I recently attended a meeting in which a number of public health administrators gathered to collaborate on the concept of reducing sexually transmitted infections (STIs) in the state of Nebraska and I was excited and encouraged when introductions around the room begun by saying your name, your job title and employer, and your preferred pronouns. While the concept of stating preferred pronouns during an introduction is nothing new, I’m always very aware of how providers of health care respond to the increasingly popular trend to share their pronouns as casually and frequently as they share other fundamental truths about themselves, such as their name or employer. It always seems there is at least one person in the room who is new to the concept or reluctant to share something they feel is obvious to a room full of strangers or casual acquaintances, further defining the role that privilege plays in how we see ourselves and the world around us. But the truth is that gender identity is rooted in fundamental truth, regardless of whether your personal gender expression is “obvious” to others around you. As an employee in the public health sector, I know that much has been said and done to increase awareness for trans identities during the past 5-10 years. Public representation is vastly important to increasing awareness and individuals such as Laverne Cox and Caitlyn Jenner, while not representing the trans community as a whole, have given the masses a “face” to associate with normalizing what was once considered an identity associated with shame, or at very least, confusion. As I type this piece, Microsoft Word continues to draw a staggered, green line under the word “trans”, once again reinforcing that there are still miles to go in terms of how we talk to and about trans identities.
Trans women make up one of the fastest-growing populations of individuals newly diagnosed with HIV each year, steadily increasing since 2009. Living in a world that is still struggling to build acceptance for both transgender identities AND people living with HIV, I wondered about the lives and challenges experienced by someone who is both trans and HIV-positive. We asked someone to help us talk about being trans and HIV-positive. We’ll call her Shevett, a pseudonym she selected to protect her identity.
NAP: Briefly describe your experience being diagnosed with HIV for the first time. Was the person caring for you at the time experienced and knowledgeable about HIV? Were there any challenges at that time related to being trans?
Shevett: I came out as a transgender woman in 1986. I first learned I was HIV positive in 2012. I was initially distraught and allowed the tears to flow but soon realized this is a part of my life now and I have to cope with it. I immediately thought of my older sister who had also been diagnosed as HIV-positive many years ago. I was fortunate to have a loved one who supported me and knew how to guide me from lived experience. I met my current boyfriend around the same time of being diagnosed. He embraced both my Trans and Positive identities and we have been in a loving relationship for nearly six years. In general, I am a very private person so I’ve chosen to disclose my HIV status only to people that are close to me.
NAP: If you are participating in any medical or treatment related to trans care, have you experienced any limitations or side effects in how you positively receive that care on top of HIV care?
Shevett: I am not currently engaged in trans-related medical care due to past experience with adverse side effects of hormone therapy. I don’t feel like I’ve experienced any barriers with health providers in relationship to either my trans or HIV-positive status.
(note that this may largely be linked to establishing care with providers who are well-informed on trans issues and HIV, this experience may not be the same for everyone)
NAP: What would you say the most interesting or difficult social stigma issues have been as it pertains to being trans and HIV+ ?
Shevett: I was fortunate to have a network of supportive friends, family, and romantic partners but I acknowledge that not everyone is so lucky. Many people face workplace and housing discrimination for being Trans and/or HIV positive. Due to the lack of awareness in the community, some family members, friends, and sexual partners will not take the news well when they learn that someone they love is Trans and/or HIV positive. The violence against the transgender community creates a constant fear for survival.
NAP: Anything else you’d like to share?
Shevett: I have a message for young, trans women today who tested positive and that is “keep your head held high and keep on living a fabulous life”. No matter who you are or how you identify, it is not our place to judge someone for who they are or what they have experienced. Lastly, I’d encourage everyone to get tested and protect yourself.
London Woolman is the Interim Executive Director of the Nebraska AIDS Project.