Abstract

The history of transgender public health in mainland China runs partly through an institutional corridor built for HIV prevention among men who have sex with men (MSM). From the late 1990s through the 2000s, AIDS programs created partnerships among local disease-control agencies, gay and tongzhi community groups, peer educators, testing sites, international funders, and digital outreach networks. Those arrangements made otherwise hard-to-reach sexual-minority populations legible to public-health institutions. Transgender women could enter many of the same bars, clubs, online channels, community organizations, testing programs, and research recruitment networks. At the same time, a behavioral frame centered on “male–male sex” often placed gender identity behind the variables that public health counted first.

This essay asks how that inherited infrastructure shaped transgender public-health visibility from 1997 to 2026. It traces a movement across five levels: contact, service entry, recording, an independent denominator, and interventions designed for that denominator. The central argument is that transgender public-health history carries a dual inheritance. The first is an infrastructure inheritance: community outreach, peer education, testing, CDC–community cooperation, and online recruitment developed within the MSM HIV response became practical channels through which transgender women could later be recruited and served. The second is a classification inheritance: transgender women initially appeared inside, beside, or as a subgroup of MSM samples before studies increasingly recorded gender identity explicitly, reported transgender-specific denominators, compared transgender women with cisgender MSM, and designed dedicated interventions.

This dual inheritance clarifies why inclusion and recognition follow different historical timelines. A program may reach transgender women while its database still compresses gender identity into a behavioral category. A later study may preserve a separate transgender denominator while continuing to use the same community organizations and disease-control infrastructure that an earlier MSM project built. Reading infrastructure history together with classification history therefore gives a more precise account of how transgender women became a distinct public-health population in Chinese HIV research and service design.

Keywords: transgender history; mainland China; HIV; AIDS; MSM; public health; community organizations; surveillance; transgender women; peer education

1. Research question: when does a population become visible to public health?

Public health makes populations visible through several linked operations. Outreach workers decide where to meet people. Programs define eligibility. Registration forms choose fields. Surveillance systems group records. Researchers construct denominators. Funders attach resources to those categories. Service organizations then design interventions around the people those categories describe. Each operation leaves a different historical trace.

That distinction matters for transgender history in China because the HIV response already possessed a dense infrastructure for reaching sexual-minority communities before transgender-specific datasets became common. China’s broader AIDS response expanded rapidly after the late 1990s and early 2000s through state programs, international projects, local Centers for Disease Control and Prevention, civil-society participation, and targeted prevention among key populations (Wu et al. 2007; Kaufman 2020). Within that field, MSM programs developed community outreach, condom distribution, peer education, voluntary counseling and testing, internet recruitment, and partnerships with gay and tongzhi organizations (Chow et al. 2014; Tang et al. 2016).

For a transgender woman who had sex with men, those channels could provide a real route into HIV prevention. The same route could record her primarily through a behavioral eligibility rule. Tang and colleagues’ 2016 scoping review captures this historical tension particularly clearly: research and prevention for transgender people in China overlapped heavily with MSM work, while national HIV, STI, and sexual-health surveillance offered limited transgender-specific measurement at the time (Tang et al. 2016). Later studies increasingly separated transgender women within samples recruited through those inherited networks.

The question here is therefore specific: How did mainland China’s HIV-response infrastructure create public-health entry points for transgender people, and how did transgender-specific data and services gradually differentiate from the MSM behavioral frame?

I use public-health visibility to describe five cumulative capacities:

contact → service entry → recording → independent denominator → denominator-specific intervention

A person can become reachable before becoming separately countable. A subgroup can become separately countable before services are designed around its particular conditions. These stages can coexist inside the same institution or even the same study. Their uneven timing is the central historical object of this essay.

2. Sources and method: a public-health visibility matrix

The source base combines four kinds of evidence. First, scholarship on China’s HIV response and queer civil society reconstructs the institutional environment that produced community outreach and state–NGO cooperation (Wu et al. 2007; Hildebrandt 2011, 2018; Cao and Guo 2016; Miller 2016; Kaufman 2020). Second, epidemiological and qualitative studies of transgender women show how recruitment criteria, survey fields, comparison groups, and outcomes changed between the mid-2010s and the 2020s (Cai et al. 2016; Shan et al. 2018; Yan et al. 2019a, 2019b; Sha et al. 2021; Shan et al. 2022; Wang et al. 2023; Zhu et al. 2024). Third, China CDC and community-organization records preserve practical details of peer education, sentinel surveillance, testing, online work, and local partnership. Fourth, WHO and UNDP materials show the wider shift toward treating transgender people as a key population with distinct health needs and toward comprehensive trans health beyond HIV alone.

To compare these materials, I use a public-health visibility matrix:

{year, institution, recruitment_frame, inclusion_rule, gender_identity_field, behavior_field, trans_separate_denominator, service_entry, intervention, referral, follow_up, source_type}

The matrix asks a simple question of each source: what exactly became visible? A community organization may make a population reachable through peer educators. A survey may preserve gender identity. A cohort may create an independent transgender denominator. A randomized trial may design an intervention specifically for transgender women. These achievements occupy different columns.

I also use a classification-inheritance chain:

MSM behavioral frame → community infrastructure → transgender subgroup field → transgender-specific recruitment → independent transgender denominator → transgender-tailored intervention

The arrows trace historical reuse. Different cities and projects moved through these stages in varied orders and at different speeds. Some transgender-specific studies continued to recruit through organizations that had grown from MSM HIV programs. This makes inheritance visible at the level of institutional practice.

The analysis concentrates on transgender women because the Chinese HIV literature located through this source set is heavily weighted toward transfeminine populations. WHO likewise describes major global HIV disparities for trans and gender-diverse people while emphasizing thinner evidence for trans men and other trans populations. This demographic boundary is part of the historical finding: growth in “transgender-specific” HIV evidence has itself been uneven across transgender populations.

3. 1997–2008: HIV response builds a community infrastructure

China’s AIDS civil-society infrastructure predates most transgender-specific HIV studies by many years. Kaufman’s history of civil-society participation identifies 1997 as an early milestone for NGO involvement in a government HIV program and describes bilateral and foundation support that expanded community work in the late 1990s and early 2000s (Kaufman 2020). Wu and colleagues place this development inside the wider evolution of China’s HIV response, including increasing political attention, surveillance, prevention, treatment, and international cooperation (Wu et al. 2007).

The practical importance of this period lies in organizational technique. Reaching stigmatized populations required trusted intermediaries, familiar venues, peer educators, confidential information, and repeat contact. Those techniques were especially important for gay men and MSM because ordinary clinic recruitment captured only part of the population. The HIV response therefore created a field in which community organizations possessed something public-health agencies needed: access.

Community organizations developed around that exchange. Chengdu Tongle traces its work to the early 2000s and became associated with HIV prevention, testing, health counseling, and community services. Profiles from China Development Brief, APCOM, and Health Equity Matters document the organization’s role as a community-based HIV actor and its cooperation with public-health institutions. Shenlan in Tianjin, Danlan, Zhejiang MSM Working Group, Anhui Youth Service Center for AIDS Prevention, Aibai, and other organizations likewise illustrate a geographically distributed ecology in which HIV work, sexual-minority community formation, online communication, and social support became intertwined (China Development Brief, organizational profiles; Cao and Guo 2016).

Miller’s ethnography helps explain the social meaning of these organizations. Queer AIDS NGOs supplied prevention and testing while also providing emotional support, care, identity affirmation, and practical help for people living with HIV. Volunteers described HIV work as a route toward healthier communities and wider social recognition (Miller 2016). This combination of public-health labor and community life matters for transgender history because later recruitment took place within a social infrastructure whose value extended beyond a testing encounter.

Government and disease-control records show a parallel institutionalization of peer work. China CDC archives preserve local examples of MSM intervention projects that used community volunteers, peer education, sentinel monitoring, internet recruitment, and partnerships between CDC staff and social organizations. A Suqian record describes community volunteer participation in MSM intervention work; Baoding records show volunteer groups assisting sentinel surveillance; Neijiang records peer education; a national multi-city project documents the scale at which MSM research and prevention networks had become organized by the mid-2010s (China CDC/NCAIDS records).

By the end of the 2000s, this infrastructure already contained several components later reused in transgender HIV research: community-based recruitment, trusted peer contact, disease-control partnerships, repeat testing, behavioral questionnaires, internet outreach, and referral. The institutional path came first. The transgender-specific denominator followed later.

4. 2008–2015: the MSM frame produces access and compression at the same time

“MSM” entered public health as a behavioral category. Its operational strength comes from a focus on sexual behavior relevant to HIV transmission. Programs can identify a prevention population through behavior even when participants use different identities in everyday life. That design allowed epidemiologists to build comparable surveillance and intervention programs across cities and over time.

The same design also shapes what a database retains. A transgender woman who has sex with men may satisfy an MSM recruitment rule. If a questionnaire records only sex assigned or a binary sex field plus sexual behavior, gender identity becomes compressed inside the larger analytic group. If a questionnaire additionally asks gender identity, the same participant can remain in the behavioral universe while also becoming visible as a transgender subgroup.

Tang and colleagues’ scoping review surveyed this landscape and found a sparse transgender-specific evidence base in China compared with the much larger MSM literature. The review described overlap between transgender populations and MSM HIV research and highlighted the weakness of dedicated surveillance and programming at the time (Tang et al. 2016). That finding gives the classification-inheritance chain a firm historical anchor: the service and recruitment infrastructure had already become dense while the independent transgender denominator was still emerging.

Local organization profiles make the infrastructure side concrete. Danlan’s public record connects online community media with health activity. Aibai linked information circulation, support, and rights work. Zhejiang and Anhui organizations documented cooperation with disease-control agencies and prevention programs. Shanghai services worked among populations that public-health programs classified through HIV-risk categories. Yang Guang’s retrospective account shows how an MSM pioneer could accumulate public-health expertise while also confronting the limits of a narrowly defined prevention role (China Development Brief, organizational profiles and reports).

This history suggests a distinction between coverage and classification resolution. Coverage asks whether a person could be reached by outreach, testing, counseling, or research. Classification resolution asks whether the resulting record preserved the social distinction relevant to that person’s life and health. MSM programs could score highly on the first dimension while producing much coarser information on the second.

The distinction also clarifies why later transgender-specific studies could expand quickly once researchers changed the fields they collected. They inherited venues, relationships, recruitment partners, laboratory procedures, and follow-up routines from a mature HIV infrastructure. A new gender-identity variable could therefore reveal a subgroup inside an already functioning system, and dedicated recruitment could then enlarge that subgroup into its own denominator.

5. 2014–2019: transgender women become an independent denominator

The middle of the 2010s marks a visible shift in the research record. Studies began to recruit transgender women explicitly, report their outcomes separately, and ask questions tied to gendered social position.

A 2016 study of transgender women sex workers in Shenyang examined condomless receptive anal intercourse with male clients and identified factors associated with that behavior (Cai et al. 2016). Its importance for this history lies in the study object: transgender women sex workers appear as the named population of analysis. The denominator itself carries gender identity.

A multi-city study published in 2018 recruited transgender women in Shanghai and Tianjin through community-based organizations and reported correlates of HIV infection specifically for transgender women (Shan et al. 2018). The affiliations and recruitment model also reveal the infrastructure inheritance: national and local disease-control institutions worked with community organizations, while the analysis preserved a transgender-specific group.

Yan and colleagues’ 2018–2019 cross-sectional survey in Nanjing and Suzhou further strengthened this separation. The study reported high HIV prevalence among transgender women and examined associated factors across the sampled population (Yan et al. 2019a). A qualitative study in Jiangsu, published the same year, moved beyond prevalence to identity, stigma, and HIV risk, showing how gender identity, social treatment, sexual relationships, and health behavior interact in lived experience (Yan et al. 2019b).

These studies changed more than sample labels. An independent denominator makes new comparisons possible. Researchers can examine employment, migration, sex work, discrimination, hormone use, gender expression, and care access as variables that may operate differently from those in cisgender MSM samples. The public-health visibility matrix therefore moves from “recording” toward “independent denominator.”

This period also coincided with broader trans-health work. The Asia Pacific Transgender Network and UNDP’s Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific, followed by Chinese dissemination, framed transgender health as a comprehensive domain involving affirming care, community participation, provider competence, and multiple health needs (UNDP/APTN 2015; UNDP China 2018). The national LGBTI survey and UNDP China’s trans-focused public materials further widened the evidentiary field beyond HIV.

The result is a historical crossing of two lines. HIV research increased categorical precision inside an existing prevention infrastructure. Trans-health advocacy expanded the range of needs that health institutions were asked to see. Together, they made “transgender public health” a larger object than a risk-behavior subgroup.

6. International key-population guidance changes the comparison grammar

International HIV guidance also changed the grammar through which programs could describe populations. WHO’s 2014 consolidated guidelines on HIV prevention, diagnosis, treatment, and care for key populations and its 2016 consolidated update list transgender people and men who have sex with men as distinct key populations. The 2022 WHO update continues that structure (WHO 2014, 2016, 2022).

This separation matters because categories do administrative work. A named population can receive a dedicated evidence review, recommendations, indicators, program targets, training material, and intervention design. Once transgender people appear as their own key-population category, a national or local program gains a widely recognized template for preserving gender identity alongside sexual behavior.

The change also sharpens a methodological point. Sexual behavior remains relevant to HIV epidemiology. Gender identity remains relevant to stigma, health-care experience, hormone use, gender affirmation, violence, employment, mobility, and many other determinants. A high-resolution public-health system can preserve both fields. The issue is therefore field architecture: which variables survive from recruitment through analysis and program design?

WHO’s current transgender page underscores both the burden and the evidence boundary. Trans and gender-diverse people experience disproportionate HIV risk globally, while data for trans men and other trans populations remain comparatively thin. The Chinese literature reviewed here displays the same asymmetry: transgender women occupy the center of transgender-specific HIV research. A historically precise account treats that concentration as a property of the evidence base.

7. 2019–2024: from separate data to tailored services and interventions

Once transgender women became an independent denominator, researchers could ask questions that the earlier combined frame handled only weakly.

Sha and colleagues examined gender-minority stress and access to health-care services among transgender women and transfeminine people in China, bringing discrimination and care access into the same analytic frame (Sha et al. 2021). Wang and colleagues later analyzed health-service utilization among transgender women in Shanghai, extending the field from infection status toward primary care and gender-affirming health care (Wang et al. 2023). These studies connect HIV history with the wider institutional conditions under which people seek care.

Longitudinal analysis added another layer. A prospective cohort in Shanghai and Tianjin compared transgender women with cisgender MSM and reported higher HIV incidence among transgender women while estimating risk factors separately for the two groups (Shan et al. 2022). The design demonstrates an important methodological achievement: shared exposure variables can coexist with distinct analytic denominators. Comparison then preserves difference instead of averaging it away.

A trend analysis of transgender women in Shenyang used repeated cross-sectional data from 2014 through 2019 to examine changes in HIV prevalence, sexual behavior, and PrEP willingness (Chen et al. 2022). Time becomes part of the visibility system: once a population is sampled repeatedly with a stable identity definition, researchers can describe change within that population.

By 2024, a randomized controlled trial of HIV self-testing among transgender women in China represented a further transition. The study recruited transgender women specifically through community-based organizations, tested an intervention intended for that population, and measured subsequent testing behavior (Zhu et al. 2024). In terms of the public-health visibility matrix, this reaches the fifth level: transgender-specific evidence informs an intervention designed and evaluated around a transgender denominator.

The shift from subgroup analysis to tailored intervention should be read together with community infrastructure. Researchers still need recruitment channels, trust, communication, sample collection, referral, and follow-up. Many of those capabilities emerged from earlier HIV community work. Classification became more precise while infrastructure remained historically connected.

8. Counterevidence and evidence boundaries: visibility has a sample architecture

The strongest counterweight to a simple story of “progressive recognition” comes from sampling. Much of the transgender-specific HIV literature in China concentrates on transgender women who have sex with men, participants reachable through community organizations, urban residents, sex workers in some studies, or people willing to enter HIV research. These samples are extremely valuable for the questions they study. Their architecture also defines the population to which their estimates travel most securely.

Tang’s 2016 review already identified a limited transgender evidence base. Later studies increased depth substantially, yet the literature remains concentrated in particular cities and networks. A Shanghai–Tianjin cohort says a great deal about participants recruited through those urban community channels; a Shenyang sex-worker study provides detailed evidence for that local population; a Jiangsu qualitative study illuminates identity and stigma through participants who entered its recruitment pathway. Public-health visibility is therefore produced by where a project can reach, whom it defines as eligible, which fields it asks, and whom it retains in follow-up.

The same boundary applies to gender diversity. The archive assembled here gives far stronger evidence for transgender women than for trans men or many nonbinary populations. WHO’s global guidance highlights comparable evidence gaps. The phrase “growth of transgender-specific data” therefore refers primarily to a rise in studies centered on transgender women within the HIV field.

A second boundary concerns service scope. HIV projects specialize in testing, counseling, prevention, treatment linkage, and related care. Gender-affirming hormones, gender-affirming procedures, identity documents, family relations, schooling, housing, and employment belong to wider clinical and social systems. The UNDP/APTN trans-health blueprint, China’s LGBTI survey, and later health-services and mental-health research expand the picture beyond HIV (UNDP/APTN 2015; UNDP 2018; Sha et al. 2021; Lin et al. 2021). High-resolution transgender public health grows through both directions: HIV systems preserve gender identity more accurately, and broader trans-health systems enlarge the range of needs that services recognize.

These boundaries make the historical claim stronger. Public-health visibility is an institutional achievement with a measurable architecture, instead of a synonym for complete representation.

9. Original synthesis: the dual inheritance of infrastructure and classification

Across these sources, transgender public-health history in China can be organized through two inheritances that move together.

The first is infrastructure inheritance:

AIDS civil-society opening → gay/MSM community organizations → peer education and outreach → CDC–community cooperation → testing and survey networks → transgender-specific recruitment and follow-up

Each step contributes practical capacity. A peer organization knows venues and networks. A CDC partnership links outreach to testing. A testing program creates confidential service routines. A research collaboration turns those routines into recruitment and follow-up. When a later transgender study recruits through a community organization, it uses an institutional asset built across earlier projects.

The second is classification inheritance:

MSM behavioral frame → transgender subgroup field → transgender-specific recruitment → independent transgender denominator → within-population trend and cohort analysis → transgender-tailored intervention

Each step increases categorical resolution. Gender identity survives more stages of the data pipeline. The analysis can then ask questions specific to a transgender social position, and intervention design can respond to those findings.

The two inheritances explain an apparent puzzle. The same HIV system can be both an early access route and a source of categorical compression. Those are compatible historical facts. A community program may have reached transgender women through a broad MSM eligibility rule and thereby supplied testing or support; its data system may simultaneously have retained little gender-specific information. Later researchers can inherit the route while changing the form.

This model also helps distinguish three meanings of “inclusion.” Operational inclusion means a person can enter a program. Statistical inclusion means a person appears in data. Categorical recognition means the data preserve a distinction that permits separate analysis and tailored design. Public-health history gains precision when these meanings are recorded separately.

The dual-inheritance model therefore reframes the emergence of transgender-specific HIV work. It came from both differentiation and continuity: differentiation in categories, measures, and interventions; continuity in people, organizations, public-health partnerships, and field methods.

10. Connecting public-health history to the wider history of transgender institutions

This HIV history intersects with several other histories that GenderLibs has been reconstructing. The 2018 “public-interface year” essay showed how hotlines, public events, legal knowledge, and specialty clinical pathways became easier to enter through publicly named interfaces. The present essay looks further back and follows a different institution: a long-running HIV apparatus that developed community reach well before those 2018 interfaces converged.

The family-interface evidence history shows another contrast. National medical rules can turn relatives into documentary participants in clinical processes, while family research records acceptance, dependence, housing, disclosure, violence, care, and peer support as distinct relationship states. HIV history similarly benefits from field separation. Sexual behavior, gender identity, community affiliation, service eligibility, and health need belong in different columns.

This approach also changes how we read organization histories. A profile that says an LGBT or MSM organization conducted HIV prevention is more than background context. It records infrastructure: who had a phone line, peer educators, an office, a web audience, links to a local CDC, testing capacity, or experience with confidential counseling. Those capacities later determine which new research questions can be asked at scale.

Public-health categories therefore deserve a place in transgender history alongside media, law, medicine, family, and community archives. A category controls what a spreadsheet can preserve. A recruitment rule controls who enters that spreadsheet. An organization controls who can be reached. A denominator controls which outcome can be estimated. An intervention trial controls which service strategy gains evidence. Together, those operations make a population legible to institutions.

Conclusion

From 1997 through the 2020s, China’s HIV response built one of the institutional corridors through which transgender women entered public-health research and services. Early NGO participation, gay and tongzhi community organizing, MSM peer education, local CDC cooperation, confidential testing, online outreach, and multi-city research created durable capacities for reaching populations that ordinary clinic systems captured poorly.

That infrastructure carried a behavioral classification logic. MSM categories organized surveillance and prevention around sexual exposure, and transgender women could enter those systems through the same behavioral frame. During the 2010s, researchers increasingly added gender-identity fields, recruited transgender women explicitly, reported independent transgender denominators, compared transgender women with cisgender MSM, followed transgender cohorts, and studied stigma, health-care access, and population-specific interventions. By the 2020s, the record included prospective incidence research and a randomized HIV self-testing intervention specifically for transgender women.

The history is best understood as dual inheritance. Infrastructure inheritance explains how earlier MSM HIV work supplied trusted community networks, public-health partnerships, and field methods. Classification inheritance explains how a behavior-centered frame was gradually supplemented by higher-resolution gender data and transgender-specific program design. Their intersection created a route from being reachable to being separately countable and, eventually, to receiving interventions evaluated around a transgender denominator.

For future historical work, the public-health visibility matrix offers a reproducible method. For each project, record recruitment frame, inclusion rule, gender-identity field, behavior field, denominator, service entry, intervention, referral, follow-up, and source type. That ledger turns a vague claim about “visibility” into a traceable institutional history: who could enter, what the system recorded about them, which differences survived analysis, and when those differences began to shape services.

References

Academic and research sources

  1. Tang, Songyuan, Weiming Tang, Kathrine Meyers, et al. 2016. “HIV Epidemiology and Responses among Men Who Have Sex with Men and Transgender Individuals in China: A Scoping Review.” BMC Infectious Diseases 16. https://doi.org/10.1186/s12879-016-1904-5
  2. Wu, Zunyou, Sheena G. Sullivan, Yu Wang, Mary Jane Rotheram-Borus, and Roger Detels. 2007. “Evolution of China’s Response to HIV/AIDS.” The Lancet 369. https://doi.org/10.1016/S0140-6736(07)60315-8
  3. Chow, Eric P. F., et al. 2014. “HIV Prevalence Trends, Risky Behaviours, and Governmental and Community Responses to the Epidemic among Men Who Have Sex with Men in China.” BioMed Research International. https://doi.org/10.1155/2014/607261
  4. Cao, Jin, and Lei Guo. 2016. “Chinese ‘Tongzhi’ Community, Civil Society, and Online Activism.” Communication and the Public. https://doi.org/10.1177/2057047316683199
  5. Miller, Casey James. 2016. “We Can Only Be Healthy If We Love Ourselves: Queer AIDS NGOs, Kinship, and Alternative Families of Care in China.” AIDS Care. https://doi.org/10.1080/09540121.2016.1195481
  6. Hildebrandt, Timothy. 2011. “The Political Economy of Social Organization Registration in China.” The China Quarterly. https://www.cambridge.org/core/journals/china-quarterly/article/abs/political-economy-of-social-organization-registration-in-china/6A04A3753759DA827000C702BA26ABD0
  7. Hildebrandt, Timothy. 2018. “NGOs and the Success Paradox: Gay Activism ‘After’ HIV/AIDS in China.” LSE Social Policy Working Paper 01-18. https://eprints.lse.ac.uk/100112/1/01_18_Hildebrandt_T.pdf
  8. Shan, Duo, Mao-He Yu, Jie Yang, et al. 2018. “Correlates of HIV Infection among Transgender Women in Two Chinese Cities.” Infectious Diseases of Poverty 7:123. https://doi.org/10.1186/s40249-018-0508-2
  9. Cai, Yong, Zixin Wang, Joseph T. F. Lau, et al. 2016. “Prevalence and Associated Factors of Condomless Receptive Anal Intercourse with Male Clients among Transgender Women Sex Workers in Shenyang, China.” Journal of the International AIDS Society 19. https://doi.org/10.7448/IAS.19.3.20800
  10. Yan, Hongjing, Wenjing Xiao, Yunting Chen, et al. 2019. “High HIV Prevalence and Associated Risk Factors among Transgender Women in China: A Cross-sectional Survey.” Journal of the International AIDS Society 22:e25417. https://doi.org/10.1002/jia2.25417
  11. Yan, Zi-Han, Jessica Lin, Wenjing Xiao, et al. 2019. “Identity, Stigma, and HIV Risk among Transgender Women: A Qualitative Study in Jiangsu Province, China.” Infectious Diseases of Poverty 8:94. https://doi.org/10.1186/s40249-019-0606-9
  12. Chen, Hui, Yingjie Chen, Shangbin Liu, et al. 2022. “Trends in HIV Prevalence, Sexual Behavior, and Pre-Exposure Prophylaxis Willingness Among Transgender Women: An Analysis of Three Cross-Sectional Studies Conducted Mainly in Shenyang, China, 2014–2019.” Transgender Health, online 2022; 9(3):222–231 (2024 issue). https://doi.org/10.1089/trgh.2022.0081
  13. Shan, Duo, Zhen Ning, Maohe Yu, et al. 2022. “HIV Incidence and Risk Factors among Transgender Women and Cisgender Men Who Have Sex with Men in Two Cities of China: A Prospective Cohort Study.” Infectious Diseases of Poverty. https://doi.org/10.1186/s40249-022-00947-3
  14. Sha, Yongjie, Willa Dong, Weiming Tang, et al. 2021. “Gender Minority Stress and Access to Health Care Services among Transgender Women and Transfeminine People: Results from a Cross-sectional Study in China.” BMC Infectious Diseases 21:1065. https://doi.org/10.1186/s12879-021-06782-5
  15. Wang, Liying, Rachel Harris, Jane M. Simoni, et al. 2023. “Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China.” Transgender Health 8(6):516–525. https://doi.org/10.1089/trgh.2021.0009
  16. Zhu, Yan-Yan, Ze-Hao Ye, Zhen-Xing Chu, et al. 2024. “Effects of HIV Self-Testing on Testing Promotion and Risk Behavior Reduction Among Transgender Women in China: Randomized Controlled Trial.” Journal of Medical Internet Research 26:e58591. https://www.jmir.org/2024/1/e58591/
  17. Zhang, Ye, John Best, Weiming Tang, et al. 2016. “Transgender Sexual Health in China: A Cross-Sectional Online Survey in China.” PLOS ONE. https://pmc.ncbi.nlm.nih.gov/articles/PMC5053843/
  18. Lin, Yezhe, Hui Xie, Zimo Huang, et al. 2021. “The Mental Health of Transgender and Gender Non-Conforming People in China: A Systematic Review.” The Lancet Public Health 6(12):e954–e969. https://doi.org/10.1016/S2468-2667(21)00236-X
  19. Chen, Runsen, Xuequan Zhu, Lucy Wright, et al. 2019. “Suicidal Ideation and Attempted Suicide amongst Chinese Transgender Persons: National Population Study.” Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2018.12.011
  20. Tang, Weiming, Chongyi Wei, Bolin Cao, et al. 2018. “Crowdsourcing to Expand HIV Testing among Men Who Have Sex with Men in China: A Closed Cohort Stepped Wedge Cluster Randomized Controlled Trial.” PLOS Medicine. https://doi.org/10.1371/journal.pmed.1002645
  21. He, Jiayu, Ying Wang, Zhicheng Du, et al. 2020. “Peer Education for HIV Prevention among High-Risk Groups: A Systematic Review and Meta-analysis.” BMC Infectious Diseases 20. https://doi.org/10.1186/s12879-020-05003-9
  22. Fu, Xiaojing, Jinlei Qi, Yifei Hu, et al. 2016. “Partner Notification in Cooperation with Community-Based Organizations among HIV-Positive Men Who Have Sex with Men in Two Chinese Cities.” International Journal of STD & AIDS 27(10):821–831. https://doi.org/10.1177/0956462416648827
  23. Kaufman, Joan. 2020. “Civil Society Involvement in National HIV/AIDS Programs.” In HIV/AIDS in China, 427–440. https://pmc.ncbi.nlm.nih.gov/articles/PMC7119907/
  24. Baral, Stefan D., Tonia Poteat, Susanne Strömdahl, et al. 2013. “Worldwide Burden of HIV in Transgender Women: A Systematic Review and Meta-analysis.” The Lancet Infectious Diseases 13. https://doi.org/10.1016/S1473-3099(12)70315-8

Policy, institutional, community, and primary sources

  1. 中国疾病预防控制中心性病艾滋病预防控制中心. 2008. “江苏省宿迁市MSM人群预防艾滋病防治知识宣传和干预工作启动.” https://ncaids.chinacdc.cn/zxzx/dfjl_10360/201804/t20180420_168095.htm
  2. 中国疾病预防控制中心. 2008/2011. “男男性行为人群干预培训手册.” https://www.chinacdc.cn/jkyj/crb2/yl/azb/cbw_azb/202409/t20240906_298385.html
  3. 中国疾病预防控制中心性病艾滋病预防控制中心. 2012. “河北省保定市疾控中心与防艾志愿者组织合作开展哨点监测工作.” https://ncaids.chinacdc.cn/zxzx/dfjl_10360/201804/t20180420_167815.htm
  4. 中国疾病预防控制中心性病艾滋病预防控制中心. 2014. “预防艾滋病 社会同参与——四川省内江市疾控中心、性艾协会联合MSM关爱小组开展同伴教育活动.” https://ncaids.chinacdc.cn/zxzx/dfjl_10360/201804/t20180420_166720.htm
  5. 中国疾病预防控制中心性病艾滋病预防控制中心. 2015. “性艾中心开展男男同性性行为人群新型毒品使用情况调查.” https://ncaids.chinacdc.cn/fzyw_10256/jjgy/201512/t20151221_123745.htm
  6. China Development Brief. “Chengdu Tongle Health Counseling Service Center.” https://chinadevelopmentbrief.org/ngos/chengdu-tongle-health-counseling-service-center/
  7. APCOM. 2013. “Spotlight: Chengdu Tongle Health Counseling & Service Center, China.” https://www.apcom.org/spotlight-chengdu-tongle-health-counseling-service-center-china/
  8. Health Equity Matters. 2013/2017. “Spotlight 4: Chengdu Tongle Health Counseling Service Center, China.” https://www.healthequitymatters.org.au/resources/spotlight-4-chengdu-tongle-health-counseling-service-center-china
  9. China Development Brief. “Shenlan Public Health Counseling Service Center.” https://chinadevelopmentbrief.org/ngos/shenlan-public-health-counseling-service-center/
  10. China Development Brief. “Danlan.” https://chinadevelopmentbrief.org/ngos/danlan/
  11. China Development Brief. “Zhejiang MSM Working Group.” https://chinadevelopmentbrief.org/ngos/zhejiang-msm-working-group/
  12. China Development Brief. “Anhui Youth Service Center of AIDS Prevention.” https://chinadevelopmentbrief.org/ngos/anhui-youth-service-center-aids-prevention/
  13. China Development Brief. “Aibai Culture & Education Center (ACEC).” https://chinadevelopmentbrief.org/ngos/aibai-culture-education-center-acec/
  14. China Development Brief. “Shanghai CSW & MSM Center.” https://chinadevelopmentbrief.org/ngos/shanghai-csw-msm-center/
  15. China Development Brief. “Yang Guang: From MSM Trailblazer to Marching in Place.” https://chinadevelopmentbrief.org/reports/yang-guang-from-msm-trailblazer-to-marching-in-place/
  16. UNDP, APTN, and Health Policy Project. 2015. Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific. https://www.undp.org/asia-pacific/publications/blueprint-provision-comprehensive-care-trans-people-and-trans-communities-asia-and-pacific
  17. UNDP China. 2018. “A Blueprint for Trans Health: Filling the Knowledge Gap in China.” https://www.undp.org/china/news/blueprint-trans-health-filling-knowledge-gap-china
  18. UNDP China. 2016. “Being LGBTI in China.” https://www.undp.org/china/publications/being-lgbti-china
  19. UNDP Asia-Pacific. 2018. Being LGBTI in China: A National Survey on Social Attitudes towards Sexual Orientation, Gender Identity and Gender Expression. https://www.undp.org/asia-pacific/publications/being-lgbti-china-national-survey-social-attitudes-towards-sexual-orientation-gender-identity-and-gender-expression
  20. UNDP China. 2018. “A Safe and Inclusive Society for Transgender People in China.” https://www.undp.org/china/blog/safe-and-inclusive-society-transgender-people-china
  21. World Health Organization. 2014. Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations. https://www.who.int/publications/i/item/9789241507431
  22. World Health Organization. 2016. Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations: 2016 Update. https://www.who.int/publications/i/item/9789241511124
  23. World Health Organization. 2022. “WHO Publishes New Guidelines on HIV, Hepatitis and STIs for Key Populations.” https://www.who.int/news/item/29-07-2022-who-publishes-new-guidelines-on-hiv--hepatitis-and-sti-for-key-populations
  24. World Health Organization. “Trans and Gender Diverse People.” https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/populations/transgender-people