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ABSTRACT We explored health care access experiences of 32 male-to-female (MtF) and 15 female-to-male (FtM) transgender people of different ethnicities in Virginia using data from focus groups conducted in 2004. Victimization associated with social stigmatization played a dominant role in participants' lives, manifested by discrimination; violence; and health care provider insensitivity, hostility, and ignorance of transgender health. Access to transgender-related medical services that would allow participants to pass in their chosen genders was their highest medical priority. Faced with barriers to access, hormonal self-medication was common, and silicone injections were reported by both MtF and FtM participants. Due to economic vulnerability, sex work was reported as a source of income by both MtFs and FtMs. MtFs expressed concern over confidentiality of HIV testing and additional discrimination if testing positive. FtMs expressed difficulty accessing gynecological care due to their masculine gender identities and expressions. Cultural and technical competency training for providers and implementation of local programs in transgender hormonal therapy are recommended to improve transgender health care access. KEYWORDS: Health care accessHIV/AIDStransgendertransgender health ACKNOWLEDGMENTS This research was funded by the Centers for Disease Control and Prevention, Cooperative Agreement # U62/CCU323468-01. The authors would like to express our thanks to our focus group facilitators and cofacilitators Madge Young, MA; Scout, PhD; Alejandro Marcel, MA; Milagritos Flinn, BS; Earline Budd; and Ruby Corado. We are grateful to the Virginia Transgender Task Force, especially Martha Lees, Catherine Hulbert, and Zakia Jemayece, and to the Virginia HIV Community Planning Committee.
Xavier et al. (Tue,) studied this question.