Sexual abuse, social stigma and HIV vulnerability among young feminised men in Lahore and Karachi, Pakistan.

This study describes the experiences of 10 young feminised men in Pakistan. They face high levels of stigma, violence and sexual abuse. The average age of first sex was 11 years old and all reported having been been raped during childhood and early adolescence, often several times. While some mothers and siblings were quietly supportive, young feminised men often end up running away from home, finding support as a member of a hijra dera, a 'pseudo-household' led by an older feminised man or guru, in which they find employment as dancers or sex workers. After their entry into sex work there is little or no opportunity to use condoms. The hijra dera offer an important entry point for improved social support and sexual health programmes, including efforts to ensure young feminised men postpone their sexual debut and/or improve their sexual health, retain access to education, explore alternative forms of employment and improve access to health care.