The needs of transgender people within the global HIV epidemic remain largely unmet, although steps are being made to redress this. Issues including  social marginalization, violence, lack of access to basic services and substance use contribute to significantly higher rates of HIV and STIs and the current situation in India was presented to underscore this. In Peru, a recent study about access to services for people living with HIV found that the majority of transgender people surveyed have relatively low levels of education and employment, lack health insurance and often do not have access to documentation. Strategies for best practice among trans populations include grounding the work in the community, acknowledging the role of race and ethnicity, being culturally appropriate, increasing access to healthcare as well as developing and supporting staff.

For younger transgender people, the first phase of a new study in San Francisco explored issues of finding diverse role models, self-acceptance and coming out, difficulty finding sexual partners and trauma from experiences of violence. Structural issues including access lack of access to medical services and little support from family and institutions such as schools was also noted. Protective effects included parental support, having a job and access to gender related health care.

Many transgender come to the Unites States to escape stigma and violence, in the hope that the situation will be better there. Factors including language barriers, lack of documentation and the difficulty securing work mean that transgender migrants face significant challenges. Many barriers also exist within the health care system, including discrimination, disrespectful language and lack of appropriate provider knowledge. There were clear benefits to integrated HIV and transgender care services.

Discussion based off questions from the audience covered service capacity development, young people and migration, however a question about the lack of a single global voice for transgender people garnered the most debate. It was noted by the speakers that the diversity of transgender people meant that a single global voice was not reasonable and that those working on these issues internationally needed to make an effort to understand that complexity and engage with the existing organisations and networks.