butler are addressing. So I don’t think you have to claim that identifying as trans directly caused a person’s victimization or HIV infection. Instead, being trans put them into this marginalized position where they were ostracized, mistreated, unemployed etc, etc which led to their vulnerability and lack of access to protection and services. But this is built into the concept of intersectional marginalization for someone like Butler, and I think Namaste overlooks that.
Of course, I’m probably being over-generous to Butler, but it’s hard to agree with Namaste’s reading of her if you’ve also read Butler’s other work. Either way I think the whole discussion highlights the need to work on it from both ends – the conceptual/social attitudes angle and the political/activist angle.
Rachel_in_WY
2 Dec 09 at 11:03 am
Thanks for that info Gina.
Also, this article is really interesting! Thanks for the link, Lisa!
~Morgan
Morgan Page
2 Dec 09 at 7:49 pm
Yes, thanks for that Gina. As with any statistic, we do need to be critical about the way those stats have been produced. Positivist social science has its problems, but I wanted to just get them out for a rough kind of idea of the kind of research that’s been produced, a basic look at the problem. If anyone’s got any more studies then by all means post them here and I’ll amend the post :)
queenemily
2 Dec 09 at 11:27 pm
And yeah, I think you are being overly generous to Butler on trans issues (a writer who I do tremendously like, btw) Rachel.
I agree with Namaste’s overall argument that Butler’s work very often obscures the shape of trans oppression. A number of her readings have just been profoundly wrong, something which I think has a bit to do with her psychoanalytic commitments–Lacan calls us psychotics in Ecrits, and it’s not really improved much over the years (Zizek’s pretty appalling, too)
Judy B’s interest is generally in the ways in which subjects are formed and the norms that regulate subjectivity, a subject which Namaste doesn’t have a lot of patience for. Bodies that Matter in particular is pretty appalling on that (Jay Prosser’s critique is right otm re the Venus Extravaganza reading), but she’s quite right in suggesting that Undoing Gender has its wtf moments on transness (eg the whole bit about Boys Don’t Cry). In so far as Butler has been guilty of theorising about transness and intersexuality as though they’re metonymic for all sex and all gender, I think Namaste’s critique is right. Namaste’s paper is an extension from her Invisible Lives book from 2000, which suggested that queer theory quite frequently uses transness as a rhetorical trope disconnected from the kinds of institutional contexts that produce trans subjects as essentially aporias (she doesn’t use the word, but the incoherent status of trans people with documents is a kind of paradoxical form of both non-meaning *and* overdetermination).. I think Namaste’s Foucaultian critique of Butler on that score is quite solid.
But I also think that Butler’s been very often horribly misread, and that Namaste’s critique applies much more to the use of Butler via citation than to much of Butler’s writing. So this has a lot to do with general academic processes too, something which “Anglo-American” feminism as Namaste terms it *is* imo complicit in. Lipservice to intersectionality or not, I think most cis feminist writers including Butler have failed to consider trans women as in any part of the broader rubric of “woman,” except in a metaphorical sense evacuated of liveability. Julia Serano accomplished more in one book on that score than Butler did in a decade, tbh.
Still, I think cautiously that Butler’s work, in particular the recent writing on ethics from Precarious Life to Frames of War, provides one philosophical framework for theorising trans experiences, but perhaps that is a task best left to trans women ourselves.
queenemily
2 Dec 09 at 11:37 pm
Rachel_in_WY,
“But to be fair to the academic feminists (like Butler) that Namaste is critiquing, I don’t think they’ve ever claimed that the problem is with the victims.”
The (cis) academic feminists by and large have never been fair to trans people, so I fail to see why trans people should be expected to extend a (non-reciprocated) fairness to them. Also, in my opinion, trans people on the whole have been EXCEEDINGLY fair. Perhaps excessively fair, even.
“Of course, I’m probably being over-generous to Butler, but it’s hard to agree with Namaste’s reading of her if you’ve also read Butler’s other work.”
So if I agree with Namaste, that means I couldn’t possibly have read Butler’s ouevre? Or does it mean that I COULD have read it but simply am not goshdarn smart enough to have properly understood it? Bah.
queenemily,
“Julia Serano accomplished more in one book on that score than Butler did in a decade, tbh.”
Actually letting trans women be the ones to talk about trans women? What absurdity, that!
Just Some Trans Guy
3 Dec 09 at 10:41 am
Oh! And thanks for posting this, queenemily, and for all the great posts y’all write here. Sorry that I forgot to say that.
Just Some Trans Guy
3 Dec 09 at 10:48 am
Yeah, I agree that, no matter how you look at it, feminist theory leaves a lot to be desired in it’s treatment of trans issues. I just think that a lot of the basic ideas are there, and I do think that Butler’s scrutiny of the gendered subject has a lot of potential to benefit trans, cis, and genderqueer alike. And I think that when you’re critiquing the sex-gender system that mainstream culture takes to be so natural and immutable, it’s natural to look at the places where the breakdown is most clearly visible, which is unfortunately squarely in the middle of the lives of trans and intersex people. And that always carries the risks of objectifying and coopting and over-generalizing and dehumanizing. So there is a profound ethical obligation involved in treading on this ground, and I think this is often overlooked or underestimated. And I also agree that it’s essential to have voices that are situated in the relevant intersection in order to really get at the issues, and to avoid these problems.
Rachel_in_WY
3 Dec 09 at 10:32 pm
Trans Guy,
I don’t believe I said that trans folk owe cis feminists any kind of nonreciprocal respect. What do we all owe to each other? At the very least, not to attribute words and beliefs to someone that they’ve never claimed, implied, or owned. I was simply saying that this particular interpretation of Butler is inconsistent with her work taken as a whole. This is a fairly standard way of doing textual interpretation, but I’m sorry if it seemed to imply some sort of insult.
Rachel_in_WY
5 Dec 09 at 2:08 pm
Rachel_in_WY,
“Trans Guy,
I don’t believe I said that trans folk owe cis feminists any kind of nonreciprocal respect. What do we all owe to each other? At the very least, not to attribute words and beliefs to someone that they’ve never claimed, implied, or owned. I was simply saying that this particular interpretation of Butler is inconsistent with her work taken as a whole. This is a fairly standard way of doing textual interpretation, but I’m sorry if it seemed to imply some sort of insult.”
The insult was here: ” …but it’s hard to agree with Namaste’s reading of her if you’ve also read Butler’s other work.”
I agrew with Namaste’s reading (not entirely, but in the whole). I have also read a fair bit, though by no means all, of Butler. Your phrasing implied that to agree with Namaste means one is ignorant of Butler (“if you’ve also read”) or perhaps just not very intelligent (“it’s hard to agree”).
That Butler and other theorists have never explicitly claimed that the fault for violence lies with perpetrators and not victims does not change the fact that a large chunk of feminist theory is focused on the construction of gender, the artificiality of gender, the “drag” of gender–all of which is of interest to them as cis feminists–to the exclusion of addressing the actual concerns of trans, not cis, people (and trans women especially).
I don’t know what Butler believes in her heart of hearts, and I don’t care. I care that her work is used in oppressive ways, and I care that it’s yet another cis academic appropriating trans people’s bodies and lives.
Just Some Trans Guy
7 Dec 09 at 8:39 am
Trans Guy,
I guess that’s just where we disagree about Butler’s project. It’s clearly true that trans people’s bodies and lives are often appropriated by academic feminists. I’ll be the last to argue with that. But in Butler’s view, the focus on the construction of gender etc does not benefit cis women alone, or only women, for that matter. If the source of one’s marginalization is undermined, then that marginalization itself, and the accompanying vulnerabilities, are also undermined. And Butler sees this focus on the construction of gender as an undermining, subversive act intended to alter (end?) the system which produces that marginalization.
As to how her work is used… I’m not sure to what degree we can hold people accountable for the ways their work is used/misused by others. Certainly there’s an obligation to disown harmful misuses of your work, and to clarify your words in order to make the illegitimacy of that use clear. But I don’t think it’s fair to paint a person with the same brush as those who have misused their words, or to write them off altogether because of someone else’s hateful bullshit.
And I didn’t mean to imply that Namaste’s reading has to be based in ignorance, although I can see how it sounded that way. I think people can, and often do, do selective readings of another writer in order to get their project going. It’s very common, and to some extent we all do it. But when an interpretation of someone’s work becomes selective to the point that it renders the original writer’s view incoherent and contradictory, then I think it’s problematic.
Rachel_in_WY
8 Dec 09 at 9:56 pm
I think I would question the effectiveness of Butler’s undermining: in the current, deeply cissexist culture an undermining project that focuses on trans sexes and genders seems to undermine those sexes and genders only – Butler’s subversive project doesn’t seem to subvert cishetero sexes and genders in any practical way at all. Certainly it could be used that way, but in fact, it isn’t. Butler’s not deconstructing cissexual people’s sexes or genders in any meaningful way as far as I can see (based on Gender Trouble, Bodies That Matter and a bit of Giving an Account of Oneself), and neither do her followers seem to. I might be ignorant and not know everything there is to know about this (I’m not in the academia), but that’s my impression anyway.
Carto
9 Dec 09 at 5:21 am
Yeah, I think a truly subversive deconstruction of gender would focus strictly on cis people’s genders.
Lisa Harney
9 Dec 09 at 6:24 am
Rachel_in_WY,
“I guess that’s just where we disagree about Butler’s project.”
I think we probably do.
“As to how her work is used… I’m not sure to what degree we can hold people accountable for the ways their work is used/misused by others.”
Not fully accountable, of course, but I do think Butler holds some accountability–she has a famously (well, famous in gender studies and women’s studies circles) incomprehensible writing style. And surely after several books and papers, she must be aware of how people are using (or misuing, as the case may be) her work.
“And I didn’t mean to imply that Namaste’s reading has to be based in ignorance, although I can see how it sounded that way.”
I did think it sounded that way. Still, I should have asked rather than accused, and I apologize for taking a more hostile approach than I should have.
Carto and Lisa,
Very true! Trans people are discussed in gender studies academia far disproportionate to how many of us exist in the general population. One could argue that that’s because trans genders are “exceptional”–but, of course, that’s a cissexist argument to make. Because, yet again, and very non-subversively, it places trans gender into the “constructed” category and (if even just by implication) puts cis genders into the “natural” category.
Just Some Trans Guy
9 Dec 09 at 9:48 am
I think it’s interesting that the original post is about how some populations of trans women have alarmingly high HIV infection rates, but the discussion seems to be focused on a cis woman who writes about trans people in an objectifying manner.
Lisa Harney
9 Dec 09 at 11:26 pm
Yeah, sorry for the derail at the start. Should’ve been more focused on the whole, but the fact is, I don’t know much about seroprevalence here.
Either it happens amongst trans women I don’t know anything about, or it isn’t such a prob here.
I’d like to think it’s the latter, as this is a seriously small country with equally small trans population, and we’ve a more-or-less functioning public health care, sex ed in schools, and free anonymous HIV screening available rather widely. Though not as widely as it should be – that is, everywhere. So some of the basics are in place: you don’t have to be rich to get tested and treated, and practically everyone’s educated in principle, at least, and the education is NOT some silly abstinence stuff, but more like “how to use condoms if you’re having sex”.
But I may well be wrong, and it may be that trans women are not identified as such by the testers – if trans women’s seroprevalence figures are colluded with the figures for gay men (wouldn’t surprise me the least), a different picture might emerge. But as it is, there’s no data.
Again, doing sex work is not totally unheard of here, but by the looks of it it’s not that common. But yet again, it could be my privilege and ignorance talking. I don’t have any numbers available.
Carto
10 Dec 09 at 12:49 am
Sorry for participating in the derail, Lisa.
These stats seem relatively in line with what I know of my community. I live in an area in my state that has high HIV rates in general. Most trans-specific services in my area are run by the local HIV/AIDS organizations. There’s a support group for trans women, attended mostly by African-American women and by women who are sex workers, and there’s a medical clinic (for hormones and referrals).
Both of these are offered by the respective organizations expliclitly as part of HIV/AIDS prevention efforts, which seems to me to indicate that there’s probably a fairly high infection rate among some demographics of trans communities here.
Just Some Trans Guy
10 Dec 09 at 1:36 pm
I apologize for participating in the derail as well.
To me it seems like the relevant questions that tie theory and reality together center on the social sources of vulnerability and how these vulnerabilities play out in the real world. I don’t for instance, think it does much good to merely try to reduce something like HIV infection rates among the trans population without also addressing the reasons why trans people are systemically so much more vulnerable. That seems like a bandaid approach. But on the other hand, theoretical discussions are all too often so detached from the reality, or get derailed or misapplied, or interpreted from the dominant (cis) perspective… There has to be some way to consistently combine the two in a meaningful way.
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