Vermont Men For Men (VT M4M) - Vermont, USA

Organisers explain that, at the outset of the project, it was unclear how many transgender and cross dressers (CDs) might live in the small rural state of Vermont - let alone how many might use the Internet. To assess the population and begin the process of reaching out, a transgender MTF (male to female) conducted online chat outreach. In 2003, the transgender peer connected with 119 Vermonters who identified as MTF and 156 who identified as CDs. She used gay.com and aol.com for chat outreach, and ran a separate message board on which messages were only posted after they were reviewed. The online support groups were by invitation only. By the end of 2003, the demand was such that the outreach peer ran 3 online support groups per week, with groups averaging 25 people per session. Of the combined 275 MTFs (9 of whom identified as HIV+) and CDs (4 of whom identified as HIV+), 186 (68%) participated in one or more online support groups.

The forum serves a means of passing on both information and resources (HIV/AIDS testing centre referral, for instance) and for creating a community of support. The conversations focus on some of the following topics:

• HIV/AIDS - participants often ask the outreach peer for testing referrals. She explains "As for following up on referrals, well...they tell me they do because they ask for help and don't want to "disappoint" me when they get scared and don't follow-through. My gut feeling is that probably 60 - 70% of the regulars do make the effort, even if it takes a few reminders before they act. I do get a significant number of "one-timers" I connected with who asked for asistance or referrals..."
• Hormones - VT M4M indicates that there is a great deal of misinformation in this community about hormones. Some participants indicate that they take black market hormones or "natural" hormones at unregulated doses.
• Violence and discrimination - in one support group where this was discussed, 16 of 18 people had experienced some kind of violent behaviour. Issues related to workplace harassment are discussed, as is the shame associated with simple socialising. With regard to the latter, the forum serves as a means for exchange and interaction among a community that is often socially isolated: "Where is it safe to appear in VT in women's clothing?"
• Identity and acceptance - Organisers suggest that the support of others can help MTFs who present as CDs come to self-identify as transgender or transsexual (TS). The outreach peer explains: "Once they see that being TS does not necessarily mean a life of despair...they relax and begin to entertain the possibility that they could be TS and then with the support of the others in the groups they gain the courage to gradually take the next step..."
• Shame - M4M finds that many participants do not understand risks of HIV and operate under the false belief that TSs are a low-risk group. Because of the shame factor, when they are engaged in a sexual situation in which they are trying to hide the fact that they are biological male, some MTFs or CDs engage in unsafe sex practices, such as being receptive to unprotected anal sex. The shame piece keeps them from seeing doctors, let alone disclosing their TS status if they do go.

This process of chat outreach and support is strengthened by an interactive, informational website. The VT M4M site includes regional resources as well as national health information about such issues as sexual health, alcohol and drugs, youth, mental health, safety, and minority health. Special sections of the site are devoted to youth, men over 50, and people living with HIV and their partners.

HIV/AIDS, Discrimination, Sexual Health.

According to M4M, approximately 8,000-15,000 Vermont men are gay or bisexual. Vermont is a small rural New England state with a population of about 600,000. On a wide range of issues, organisers say, the lesbian and gay community has achieved victories that make Vermont a favourable state for protection of the civil rights of lesbian, gay, and bisexual people. For instance, Vermont has no law criminalising private sexual activity between consenting adults. Discrimination based on sexual orientation in employment, housing, public accommodations, credit, and insurance has been illegal in Vermont since 1992. And Vermont grants domestic partner benefits to state employees.

Based on M4M's experience to date, organisers surmise that the Vermont community using the transgender Internet forums are very much at risk for HIV. Many do not know their status and those who do know aren't necessarily telling their partners. While many indicate they are looking for sex, what they are often seeking is a relationship as well as acceptance. There are not many social venues for the transgender community in Vermont, so feelings of isolation and depression are common.