Transgenderism, scientifically classified as “gender identity dysphasia,” has occurred throughout history and in all cultures; its effect is that persons are born one sex, but identify spiritually, psychologically and physically with the opposite sex. Otherwise, transgenders are the same as other, “gender concordant” human beings.

Since gender differences and appropriate gender behaviors are crucial to social functioning in western society, transgenders are harassed and discriminated against from an early age. In Hawaii, many male-to-female transgenders find public school unbearable so they drop out. Their options for employment are limited to low-paying jobs, prostitution and drug dealing. They find it difficult to access mainstream social services and are often homeless or at high risk for homelessness. Surveys over the past five years show that transgenders have a significantly higher incidence of homelessness, poverty and physical and mental health problems than the community at large. Most transgenders live on SSI or welfare supplemented by drug dealing and/or sex industry work. The following table illustrates some of the needs. It is based on a study of 100 Hawaiian transgender clients of Ke Ola Mamo in 2001.

Table. Comparison of Male-to-Female Transgender clients with the state of Hawaii general population for Certain Risk Indicators*

*From a study of 100 case management files of transgender clients at Lei Anuenue, 2000-2001.

For a more detailed discussion of transgender needs, see Eo NA Mahu o Hawaii; the extraordinary health needs of Hawaii's Mahu, (Odo & Hawelu) in Pacific Health Dialog, Vol. 8. No 2. 2001.

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