Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study
Abstract Background Transgender women in Malaysia face social and healthcare marginalisation. Research about their oral health and oral health care utilisation is sparse. Despite growing clinical evidence highlighting the risk of transmission of sexually transmitted infections (STIs) through oral se...
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2025-04-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22417-9 |
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| author | Lahari A. Telang Hezreen Shaik Daud Abdul Rashid Aoife G. Cotter |
| author_facet | Lahari A. Telang Hezreen Shaik Daud Abdul Rashid Aoife G. Cotter |
| author_sort | Lahari A. Telang |
| collection | DOAJ |
| description | Abstract Background Transgender women in Malaysia face social and healthcare marginalisation. Research about their oral health and oral health care utilisation is sparse. Despite growing clinical evidence highlighting the risk of transmission of sexually transmitted infections (STIs) through oral sexual practices, research in this area remains less explored. This study aimed to understand the experiences of transgender women in Malaysia by exploring oral health care needs and the barriers and enablers of oral health care utilisation as well as safe sexual practices relating to oral transmission of STIs. Methods Participants were recruited through a snow-balling method of sampling with the help of community workers. Semi-structured in-depth interviews (IDIs) with transgender women in northern Malaysia and Focus group discussion (FGD) with a mixed group of transgender women and health care professionals were conducted to gain insights into the needs of the community. Data obtained from IDIs and FGD were coded, transcribed, and thematically analysed to derive codes and themes through the interpretative lens of the Information, Motivation and Behavioural skills (IMB) theory. Results Participants of the IDIs were transgender women (n = 20, median age 39.8 (9.75 IQR) years). Aesthetic dental needs were prioritised, yet poor utilisation of dental services was reported, with many opting for self-medication or care from a non-qualified dental practitioner. Routine engagement in oral sex practices, primarily receptive fellatio with or without ejaculation with multiple cis-gender male partners, was reported. Low awareness of oral STIs, along with a perceived low risk of transmission of STIs through oral sex, was reported, with most (18, 90%) not using condoms for clients/partners or inconsistently using them during oral sexual practices. The themes identified from IDIs and FGD included: ‘Place in the society’ ‘Attitudes and beliefs linked with dental care’, ‘Access to dental care’, ‘Lack of trans-specific health care’ and ‘Use of condoms for oral sex’. Conclusion The study’s findings report poor dental service utilisation among transgender women despite aesthetics being prioritised. Gaps in knowledge regarding the oral transmission of STIs were also noted. These insights underscore the need for trans-specific health campaigns designed to address these concerns and enhance awareness through an integrated approach to improve access to inclusive oral health care and sexual health care for this vulnerable population. |
| format | Article |
| id | doaj-art-d6001860729a4b15855654f1e1ed3f2a |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-d6001860729a4b15855654f1e1ed3f2a2025-08-20T03:08:12ZengBMCBMC Public Health1471-24582025-04-0125111210.1186/s12889-025-22417-9Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative studyLahari A. Telang0Hezreen Shaik Daud1Abdul Rashid2Aoife G. Cotter3School of Medicine, University College DublinPenang Family Health Development Association (FHDA)RCSI-UCD Medical Campus (RUMC)School of Medicine, University College DublinAbstract Background Transgender women in Malaysia face social and healthcare marginalisation. Research about their oral health and oral health care utilisation is sparse. Despite growing clinical evidence highlighting the risk of transmission of sexually transmitted infections (STIs) through oral sexual practices, research in this area remains less explored. This study aimed to understand the experiences of transgender women in Malaysia by exploring oral health care needs and the barriers and enablers of oral health care utilisation as well as safe sexual practices relating to oral transmission of STIs. Methods Participants were recruited through a snow-balling method of sampling with the help of community workers. Semi-structured in-depth interviews (IDIs) with transgender women in northern Malaysia and Focus group discussion (FGD) with a mixed group of transgender women and health care professionals were conducted to gain insights into the needs of the community. Data obtained from IDIs and FGD were coded, transcribed, and thematically analysed to derive codes and themes through the interpretative lens of the Information, Motivation and Behavioural skills (IMB) theory. Results Participants of the IDIs were transgender women (n = 20, median age 39.8 (9.75 IQR) years). Aesthetic dental needs were prioritised, yet poor utilisation of dental services was reported, with many opting for self-medication or care from a non-qualified dental practitioner. Routine engagement in oral sex practices, primarily receptive fellatio with or without ejaculation with multiple cis-gender male partners, was reported. Low awareness of oral STIs, along with a perceived low risk of transmission of STIs through oral sex, was reported, with most (18, 90%) not using condoms for clients/partners or inconsistently using them during oral sexual practices. The themes identified from IDIs and FGD included: ‘Place in the society’ ‘Attitudes and beliefs linked with dental care’, ‘Access to dental care’, ‘Lack of trans-specific health care’ and ‘Use of condoms for oral sex’. Conclusion The study’s findings report poor dental service utilisation among transgender women despite aesthetics being prioritised. Gaps in knowledge regarding the oral transmission of STIs were also noted. These insights underscore the need for trans-specific health campaigns designed to address these concerns and enhance awareness through an integrated approach to improve access to inclusive oral health care and sexual health care for this vulnerable population.https://doi.org/10.1186/s12889-025-22417-9Transgender womenMalaysiaOral health needsDental service utilisationOral transmission of STIs |
| spellingShingle | Lahari A. Telang Hezreen Shaik Daud Abdul Rashid Aoife G. Cotter Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study BMC Public Health Transgender women Malaysia Oral health needs Dental service utilisation Oral transmission of STIs |
| title | Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study |
| title_full | Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study |
| title_fullStr | Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study |
| title_full_unstemmed | Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study |
| title_short | Exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in Malaysia: a qualitative study |
| title_sort | exploring the barriers and enablers of oral health care utilisation and safe oral sex practices among transgender women in malaysia a qualitative study |
| topic | Transgender women Malaysia Oral health needs Dental service utilisation Oral transmission of STIs |
| url | https://doi.org/10.1186/s12889-025-22417-9 |
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