Introduction A four-country study was conducted by the ISEAN-Hivos Program (Global Fund regional AIDS grant) which aims to provide information on the status of stigma and discrimination (SAD) among males having sex with males (MSM) and transgender people in health care settings (including HIV/AIDS services) using a questionnaire based on the forms of SAD described in the Stigma and Discrimination Index Questionnaire.

Methods The study’s questionnaire described SAD in terms of the respondents’ self-reported perception of: 1. Refusal of health care services, 2. Physical maltreatment, 3. Verbal maltreatment, and 4. Provision of health care service below standards. A total of 2409 respondents, 30% (n=719) of whom are self-identifying male-to-female trans persons, participated in this study. There were 264 trans respondents from Indonesia, 204 in the Philippines, 174 in Malaysia, and 77 in Timor Leste.

Results Overall, the results indicate that significantly more trans people experienced SAD in health care settings compared to MSM. Verbal maltreatment was the most commonly experienced (24.26%), followed by receiving a perceived low quality of health service (22.57%), being refused access to health care services (18.23%) and lastly, physical maltreatment (18.21%). There were proportionately more SAD experiences reported by trans people in Timor Leste (41.06%), followed by Malaysia (32.67%), Philippines (7.47%) and Indonesia (2.0%).

Conclusion The result of the SADS suggests that there is a wide variation across the four countries in terms of trans people experiencing stigma and discrimination. Verbal maltreatment is the topmost common form of SAD among trans people. The study indicates that trans’ personal experiences of SAD are more frequent than MSM. Also, about one third of the trans people continue to experience SAD. Almost 60% of the trans people, however, did nothing to address SAD. SAD still exists in health care settings, which needs support for more interventions to significantly decrease, if not totally eradicate SAD in its many forms.