Introduction: Mak nyahs (male-to-female transgenders) often consume feminizing hormones to achieve and maintain the female physical appearance. They do it without professional prescription/advise, and often take excessive doses. This renders them at risk of developing complications of hormone consumption. This paper provides some quantitative data on hormone consumption among mak nyahs in Kuantan, Pahang, in Malaysia. Materials and Methods: A cross-sectional study was carried out from July to August in 2015 among 35 mak nyahs. Convenience sampling was used. Participants who gave consent answered an interview-guided questionnaire which documents socio-demographic profile, hormone usage, and morbidities as a result of hormone consumption. Data was analysed using SPSS, Version 16.0. (version 16). Results: Majority of the subjects were Malays (91.4%) and Muslims (97.1%), their median (IQR) age being 31 (±17) years, more than half (57.1%) were between 20 to 40 years old. Most (80.0%) of them are sex workers. Oral hormone was most commonly used (88.6%), while more than half (67.7%) of them added hormone injections. Almost all subjects purchased hormones over the counter from local pharmacies (94.2%). However, many received information on hormone from non-professional sources. Possible adverse effects of hormones reported among subjects were hypertension, ischemic heart disease, diabetes mellitus, and venous thrombo-embolism. Conclusion: Hormone consumption was very common among the subjects in this study, and may be associated with certain medical problems. Medical personnel must pay more attention in educating the mak nyahs on adverse effects of hormones consumption. Mak nyahs should also be screened for complications every time they seek medical attention.
Mak nyahs are locally known male-to-female transgenders in Malaysia. In Western countries, medicalization of transgenderism allows strictly selected patients to undergo sex reassignment surgery. However, a standardized treatment system is not yet available in Malaysia. A number of mak nyahs underwent sex reassignment surgery at their own will. This study aimed to explore mak nyahs’ knowledge and perception on sex reassignment surgery. Materials and Methods:A qualitative research was carried out from 13thJuly 2016 till 31st August 2016 among 8 adult mak nyahs in Kuantan, Pahang. Snowball sampling was used. Participants who gave verbal consent were interviewed individually and in focus groups. Data obtained was transcribed and used as the primary data source. Results: All informants were Malays and Muslims. They generally had some knowledge about the standard procedures and risks in sex reassignment surgery. All informants expressed their desire to have the surgery, but chose not to. Reasons discouraging them from having the surgery were: i) religion, ii) forbiddance from family, iii) fear of regret, iv) death from surgery, and v) the lack of necessity. Factors driving them to have the surgery: i) more income from sex work, ii) pressure from sex clients, iii) securing a stable relationship, iv) self-satisfaction, and v) hope for a better future. Conclusion: Religion seemed to be the main reason refraining them from undertaking the surgery. Counselling mak nyahs should include the advantages and disadvantages of sexual reassignment surgery. Islamic religious preaching is very important to help reduce high risk behaviours, as well as teaching mak nyahs to cope with challenges in adult life. Further research is necessary to show association between religious knowledge and successful rehabilitation of the mak nyahs’ community.
Introduction: Transsexuals face discriminations and rejections from the Malaysian society. The number of
studies done on understanding the phenomenology, experiences, and problems faced by transsexuals is still
few in Malaysia. This research aims to document their psycho-social and spiritual backgrounds and the
relevant experiences, and to explore their perceptions and needs as male-to-female transsexuals in the
context of Persatuan Insaf Pahang, Malaysia. Materials and Methods: A qualitative research was carried out
in July and August 2015 among eight male-to-female transsexual adults in Kuantan, Pahang. Snowball
sampling was used. Participants who gave consent were interviewed in two focus groups. Data obtained was
transcribed and used as the primary data source. Results: Subjects in this study reported confusions over
their gender identity since childhood. They struggled against conflicts regarding their transsexuality in
adolescence, and eventually many quit their studies. As adults, they were discriminated against in
employment and religious settings. They provided positive feedbacks on religious authorities who could
understand problems unique to transsexuals and empathise with the transsexual community. Conclusion: The
psycho-sexual phenomenology is the same in transsexuals all over the world. Misunderstanding and
discrimination from the society remain heavy towards this community. Transsexuals should learn to adapt to
meeting expectations from the society as well, so they could be accepted in public. They will need religious
guidance and spiritual support for better quality of life. Dedicated efforts are still needed in training
professionals in the educational, medical, and religious fields to attend to the specific needs of transsexuals
in this country.
Introduction. Male-to-female transgender individuals are known as mak nyahs in Malaysia. Akin to many other countries, mak nyahs face discriminations in securing proper employment, thus many end up in sex trade, exposing them to HIV-related high risk behaviours. This paper aims to investigate the knowledge, attitude, and risk behaviours in HIV/AIDS among mak nyahs in Malaysia. Method. Validated questionnaires in local language were used. Knowledge, attitude, and HIV-related risk behaviours were measured. With respondent-driven sampling method, 54 subjects participated in the survey. IBM SPSS was used for data analysis. Results. Majority of the subjects reported to have HIV-related sexual risk, although only a quarter were sex workers. Misconceptions still remained among the subjects. Inconsistent condom use was common. Adequate knowledge did result in better attitude towards HIV/AIDS. However, multiple regression analysis showed that subjects with higher knowledge in HIV/AIDS tend to have higher sexual risks (β = 0.320, p = 0.030). Conclusion. Educating the transgender community about HIV/AIDS does not seem to adequately reduce the HIV-related sexual risks. Other approaches, i.e. socio-cultural values and religious practices may be effective to instil higher levels of awareness and self-responsibility in this community to eliminate HIVrelated high risk behaviours.
Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang.
Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test.
Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01).
Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.