01.11.2013 At first hand

Editorial Steven Derendinger. The first Swiss HIV & STI forum on the sexual health of trans people, which was organised by the Federal Office of Public Health (FOPH), marks not only an increased awareness of this topic, but also an important and welcome change in its development.

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This change is partly ideological. Recognition of the existence of trans people and their needs obliges us to question our traditional understanding of gender, gender identity and sexual orientation. This in turn necessitates continuous efforts to improve the sensitisation and education that will direct our society and administrative structures towards a more humane and open-minded approach to the issue. While the transgender community is already confronted with stigmatisation on a daily basis, it faces a further social stigma that constitutes a great challenge: HIV/AIDS.

But the change is also epidemiological in nature. The FOPH-commissioned "Rapid Assessment" of the situation of trans people and the inclusion of their identity in the BerDa software for VCT puts an end to their invisibility in national statistics and in the monitoring of HIV and other notifiable sexually transmitted infections. The inclusion of the variable "Transgender" in the next Swiss Health Survey conducted by the Federal Statistical Office (FSO) would make it possible to obtain more accurate data on the health of this population group and define their needs more precisely.

Finally – and above all – the change is strategic. There is still so much work to be done, particularly in the field of sexual health. New research and prevention programmes need to be developed and implemented in close cooperation with the transgender community. Alongside HIV/AIDS, the most important issues are poor access to medical care, social discrimin­ation and its consequences (family and social exclusion, loss of jobs, low self-esteem, drug use, marginalisation and violence) and the legal hurdles that so often attend the coming-out of transgender people. These are social obstacles that can be overcome only through far-reaching changes in society involving input from politicians and dedicated specialists.
The first step has been taken.

Steven Derendinger
Prevention and Promotion Section
Federal Office of Public Health

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