Unique challenges for transgender community

Self-esteem, employment and HIV can be everyday problems

Ken Shigematsu remembers it well: When he came out as a gay man, it was a community of transgender people in his home state of Hawaii that embraced and helped him through a difficult time in his life.

"What mattered to me was that they were interested in ensuring I was safe, nurtured and loved," says Shigematsu, now a social worker and team leader at the S.F. AIDS Foundation.

His office is in San Francisco's Tenderloin District, home to a tightly knit community of transgender women, and where the same sense of community and support exists.

HIV infection among San Francisco's self-identified transgender community is thought to be at a rate even higher than that which exists in the gay men's community.

Because of the stigma that often accompanies the physical changes transgender women manage, it is very difficult for these women to find acceptance mainstream society as well as gaining meaningful and sustaining employment. As a result, many engage in basic survival activities such as exchanging sex or drugs for money, or becoming wholly dependent upon other individuals for support.

"There are definitely issues of self-esteem, domestic violence, suicidal ideology and depression," says Shigematsu.

Transgender women asking for support come seeking many of the same services as other clients, including financial benefits counseling, housing and emotional support. Of the 350 women who are seen regularly by the S.F. AIDS Foundation social workers in the Women & Family Services program, 19% self-identify as transgender women. The goal is to fully integrate transgender women into emotional support activities and program services and help them to live a fuller, happier life.

Copyright 1997, San Francisco AIDS Foundation.