To date, studies of both transgender people and gay men have paid little, if any, attention to the HIV prevention and sexual health needs of gay, bisexual or queer trans men who have sex with men (TMSM). The little research that does exist has identified individual and interpersonal HIV-related risk factors (eg. navigating disclosure of trans status) but has not evaluated their impact on sexual decision-making or behaviour through in-depth qualitative interviewing. This research aims to better understand the nature of HIV risk amongst TMSM. Its goal is to enhance the well-being of TMSM by collecting in-depth information about their sexual health issues, concerns, sexual decision-making processes, and the social context of their lives. This study will create a base for effective and culturally-relevant knowledge exchange by providing a detailed and rich understanding of how social exclusion works to produce unique HIV prevention and sexual health challenges for TMSM in Ontario. In this project, we will undertake a qualitative exploration of the experiences of TMSM in Ontario. Forty in-depth interviews will be conducted with TMSM, providing opportunities to discuss more complex issues related to identity, sexuality, sexual health and service needs. In the Canadian context, there is a dearth of knowledge about the health- and HIV-related issues facing TMSM. This project will contribute significantly to the limited pool of information available about TMSM by providing in-depth information focussed specifically on their unique needs. Moreover, it will provide a theoretical understanding of what TMSM experience thus enabling us to create a rich and comprehensive understanding about the extent and scope of social exclusion in these communities and the impact on sexual health as well as HIV risk. This qualitative study will also provide a rich understanding of the ways that social exclusion may impact access to HIV prevention services for TMSM.