Sukri Palutturi, SKM, M.Kes.
Student of MSc.PH & Leads., Griffith University, Queensland, Australia
Louis Wirth, sociologist, as cited in Wikepedia, the free encyclopedia defined that “a minority group as “a group of people who, because of their physical or cultural characteristics, are singled out from the others in the society in which they live for differential and unequal treatment and who therefore regard themselves as objects of collective discrimination. This definition includes both objective and subjective criteria: membership of a minority group is objectively ascribed by society, based on an individual’s physical or behavioral characteristics; it is also subjectively applied by its members, who may use their status as the basis of group identity or solidarity. In any case, minority group status is categorical in nature: an individual who exhibits the physical or behavioral characteristics of a given minority group will be accorded the status of that group and be subject to the same treatment as other members of that group”.
Therefore, there are some types of minority groups such as racial or ethnic minorities, religious minorities, gender and sexual minorities, age minorities, disabled minorities, minority of political party. On the other hand, minority is also related to language, and nationality. Because the minority scope is very broad so that on this papers I only will focus on a minority groups relating to gender and sexual minorities. This target groups is very important because of the probability to get inequality and discrimination that will affect the health status of transvestites groups.
B. The difference between transvestites, gay men and lesbians
Transvestism is the practice of cross dressing, which is wearing the clothing of the opposite sex. Transvestite refers to a person who cross-dresses; however, the word often has additional connotations. So, transvestite is a male dressed as a female. In contemporary usage, the adjective gay usually describes a person’s sexual orientation, being the standard term for homosexual. In earlier usage, the word meant “carefree”, “happy”, or “bright and showy”, though this usage is infrequent today.
The word gay is sometimes used to refer to same-sex relationships more generally, as in “gay marriage”, although this usage is discouraged by some LGBT supporters: the rationale is that this usage is exclusive of not only bisexual and transgender people but also lesbians who generally reject labels of being a subset of men, even gay men. While gay applies in some contexts to all homosexual people, the term lesbian is sex-specific: it is used exclusively to describe gay women. Sometimes gay is used to refer only to men. Outside of Western culture the concept of “gay” identity is less clearly defined and may clash with local models of sexuality.
Lesbian is a woman who is romantically and sexually attracted only to other women. Women who are attracted to both women and men are more often referred to as bisexual. An individual’s self-identification might not correspond with her behavior, and may be expressed with either, both, or neither of these words.
Therefore, transvestites are a male dressed as a female whom has sexual orientation men to men but also can men to women. Meanwhile, gay men and lesbians are homosexual whereas lesbians are females to females. But both gay men and lesbians can be bisexual. We also identify “cats” in sexual orientation. “Cats” are opposite of gigolos, look like sexual workers on females.
C. A Case Study of Transvestite: Gaya Celebes Foundation
Gaya Celebes Foundation is a Non Government Organization which concern in HIV/AIDS program particularly on transvestites, gays and lesbians. This foundation was established in 2001 with the goal to encourage their target group to claim their rights such as social, security, cultural, economic rights. In fact, transvestites often get rough action, discrimination, alienation from the government, mass media, polices, communities even their family as well.
There is no exact data relating to the number of transvestites in South Sulawesi but it can be predicted around 7,000-8,000 people. The actual number of transvestites is estimated to be much more than the data got because many transvestite do not want to give their identity openly and they have not been already psychologically to inform to other people including their family. Therefore, this data was only got by the activity in Non Government Organization “Gaya Celebes Foundation =GCF” or by a snowball technique. From 23 provinces in South Sulawesi, Makassar has the largest number of transvestites (around 5,000 people). Meanwhile, the other transvestites live in the other districts. The target group of GCF is only around 1500 people. Predicted, that number of HIV/AIDS cases among transvestites is about 300 cases. The main cause of this case is by sexual transmission (Gaya Celebes Foundation, 2008). This differs from other HIV/AIDS cases in South Sulawesi that generally it is caused by injecting drug users.
D. The involvement of transvestite groups in Indonesian development
Although transvestites often get treatment such as discrimination and gossip but actually they have contributed in Indonesia development in many aspects for example:
• Dorce is as a multitalented comedian (advertisement and singer)
• Chenny Han is as a designer of bridge or bridegrooms dress.
• Transvestites working in salons
• Transvestites are as a designer of interior.
• Transvestites are as a designer of raiment.
• Transvestites are as a chef at restaurants.
• Dede Oetomo becomes an intellectual transvestite. He graduated from Cornell University, United States for PhD program, and others.
E. The social determinant and policies that affect the health of transvestite groups
1. Knowledge, attitude and practice
A survey that was conducted by Lubis, I, et al. 2006 in Jakarta to transvestites states that mostly among transvestites fear about HIV/AIDS. They do not have sufficient information to determine whether they are infected or not but they have willingness to change their sexual behavior. From over 600 transvestites which were asked, there are 40 percent having 8 or more different sex partners per week. This survey also found that low risk receptive are oral sex, thigh massage (simulated vaginal sex) and masturbation of the client were routine activities but high risk receptive anal sex without condoms was most common.
A study which was also conducted by Lubis, I, et al. 1995 at the same city states that from 253 transvestites asked about the pattern of their sexual behavior and knowledge and attitude toward HIV/AIDS, that are still inadequate knowledge on HIV/AIDS transmission mode. They are still practicing unsafe sex such as exchange sexual partners and low condom use. It is predicted that they have an average of diverse sexual partner around 5 men per three weeks. This study finds that exchange sexual partner is lower than previous study. In addition, they, generally, do not want to use condom. Their reason is such as forgetfulness 35.3% and partner does not like condom 38.2%. However, most of transvestites know about condoms (94.5%), but it is difficult to access condom from small shops around them. Therefore this study suggests that to minimize and prevent further spread of HIV/AIDS in transvestites, condom use should be used constantly. It has been shown from another study, that more information, better availability and better promotion of condoms can increase condom use. Thus, attention should be placed on various ways of distributing condoms for transvestites in Jakarta, especially community-based distribution by peer leaders, social marketing and commercial sales
2. Culture, stigma, discrimination and social exclusion
Generally, Indonesian community have not received yet about existence of transvestites particularly in villages although some of them have to brave to coming out. Stigma and discrimination still often occurs to them, for instance: 1). A mother bans her boy to be friend with transvestites, 2). Transvestites did get treatment well from a doctor or health providers, 3). Transvestites were caught by a police and threw them to a sea and after that, the police brought them to policy office and asked them to open undershirt, 4). The other cases, a policy separated a transvestite with his partner. 5). Transvestites found difficulty to arrange resident chard (its reason: hospitalized patients go to toilet). For resident card, this still become a problem for transvestites in Indonesia except in Papua’s local government. This district, the local government recognizes three genders: males, females, and transvestite. Many transvestites are still closed. They generally, have been not ready yet to inform about their identity to their family. The most problem of stigma by transvestites comes from his family because their families do not want to receive this reality. Even, they get discrimination, gossip, ridicule from their family. As a result of these causes will create social exclusion. They do not want to inform their problem to other non-transvestites. Social exclusion will be associated with poverty and risk factor to their health.
3. Minority rights in National and International Law
Minority rights, as applying to ethnic, religious or linguistic minorities and indigenous peoples, are an integral part of international human rights law Like children’s rights, women rights and refugee rights, minority rights are a legal framework designed to ensure that a specific group which is in a vulnerable, disadvantaged or marginalized position in society, is able to achieve equality and is protected from persecution. Subsequent human rights standards that codify minority rights include the International Covenant on Civil and Political Rights (Article 27), the United Nations Declaration on the Rights of Persons Belonging to National or Ethnic, Religious and Linguistic Minorities, two Council of Europe treaties (the Framework Convention for the Protection of National Minorities and the European Charter for Regional or Minority Languages, and the OSCE Copenhagen Document of 1990. Minority rights cover protection of existence, protection from discrimination and persecution, protection and promotion of identity, and participation in political life
To protect minority rights, many countries have specific laws and/or commissions or ombudsman institutions. For example Indonesia places the rights of transvestites groups in Subcommittee for protection of specific group. Minority groups have eighth sub themes: two of them are LGBT group (Lesbian, Gigolo, Bisexual, and Transvestites) and people living with HIV/AIDS (ODHA).
1. There is no relationship between transvestites’ knowledge of HIV/AIDS with their practice.
2. Exchanging sexual partner often occur to them with unsafe sex
3. Culture, stigma, discrimination and social exclusive contribute to health status of transnvestite groups.
4. The national and international law insure the minority rights.
G. Reference list
Halim, A (2008). Gaya Celebes Foundation, Makassar, Indonesia.
Lubis, I., Master, J., Bambang, M., Papilaya, A., & Anthony, R.L. (Years). AIDS related to attitudes and sexual practices of the Jakarta WARIA (male transvestites). Jakarta: Indonesian Public Health Association. Retrieved April 5, 2008, from http://www.ncbi.nlm.nih.gov/pubmed/7824998?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
.Lubis, I, Master, J., Munif, A., Iskandar N, Bambang M, Papilaya A, et.al. (1997). Second report of AIDS related attitudes and sexual practices of the Jakarta Waria (male transvestites) in 1995. PubMed-indexed for MEDLINE. Retrieved April 2, 2008 from http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Master%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus
The social determinants of health. The Fred Hollows Foundation. Australia.