UF Study: Discrimination Forces Transvestites Into Prostitution

September 10, 1998

GAINESVILLE — Being ostracized from society forces many transsexuals and transvestites into prostitution, putting them at risk for abuse, violence and the deadly virus that leads to AIDS, a new University of Florida study finds.

Often rejected by their families at an early age, and with few sources of social support, they are left with little option for survival other than prostitution, said James “Al” Bay, a UF graduate student in anthropology who did the research for his dissertation.

“It’s a very difficult life out on the street, where they’re subject to robbery, rape and gun shots, literally on a daily basis,” Bay said.

Between February and June 1997, Bay conducted a series of interviews in Miami with 48 of these male prostitutes. Most reported having a strong sense of being, or wishing to be, female, since early in life. Often cross-dressers, many go to great lengths to feminize their appearance, and although the participants in this study had not undergone sex changes and do not plan to have them, many took hormones and injected silicon into their breasts and hips, he said.

“When we look at a person, the first thing we see is whether they are male or female, and we have a whole set of expectations that go with that observation,” Bay said. “These people upset that. They are outside the mainstream of society in a most basic way.”

Because these people remain hidden from much of society and don’t fall into a designated high-risk group for AIDS, they are not targeted for programs or intervention by the public health community, Bay said. “The tragic result is that here in Miami, with the third-highest rate of AIDS in the United States, we have a significant group of individuals who are overlooked,” he said.

Of the group Bay studied, 40 percent tested positive for HIV, 69 percent for hepatitis B and 19 percent for syphilis, he said.

Although the study participants knew how to prevent HIV transmission with condoms, they often neglected to do so because their customers offered them more money for sex without them, Bay said. “If they need the money and a client says, I’ll pay you twice as much without a condom,’ where does that leave them?” he said.

Little is known about their customers, though many are married or in heterosexual relationships, said Bay, who is the Miami coordinator for the Young Men’s Survey, an HIV-related research project funded by the U.S. Centers for Disease Control and the Florida Department of Health. Although these customers have sex with other men, Bay said, they may not frequent places where they would receive AIDS- and HIV-prevention information.

Most people reported they would prefer some other line of work to prostitution but felt they had no choice, he said.

“Many participants in the study said they receive so much harassment that they couldn’t go outside during the day, much less sit in a waiting room for a job interview,” he said. “And if they did apply for a job, they weren’t even considered.”

Don Kulick, an anthropology professor at Stockholm University in Sweden and one of the world’s foremost experts on transvestites and transsexuals, said Bay’s insights into that community are invaluable for disease prevention.

“Bay’s research is crucial for health-care officials working to halt the spread of HIV and other [sexually transmitted diseases],” Kulick said. “For health-care workers to be able to helped transgendered sex workers, and to be able to treat them with the respect that we ourselves demand, we need to know more about their lives, their concerns and their problems.”