Breaking barriers and building bridges: Capacity building workshop to build inclusive health services for young transgender and gender diverse people in Indonesia

In 2019, young people aged 15-24 accounted for a significant portion of new HIV infections globally, highlighting a critical gap in efforts to address HIV among young key populations, particularly in some regions of Asia and Africa  (UNAIDS, 2021). Young transgender individuals, notably vulnerable within this group, face disproportionately higher risks of HIV infection. Studies in 2021 showed that trans women are 66 times and trans men nearly seven times more likely to contract HIV compared to their cisgender peers. However, accurate data on the global HIV burden in transgender populations is scarce due to their low visibility in national surveillance systems (Stutterheim et al., 2021; Zhang et al., 2020).

To combat these challenges, Youth LEAD conducted a study focusing on healthcare inclusion for transgender youth in Indonesia, Thailand, and the Philippines. The study revealed a prevalent practice of unsupervised hormonal therapy among transgender youth, highlighting a need for better healthcare access and education (Wolter & Hegarty, 2022). In response, Youth LEAD, alongside a transgender doctor and consultant, Alegra Wolter, developed a training module: “Delivering inclusive services for young transgender and gender diverse people: A training module for healthcare workers,” with the aim to sensitise healthcare workers (formal and informal) on the unique needs and challenges faced by young transgender and gender-diverse individuals.

The module was successfully piloted in Jakarta, Indonesia, on December 2, 2023, in collaboration with Inti Muda Indonesia. The sensitisation workshop welcomed 42 attendees from a range of professions, including healthcare, activism, NGO work, and academia. Participants, aged between 21 and 65, represented a spectrum of gender identities—cisgender, transgender, and non-binary. Many were engaged in gender and health-related fields, holding roles such as doctors, nurses, midwives, public health officers, counsellors, community health workers, and educators. Notably, many were from organisations championing transgender and gender-diverse rights, illustrating a shared dedication to enhancing inclusive health services for young people in Indonesia.

Led by consultant and facilitator Alegra Wolter, co-facilitator Agatha Syailendra Hamdan, and organisers from the Inti Muda team—including Hanam Tyara Treechada, Turip, Bella Aubree, among others—the workshop brought together healthcare professionals and transgender community advocates to explore the complexities of gender identity and intersectionality. Through the "Wall of Hope" and the "SOGIESC Show," participants shared their experiences and visions for a more inclusive future. The program delved into the health rights of young transgender individuals, highlighting the need for universally accessible healthcare as human rights and exploring the challenges posed by discrimination and non-inclusive policies and programs. Role-playing exercises underscored the importance of respectful healthcare interactions, while discussions condemned unethical practices like conversion therapy and stressed the importance of evidence-based, gender-affirming interventions. The workshop culminated with a commitment to integrating LGBTQIA+ considerations into broader health and educational frameworks, marking a significant step toward inclusive and affirmative healthcare for transgender individuals.

Overall, the Youth LEAD and Inti Muda workshop was a crucial step in raising awareness and understanding of the unique needs and rights of the transgender community in healthcare. It set the stage for future collaborations and training programs to provide inclusive and affirmative healthcare for transgender individuals, underlining the importance of evidence-based approaches in tackling transgender health and rights issues.

Authors: Alegra Wolter, Leo Villar, Agatha Syailendra Hamdan

Sources:

Stutterheim, S. E., Dijk, M. van, Wang, H., & Jonas, K. J. (2021). The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis. PLOS ONE, 16(12), e0260063. https://doi.org/10.1371/journal.pone.0260063

UNAIDS. (2021). Young people and HIV. https://www.unaids.org/sites/default/files/media_asset/young-people-and-hiv_en.pdf

Wolter, A., & Hegarty, B. (2022). Transgender youth inclusion in healthcare in Southeast Asia: Insights from Indonesia, Thailand, and the Philippines. https://www.youthleadap.org/application/files/3616/8568/5636/TransYouth_SituationAnalysis.pdf

Zhang, Q., Goodman, M., Adams, N., Corneil, T., Hashemi, L., Kreukels, B., Motmans, J., Snyder, R., & Coleman, E. (2020). Epidemiological considerations in transgender health: A systematic review with focus on higher quality data. International Journal of Transgender Health, 21(2), 125–137. https://doi.org/10.1080/26895269.2020.1753136