Transgender Rights and HIV: Getting to Real Solutions

Cecilia Chung
Cecilia Chung, senior director of strategic projects, Transgender Law Center

Living with HIV is a challenge for anyone, but transgender people of color have unique obstacles to overcome in order to thrive. A Brown Bag Lunch Webinar held by the Black AIDS Institute on Feb. 13, 2018, shared some of the biggest challenges, as well as some strategies to combat them.

Challenge 1, discrimination and violence: Transphobia is prejudice that is directed at transgender people because of their gender identity or expression. Unfortunately, discrimination against transgender people sometimes leads to violence and harassment, said webinar presenter Cecilia Chung, senior director of strategic projects at the Transgender Law Center (TLC). Already this year, at least four trans women have been killed, and two of them were Black. Compounding the problem for transgender people of color is racism, which can add to the weight of discrimination that they experience each day.

Potential solutions: Education is one way to address this problem. It's important for advocates, organizations and individuals to learn about the violence and discrimination that transgender people face. Armed with this knowledge, people can call out transphobia when they see it and take steps to allow transgender voices to be heard.

Challenge 2, over-policing and criminalization: Black people are more likely to be under the jurisdiction of the criminal-justice system than are people of other races. For transgender Americans, there are other factors at play. For example, bathroom laws, which would criminalize transgender people for using the restroom that corresponds to their gender identity, are being debated in various states. Transgender people who are placed in the criminal-justice system are often placed with the group that does not correspond to their gender identity. For example, a trans woman might find herself placed in a men's prison.

Related: Voices of Activists for Transgender Rights

Potential solutions: Criminal-justice reform is at the heart of potential improvements in this area for transgender people. Police departments should reform their approach to dealing with transgender people by training all officers in how to treat transgender and gender-nonconforming people respectfully. Corrections staff should also be trained in how to allow transgender people to express themselves and their identity through their clothing and grooming habits. Prisons and jails should also provide appropriate medical care to transgender people and gender-nonconforming individuals. Federal, state and local governments should also pass or strengthen laws that prohibit profiling based on race, ethnicity or gender identity.

Challenge 3, access to quality health care: Many transgender people lack heath insurance coverage, and health-care and social service workers often offend trans people by using incorrect language to address them, Chung said. Some health-care providers even refuse to treat transgender individuals or are not equipped to meet their health needs. "This kind of transphobic behavior leads many trans women to give up on the health-care system altogether or to wait until they have a symptomatic STI [sexually transmitted infection] to seek care," Chung said.

Potential solutions: Cultural competency is the ability of providers to effectively deliver health-care services that meet patients' social, cultural and linguistic needs. Cultural humility is a commitment to developing mutually beneficial partnerships with different communities. Organizations must strive to achieve both. "We need to meet clients and patients where they are," Chung said.

Ways to implement cultural competency and cultural humility include the following:

  • Make sure forms that ask questions about identity have write-in options.
  • Create a space that is both accessible and comfortable.
  • Train staff to relate to the concerns of transgender people.
  • Create a learning culture where the staff feels comfortable asking questions if they don't know how to meet a client's need.

Challenge 4, employment: Statistics show that poverty increases one's risk of acquiring HIV. Employment is a way to avoid poverty, yet transgender people experience unemployment at twice the rate of the general population. Transgender people of color experience unemployment at up to four times the rate of the general population. Among those surveyed in the TLC's Positively Trans (PDF) report on transgender and gender nonconforming people, 90 percent of transgender people reported experiencing harassment or mistreatment on the job or took actions to avoid it.

Potential solutions: Federal, state and local laws prohibiting discrimination in the workplace based on gender identity should be enforced. Government agencies can also issue compliance guidelines and training materials to help businesses adhere to laws protecting transgender employees.

The Black AIDS Institute is forming a national Black Trans Community Advisory Board that will explore ways to address HIV/AIDS among transgender people of color. An end to the epidemic must meet the entire community's needs.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes about health, wealth and personal growth.

[Note from TheBody: This article was originally published by The Black AIDS Institute on Apr. 9, 2018. We have cross-posted it with their permission.]