title: 'You should build yourself up as a whole product': Transgender female identity in Lima, Peru.
abstract: Transgender women in Lima, Peru have, until recently, been grouped together with gay and bisexual men in the category MSM, or men who have sex with men, with little consideration of their unique situation and needs. Transgender women, self-identified in Peru as travesti, are a socially vulnerable population with many unmet health needs, including an HIV prevalence of 30%. Understanding specific transgender identities and their contexts will contribute to the improvement and development of HIV prevention programs. Through qualitative open-ended interviews with trans-identified women in Lima, Peru, this study found that the non-normative travesti identity is constructed within a conservative homophobic and heteronormative social context. Participants strive towards appearances and relationships perceived as feminine, seeking out silicone injections and abusive men as social markers of this femininity. Sex work is the primary economic activity available and travestis are often alienated from their families and communities. Work is needed to increase self-esteem and decrease violence, stigma, and discrimination. There is a need for multilevel HIV prevention campaigns prioritising travesti in Lima, utilising a human rights framework.
authors.affiliation: a Department of Family and Community Medicine , University of California, San Francisco , San Francisco , CA , USA.
authors.forename: Lealah
authors.initials: L
authors.lastname: Pollock
authors.affiliation: b Center for Interdisciplinary Research on Sexuality, AIDS, and Society , Cayetano Heredia University (Centro de Investigación Interdisciplinaria en Salud, Sida, y Sociedad de la Universidad Peruana Cayetano Heredia) , Lima , Peru.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Silva-Santisteban
authors.affiliation: c Department of Medicine , Center for AIDS Prevention Studies, Center of Excellence for Transgender Health, University of California, San Francisco , San Francisco , CA , USA.
authors.forename: Jae
authors.initials: J
authors.lastname: Sevelius
authors.affiliation: b Center for Interdisciplinary Research on Sexuality, AIDS, and Society , Cayetano Heredia University (Centro de Investigación Interdisciplinaria en Salud, Sida, y Sociedad de la Universidad Peruana Cayetano Heredia) , Lima , Peru.
authors.forename: Ximena
authors.initials: X
authors.lastname: Salazar
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D054625:Healthcare Disparities; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D036301:Qualitative Research; D012649:Self Concept; D063508:Social Discrimination; D057545:Social Stigma; D063106:Transgender Persons / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: HIV; Latin America; Transgender persons; gender identity