"Trans* persons have long been important figures in the landscape of the Malay archipelago. In the 19thcentury, the manang bali or Iban shamans who dressed as women were respectable curers and local leaders. Right up to the 20th century in the archipelago, many transwomen were royal courtiers. Transwomen village performers were also favourably treated by the Sultan of the state of Kelantan in the 1960s. Such amenable attitudes towards transwomen underwent a change from the 1970s onwards, notably due to the expanding Islamisation of Malaysia. In 1983, the Malaysian Conference of Rulers declared a fatwa against cross-dressing and genital reconstruction surgery (GRS). This was a reaction from the Malay monarchy towards former premier Mahathir Mohamad, who challenged their traditional authority on various levels. As this systematic religio-political rejection of the personhoods of mak nyahs persists to this day in numerous circles, many Malaysian transwomen find it near impossible to secure gainful employment and some resort to sex work. This, in turn, places many of them at great risk of exposure to HIV and other sexually-transmitted infections."