Original Research - Special Collection: Sexual Health

Distinguishing trans women in men who have sex with men populations and their health access in East Africa: A Tanzanian study

John Kashiha, Michael Ross, Nic Rider
African Journal of Primary Health Care & Family Medicine | Vol 14, No 1 | a3428 | DOI: https://doi.org/10.4102/phcfm.v14i1.3428 | © 2022 John Kashiha, Michael Ross, Nic Rider | This work is licensed under CC Attribution 4.0
Submitted: 11 January 2022 | Published: 11 August 2022

About the author(s)

John Kashiha, Community Health Education Services and Advocacy (CHESA), Dar es Salaam, Tanzania, United Republic of
Michael Ross, Department of Family Medicine, Faculty of Medicine, University of Minnesota, Minneapolis, Minnesota, United States
Nic Rider, Department of Family Medicine, Faculty of Medicine, University of Minnesota, Minneapolis, Minnesota, United States


Background: Few data are available on the presence and characteristics of transgender populations in sub-Saharan Africa (SSA), which makes the provision of health services for key populations difficult.

Aim: This study aimed to ascertain the presence and characteristics of trans women in seven cities in Tanzania, East Africa.

Setting: Tanzania, East Africa.

Methods: Outreach to men who have sex with men (MSM) in seven large cities in Tanzania was carried out by non-governmental organisation (NGO) staff familiar with this community. Survey questions administered via interviews were used to identify participants who self-identify as trans. From the self-identification data, an estimate of the relative size of the trans women population in this sample was calculated.

Results: In the sample of 300 participants, 17.0% of participants were identified as ‘transsexual or transgender’ (survey wording); 70.1% of these trans participants indicated that they identify themselves as a woman. Of those identifying themselves as transsexual or transgender, 43.1% reported living part- or full-time as a woman and eight (15.0%) reported hormone use. The highest percentage of hormone use (40.0%) was found in those living as a woman full-time. Notably, there was significant ignorance amongst the sample of the terms ‘transsexual and transgender’ or their explanation in Swahili, reported by interviewers.

Conclusion: In this study, it is clear that trans women populations exist in Tanzania, with high levels of stigmatisation and threats to their lives. They should be included in health outreach and services to key populations. One in six self-identified as trans women, although the lack of knowledge of this concept in Swahili or English may have inaccurately represented numbers.


trans women; transgender; Tanzania; Africa; stigma; prevalence; gender spectrum; healthcare


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Crossref Citations

1. Transgender women in Kenya experience greater stigma, depressive symptoms, alcohol and drug use and risky sexual practices than cis-gendered men who have sex with men
Supriya D. Mehta, Fredrick O. Otieno, Joshua Kimani, Elizabeth Wahome, Duncan Okal, Abhishikta Roy, Elise van der Elst, Susan M. Graham, Eduard J. Sanders, Robert C. Bailey
BMC Public Health  vol: 23  issue: 1  year: 2023  
doi: 10.1186/s12889-023-16348-6