As the Trump administration continues in its efforts to revoke discrimination protections for transgender people in health care, a new study is focused on how advocates can better serve transgender and gender nonconforming people living with HIV.

The results of the study, titled “Wellness for Our Communities,” were announced yesterday (July 29) by Positively Trans (T+), a project launched by The Transgender Law Center that focuses on self-empowerment and advocacy by and for transgender people living with HIV. The needs assessment, performed in 2018, draws on interviews with 155 participants living with HIV in the Detroit, New Orleans, Miami and Fort Lauderdale areas. Of the 76 percent of respondents who identified as trans women were mostly Latinx and Black.

According to the report:

Recent studies indicate that transgender people, especially trans women of color, experience disproportionate economic marginalization, homelessness, stigma, discrimination in health care access and provision, harassment and violence at school, police abuse, and physical and sexual violence. In the face of these systemic threats and barriers to autonomy and well-being, the impact of HIV on the transgender community cannot simply be addressed by programs that work to affect individual behaviors.

“Transgender women of color living with HIV have always had to be our own advocates. The issues outlined in this report are questions of life and death for us, particularly as Trump works to undermine our access to health care with his attacks on the Health Care Rights Law of the Affordable Care Act,” said Cecilia Chung, Transgender Law Center’s director of evaluation and strategic initiatives, in an emailed statement. “To fight back on these attacks, we must use data-driven advocacy led by the community for the community.”

Key findings from the study include:

  • Nearly half of the respondents were unemployed, yet 72% reported having health insurance 
  • The greatest legal needs reported were employment discrimination (86%), HIV-related discrimination (60%) and name change or identification document-related discrimination (54%)
  • Top health concerns were dental care (62%), trans-affirming health care (59%), gender reassignment surgery options (49%), mental health care (42%) and hormone replacement therapy (38%).
  • 49% of respondents said they were harassed or threatened on the street in the last year, and 34% reported being attacked on the street in the past 12 months.

Among a number of the report’s recommendations for communities and advocates are sensitivity training for medical providers, health-care staffs and law enforcement personnel; creating programs that address nutrition, food security, and holistic personal care for transgender and gender nonconforming people living with HIV; and increasing the ability for community agencies to document and track cases of employment and housing discrimination.

Read the entire report here.