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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 (ß = 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]