‘Transgender women living with HIV are less likely to have excellent adherence to antiretroviral treatment (ART) and durable viral suppression compared to other groups, investigators report in the online edition of LGBT Health. The study also revealed that many transgender women living with HIV are struggling with the basic necessities of life, including food and housing’
The word ‘no’ to me as a trans women has a multitude of implicit meanings which are often negative.
‘No’ you can’t be referred for surgery as we don’t fund it
‘No’ you can’t have surgery you don’t fit our criteria
‘No’ I don’t find you attractive ‘you’re trans’
‘No’ I’m not using a condom
‘No’ no one can know I’m sleeping with you it’s embarrassing
‘No’ I can’t give you any information about your body as its foreign to me
‘No’ I’m not paying you for sex
‘No’ I’ve never given advice to an HIV positive trans woman, I don’t know what safe sex means to you
‘No’ you’re HIV positive we’ll never fund gender surgery for you
‘No’ you’re not feminine enough
‘No’ you’re too feminine
‘No’ of course you can’t keep your job and be transgender
‘No’ you can’t use that toilet
No. No. No.
This list seems extensive and judgemental and on many levels almost comic in its limits. But they are all examples of the word ‘no’ being directed at me throughout the last 10 or so years of my life. There are possibly many more. There are some too painful to remember.
Often the word ‘no’ preceded or followed violence.
I have been HIV positive for many years – over 25, and female from the day I was born, my journey of transition started many years ago, punctuated many times by the word no.
The word no led me to transition privately for over ten years without medical input, the word no led me to a place with little confidence where I spiralled into addiction and sex work.
The word no led me a life of great vulnerability where I took great risks.
Sex, drugs and lifestyle.
Avert statistics show that trans women worldwide are 49 times more likely to be positive than any other group.
They also show that worldwide 19% of all trans women are positive.
Is this just a problem elsewhere; that’s what people say. It doesn’t apply here in the UK.
But according to my life story and my life experiences it does apply.
I share so very much with women worldwide dispossessed of aspirational opportunities and poorly served by health services.
I was told no so I tried to do things on my own, That was hard, so drugs followed and they didn’t allow me the time or space to make good, safe decisions.
I became HIV through sex, drugs or drug-linked sex work. Sometimes I thought this sex was love until people said no it wasn’t don’t be stupid.
It wasn’t just the word ‘no’ that made me high risk but its continued use added to my isolation within the worlds of; drug use, sex work, HIV care and trans healthcare.
This continues to this day in relation to all aspects of mine and others healthcare.
It’s probably why as a campaigner I’m so incensed to see trans identities and specifically trans women excluded completely from the PrEP debate but also excluded wider within funding streams and government/third sector healthcare campaigns.
My experience is not unusual, or unique.
I stand proudly with the others in the 19% who are forgotten, whose lives are ignored and who far too frequently are left to manage their own nuanced healthcare.
It’s not good enough, it is our turn now to say the word ‘no’.
No we will not put up with it anymore.