A local trans man says that a recent decision by a community health centre to limit its display of trans-specific sexual health literature is just another blow to him and his community.

According to Peter Dunnigan, the Centretown Community Health Centre sent a strong message when it decided not to display 'Primed: The Back Pocket Guide for Transmen & the Men who Dig Them' in public areas of their facility. The guide offers information and frank advice about safer sex for gay trans men. The centre, whose representative declined to be interviewed for this report, previously told Capital Xtra that the images in the guide, including the pair of naked bums on the cover, were simply too racy.

However, in a recent letter to Capital Xtra, CCHC executive director Simone Thibault wrote that "CCHC staff have been informed of the availability of this resource. We have posted several posters throughout the centre explaining that the guide is available at our reception desk and on the website queertransmen.org."

That means anyone who wants to get their hands on the guide onsite must still approach a stranger and ask for it, an experience which may intimidate or embarrass some.

"In terms of this brochure, what insults me is that it's not just about my ass," says Dunnigan. "It's about saying to the gay and lesbian community and the transgendered community, 'We accept you, but it comes with conditions.' "

Dunnigan adds that he feels like he is being told that he, and other transgendered people, somehow make others uncomfortable.

"Part of the gay and lesbian transgendered community is very sexual, it's part of our being, we're very proud of our sexuality. So when you put a condition on our sexuality you're actually putting a condition on us."

Dunnigan says that one reason he feels so strongly is that the creation of a sexual health guide for trans men is a huge step for a community whose members he says often feel invisible and ignored.

"This is the first time that trans men have ever, ever been acknowledged in Canadian history. Think of it, on this level: this is huge. This is not minor, this is huge. That means my community has an opportunity to get information to have safe sex. We have arrived, only to be insulted. For arriving? There's something wrong with that."

Sexually frank messaging has been a touchstone of AIDS prevention work in the gay male community for 20 years. From the outset, gay men have insisted that safe sex material reach audiences "where they're at" — no matter who it made uncomfortable.

And transgendered people need access to solid sexual health information, because, like other groups, they're at risk for sexually transmitted infections such as HIV, says Adam Graham, the gay men's prevention coordinator at the AIDS Committee of Ottawa.

One reason for this risk is the lack of access to safe, affordable sexual reassignment surgery for those who want it. Additionally, safer sex equipment such as condoms are not adaptable for the needs of the trans community, which leaves trans men with less choice for protecting themselves in risky situations.

"We know that there are certain medical facilities that are a little bit more friendly for the lesbian, gay and bisexual communities," says Graham. "But when a trans person goes in there and drops their pants and wants to have a test, then where's the guarantee that the medical personnel who are working there are going to understand the situation and be friendly to that situation? We have no idea."

"There's not a real push to train some health practitioners on some of the things that socially determine our health. Definitely trans-friendly services are not even on the menu at this point, which is really unfortunate because we know that not offering those services has a direct correlation with increased rates of HIV and other STIs."

But with scant research into trans men's health, it's hard to say for certain just how at-risk trans men are. But Graham says that there is a flurry of socioeconomic factors that affect the trans community in greater proportion, which in turn likely increases the risk of HIV/AIDS.

"We know that stigma and discrimination lead to higher rates of things like drug use, mental illness, depression, all that kind of stuff. So we know that when people are in a situation like that, they may take greater risks, which might mean not using a condom, that might mean all sorts of things," Graham says.