HEALTH-ARGENTINA: "Buddies" Ease
Transgenders' Hospital Visits
By Marcela Valente
BUENOS AIRES (IPS) - Keeping a
hospital appointment in the Argentine
capital is a far less fearsome ordeal for
transgender persons, a sector of the
population that according to doctors had
"dramatic" statistics of illness, when they
are accompanied by trained health promoters
who, like them, have chosen a different
gender identity.
"It's easier to communicate among ourselves
than with hospital staff," Valeria Ramírez,
a transgender promoter with the city of
Buenos Aires' Programme to Facilitate Access
to the Health System for the Transgender
Population, told IPS.
In place since 2007, the strategy has
increased the frequency of consultation and
health check-ups by this marginalised
community, as well as boosting the immune
systems of those infected with HIV/AIDS.
Ramírez, who is also the coordinator of one
of the centres run by the Buenos Aires AIDS
Foundation (FBAS), meets transgender
patients as they arrive at the Ramos Mejía
Acute General Hospital, and accompanies them
as they request appointments and have X-rays
and other tests.
"The plan emerged in order to improve the
treatment rate of 'trans' persons, who
exhibited high levels of illness," Dr.
Marcelo Losso, of the hospital's department
of services for immunocompromised patients,
told IPS.
According to a study by Losso's department
in conjunction with other organisations,
such as Ramírez's FBAS, the prevalence of
HIV/AIDS and syphilis in this population is
much higher than among the other patients
who attend the hospital.
Between 2002 and 2006 they examined 105
transgender sex workers, with an average age
of 28. Their HIV prevalence was 27.6
percent, compared with 6.2 percent among
non-transgender patients attending the same
department.
In the case of syphilis, a sexually
transmitted infection that is easily treated
nowadays, prevalence in the transsexual
community was 42 percent, compared to 18
percent in non-transgender patients.
The study, published in the Buenos Aires
medical journal Medicina under the title "Infecciones
de Transmisión Sexual en Personas
Transgénero y otras Identidades Sexuales"
(Sexually transmitted infections among
transgender individuals and other sexual
identities), found that the transgender
group had comparatively low education and
income levels and a relatively high
incidence of alcohol and drug abuse.
"Clearly, this group is not taking the
necessary prevention measures, particularly
correct, constant condom use," said Losso.
But he put forward other reasons, too, that
might explain the worrying indicators.
"There's a difference between transgender
and non-transgender sex workers. The latter
have an HIV prevalence of 4.5 percent. The
transgender group is evidently a high-risk
population, and has very limited access to
the health care system," he said.
"They definitely do not find the hospital a
friendly place, and the same is true of
educational institutions and workplaces.
When so many of them turn to prostitution
for a living, it indicates that they have
very few opportunities to find work
elsewhere," he concluded.
On the basis of these findings, in 2007 the
hospital created the Programme to Facilitate
Access to the Health System, funded by the
Global Fund to Fight AIDS, Tuberculosis and
Malaria.
"The programme covers three areas," Dr.
Javier Toibaro, of the department of
services for immunocompromised patients,
told IPS. Training of health personnel and
the lay promoters is one area, and
activities inside and outside the hospital
are the other two.
Sociologists, anthropologists and sexual
minorities organisations participated in the
training, aimed at raising awareness among
doctors and nurses who treat transgender
patients, and identifying those most suited
to the challenge.
Training was also provided for promoters
from the Argentine Association of
Transvestites, Transsexuals and Transgender
Persons (ATTTA), who are on hand to meet
patients from these groups when they arrive
at the hospital and accompany them to
different departments for tests or
treatment, providing company and support.
But the doctors and promoters also reach out
into the community. "We go to neighbourhood
centres with the specialist in infectious
diseases, we take blood samples, respond to
queries, and go back with the results of
routine tests," Ramírez said.
This involves visiting the places where the
target population lives, works or otherwise
frequents. Apart from the tests and
consultations they offer, the promoters also
distribute condoms.
In Ramírez's view, the programme "has had
very good results," because it counteracts
the discrimination that transgender persons
dread, and that they say is expressed in
insults, mistreatment, trivialisation of
symptoms and other ways.
"For instance, something that happens to us
frequently is that although by law we should
be called by our new gender name, we are
asked for documents and they call us by the
name matching our biological sex, which is
unacceptable," Ramírez said.
Calling a transgender person by the name she
has rejected is a bad start, especially when
the patient is seated in a gynaecological
waiting room awaiting hormone treatment, and
is surrounded by women, she said.
The programme to facilitate access has
resulted in a six-fold increase in the
number of consultations per month. Toibaro
said it has been "very effective," with
results that are "over and above
expectations." He said the patients'
immunological systems are strengthened now,
which prevents or delays opportunistic
infections that strike when defences are
low.
The doctor said the results suggest that the
appalling health indicators among this
minority group "are not related to their
choice of gender," but to sociocultural
factors of the type that this programme is
trying to correct, such as violence,
discrimination and lack of opportunities.
"Once we went to a hotel in the Flores
district where transvestites were living.
They were mainly from Peru, and had certain
conflicts with other groups. Besides me, our
group included a nurse, two social workers
and a lawyer," he said.
"The questions they asked were all directed
at the lawyer. And that shows that, while we
are proposing health care and prevention for
the long term, they are just trying to
survive the everyday violence they face,"
Toibaro said. |
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