HIV in the Transgender Community


By Kelly Gluckman
May 3, 2016

HIV in the Transgender Community: Two UCLA Sex Squad Members Share Their Insight

I remember the first time someone told me they were transgender. Several years ago, I was able to spend quality time with a friend, his sister, and their “aunt.” They don’t tell very many people, but after eight months of knowing me, they decided they were comfortable enough to share with me that Aunt Carol* is actually their father.

Carol was in her early sixties and had transitioned to female later in life, after a marriage and two children. I’m not going to lie, when she came out to me, I freaked out at first. I was shocked and in disbelief. I yelled “Oh my God! No way!” several times and paced around their house a bit. I pride myself on being open minded, but this was different. I tried to wrap my head around this new idea, that someone would want to change their gender. I was confused; it didn’t make sense to me.

Everything I knew about people who are transgender came from the media, and it’s not pretty. They have always been portrayed as monster-esque or caricatures, and yet here was this normal human being in front of me. I had grown to love this family, and so I confronted my preconceived notions. I had many conversations with Carol about her life, and she was very open and loving towards me. I heard how difficult her journey had been. She explained that when she was a man, she would stay awake at night, staring at the ceiling, feeling that something was very wrong. What she saw in the mirror didn’t align with who she felt she truly was. She had done everything society told her to; married, had children, and built a career, but she still wasn’t happy. She eventually came out to her family, and her wife decided to end the marriage. Carol made the decision to start transitioning and never looked back. She’s finally comfortable in her skin and lives her life as best she can. Since then, I’ve gained more friends who identify as transgender and felt a conviction to advocate for the trans community.

April 18, 2016, marked the very first National Transgender HIV Testing Day in the US. This day is so important because the transgender community is one of the most affected demographics of the HIV/AIDS epidemic. In fact, transgender women of color have the highest rates of HIV infection in the country. The reasons for this are complex.

To properly talk about these issues, I asked my friend Kara Chang to sit down with me for an interview. Kara and I met in September last year when we were on the Sex Squad together at UCLA. Sex Squad is a group of students who put together an “edutainment” style theatre production, based on personal narrative, around the subjects of sexual and mental health and perform at high schools all around Los Angeles. Kara is, in her own (very true) words “a strong, independent, queer, transgender, non-binary Taiwanese-American human being”. Her accolades are extensive and to say she’s amazing is an understatement.

Kara and I had an in-depth conversation not only about statistics and HIV testing in the trans community but also about her personal journey and societal ideologies around gender. She taught me that in order to understand why the trans community is so affected by HIV, it’s important first to look at how society treats gender.

We live in a world where there is a strict gender binary. You are either male or female, and if you don’t fit clearly into a category, you are ostracized. Something that Kara said several times stuck with me. She said that people in the trans community simply don’t have opportunities, especially if they don’t fit neatly into the gender binary. A transition is just that. It’s a transition, and it takes time, and some people don’t necessarily even care to fit into the male or female categories. Kara herself was subject to harassment when she was young. She was called ‘gay’ and ‘faggot’ before she knew what those words meant, and was even pushed down the stairs and sent anonymous death threats online. This kind of disrespect and mistreatment, and many times even worse, are very common for a trans person to experience.

This prejudice boils down to our fear of what’s different. When we are confronted with an idea like the transgender experience that shakes the bedrock of our understanding of the world, many of us respond with anger rooted in fear of change. The rigidity of the gender binary is so deeply ingrained that it bleeds into laws and policy, and has resulted in a dire lack of research. As Kara put it, “it comes down to the fact that we are considered the lowest rung of society. We are the untouchables.” She continued, explaining that it’s legal in 28 states to fire or evict someone because of their gender or sexuality, and that right is routinely exercised by employers and landlords towards trans people, leaving them homeless and unemployed.

Kara also noted that resources for information and research are limited for someone coming to realize that they are transgender. I know from experience that navigating the health system in this country is confusing and overwhelming. Add to it that many medical insurance companies have policies that deem therapies and procedures that are necessary for someone who is transitioning to be cosmetic. For this reason, many trans people don’t stand a chance at “fitting in” to the gender binary, so they live their life in fear of termination, eviction, and violence.

Society is set up for transgender people to fail, and this pushes many into sex work for survival. This lifestyle intrinsically comes with higher risk of contracting HIV, especially because many clients demand unprotected sex for their purchase. It’s harder to exercise your right to use protection when your body is a commodity being sold. Clients will often even threaten violence if their request isn’t met. So the decision-making ability is distorted because often the next meal, rent, and bodily harm are at stake.

I asked Kara what advice she would give other trans people when it comes to getting tested and asserting agency with using protection during sex. She said she doesn’t feel like she’s in a position to give advice for many reasons. She has yet to be in a long term relationship and is sexually inexperienced. She also acknowledges that she’s in a position of privilege as a student at an institution of higher learning and has never been in a situation like this that so many of her trans sisters, unfortunately, find themselves in. After talking to Kara, I feel that the advice should be directed at society and how we treat this human experience.

Something Kara and I discussed that most don’t realize is that transgender people have existed in every culture, in every part of the world, throughout human history. The way it’s seen in other cultures is as diverse as the trans community itself. For example, pre-colonial Hindu culture looked to trans people as heightened spiritual leaders, called Hijras, who are considered neither male nor female. The cultural attitude has shifted since being colonized by the British, but the government in Pakistan and Bangladesh still legally regards and protects the Hijras as a “third gender.” Taking this step back and looking at the bigger picture is a great way to open the mind and gain perspective. We don’t have to treat other humans so inhumanely.

With the new visibility of stars like Laverne Cox, Caitlyn Jenner, Ruby Rose (who identifies as genderqueer), Carmen Carrera, Chaz Bono, and Lana Wachowski, among so many others, we are moving in a more accepting direction. Target’s recent stand for inclusion with gender neutral bathrooms is doing great things to get the conversation started too, but I think we can do better. There are more people who identify as transgender or genderqueer than many of us realize and they just want to be treated with dignity and compassion, like the rest of us. As Kara put it, “For the most part, trans people are just regular people in the world trying to be themselves. We just happened to be dealt a different hand of cards.” The fact that transgender people in our society live in fear of discrimination, eviction, unemployment, harassment and assault for simply being who they are is the major reason they face higher rates of HIV infections. It’s time to open our minds and seek understanding of what’s different instead of responding out of fear with anger. We will not change the devastation of HIV in our communities until we do.

*Name has been changed

Kara was the first person from her high school to be admitted to UCLA. When she first started attending classes in fall 2012, she still responded to masculine pronouns. In February of 2015, Chang announced on FaceBook that she would now be going by the name Kara and using feminine pronouns. Since coming out, she has told her story in front of a crowd of 8,000 incoming freshmen at UCLA and performed with the Sex Squad. She served as director of Pan-Asian Queers for three years, sits on UCLA LGBTQ Student Leadership Council, volunteers for the Asian Pacific AIDS Intervention Team, and is a member of Trans Students Educational Resources. She also canvasses with the Leadership LAB, part of the Los Angeles LGBT Center, and goes door-to-door to discuss LGBT issues with registered voters. She is studying communications at UCLA and plans to continue her warrior advocacy after graduation this June.