Talking about safer sex is a complicated process for individuals in the transgender community, a new study has found.
The finding from North Carolina State University may help efforts to promote safer sex practices in a community facing high HIV rates - and also shed light on broader questions related to safer sex for everyone.
"The main reason for this study is the fact that we're seeing evidence of devastatingly high HIV prevalence rates in the transgender community," Dr. Kami Kosenko, an assistant professor of communication at NC State and lead author of the study, said.
"The HIV prevalence rate is less than 1 percent for the general U.S. population.
"But for the transgender population, the HIV prevalence rate is estimated to be as high as 60 percent in major metropolitan areas. Although these are only estimates, they are troubling," Kosenko stated.
Kosenko notes that research on sexual communication in general is fairly limited. Historically, sex communication research has defined safer sex discussions as one of two things: finding out about a partner's sexual history; or trying to persuade a partner to use a condom.
What Kosenko found is that communication about safer sex, at least in the transgender community, is far more complicated.
After interviewing 41 transgender individuals from around the country, Kosenko found, for example, that privacy is a significant issue.
Transgender individuals have to make often-difficult decisions about when and how to disclose their biological sex to prospective partners - because that revelation carries the risk of rejection, or even violent behaviour.
Kosenko found that transgender individuals - like people in other groups - try to gauge sexual health risks by talking to prospective partners about their sexual history and safer sex practices.
But Kosenko also found that these talks can be undermined if a partner is being dishonest about his or her past - a problem that is presumably faced by those outside the transgender community as well.
"This study shows that understanding sexual communication goes beyond attempts to discuss sexual history. It also entails the difficult process of trying to determine if a sexual partner is being forthcoming," Kosenko said.
"I think these findings will help us provide safer sex outreach tools for the transgender community that are based in reality.
"And a lot of what we found in this study applies to sexual communication outside of the transgender community as well.
"Pushing for people to always use condoms may be impractical. Perhaps it would be more effective to promote a broader definition of safer sex practices," Kosenko added.
The study, 'The Safer Sex Communication of Transgender Adults: Processes and Problems', has been published in the June issue of the Journal of Communication.