Since 2007, the Philippine Integrated HIV Behavioral and Serological Surveillance (IHBSS) still lump the transgender (TG) women population with men having sex with men (MSM), which is a socio-political issue among empowered Filipino TG women. Recognizing similar sexual behaviour risks among MSM and TG women, the latter associated with body modifications concept(i.e. hormone replacement, collagen injections/implants) have a heightened risk due to unsafe and improper injecting practises. Thus, the ISEAN-Hivos Program (IHP) (a Global Fund Multi-country Grant) in the Philippines, through consultations with the TG community, aims to develop an operational TG definition that would hopefully be feasible in a national surveillance.

The method used was the conduct of four (4) focus group discussions (FGDs) with TG women members (with 5–10 participants each FGD) from community-based organisations (CBOs) in Metro Manila, Cebu City and Davao City.

The findings revealed that majority of the participants do not generally agree with the three (3) proposed qualifiers/criteria in identifying TG women used in the IHBSS 2011 MSM questionnaire. “Looks like a female” is subjective; “Taking/injecting hormones” is not necessary; and those who have “undergone sex reassignment surgery” would identify themselves as a non-TG woman. Some of the suggestions are the inclusion of a time element in one’s gender identification/expression to eliminate those who just occasionally identifies/express themselves as female; consider any form of affirming one’s identity as a woman; and the use of three (3) questions - asking one’s sex assigned birth, gender identity and gender expression.

The study concludes with IHP-Philippines’ proposed operational definition of TG women: those whose sex assigned birth is male; and whose gender identity is generally female and/or whose gender expression is generally feminine. They need not undergo any form of body modification, may have varying sexual orientations, and may self-identify using various local gender terms.