A Decade Delayed
by Jeff Berry
When we at Positively Aware began planning this issue on Transgender and HIV well over a year ago, I loved the idea but must admit I wondered at the meeting whether there would be enough to fill an entire issue (I always like to play devil’s advocate). My doubts were immediately squelched with a resounding, “Yes, absolutely!” from my fellow writers, and it turns out, for once, they were right.
We don’t hear much about the course of HIV among the transgender community and, as psychologist Walter Bockting pointed out during his interview, the progress made thus far is “a decade delayed.” There seem to be a number of reasons for this. For one, we don’t even know how many transgender individuals there are in the U.S., since it’s not tracked by the census. Additionally, there is scant research that has been done to date, partly because the CDC surveillance data doesn’t even exist. And what little funding for research or prevention that has been available was for programs mainly created or already in place for “men who have sex with men.” One thing is clear—the current category under which funding is appropriated is inadequate for transgender individuals. And they deserve a place at the table as the prevention and care programs are designed and implemented, in order to effectively address the unique needs and challenges that face their community.
As my colleagues and I delved into the topic at hand, it immediately became clear that there was a steep learning curve that we ourselves needed to overcome before we could even begin. First there was the confusing terminology. Then, what exactly should we include, and what could we leave out? What assumptions were we willing to make about what our readers already knew? And could we talk about HIV and transgender without giving some added background on transgender-specific issues that were broader than just HIV? These and many other questions lingered for months over our minds like a dark cloud, but finally the cloud began to lift and dissipate as our work neared completion.
We understood it was essential that we remain sensitive to the transgender community in our approach to the material, while presenting the information to our readers in a positive and affirming manner. Just keeping my pronouns straight during an interview soon became a challenge. I found myself pausing to think long and hard before even asking a question. I had to ask myself more than once, would I ask someone else this same question? Was the question really relevant to the story, or was I just curious? It was a humbling self-revelation.
In the stories that follow we learn that there are some ways HIV is affecting the transgender community that in many ways parallel how HIV has affected and made its inroads into other communities as well. These include stigma, low self-esteem, violence, poverty, homelessness, and substance abuse, all of which oftentimes lead to an increased risk for HIV. There are additional co-factors and behaviors that are unique to certain subgroups within the transgender community, such as the sharing of needles used for injecting hormones and silicone.
Sadly enough, one thing that still lingers is the existence of stigma and discrimination within the GLB community itself towards the “T” that falls at the end. This is something that really stood out for me as I researched and talked with others about this issue. It also presents us with a unique opportunity, because it is the one thing that, luckily, we have in our power to change.
Ultimately I began to realize that our stories were virtually one and the same. I recognized the stigma, the pain, and the shame in these stories. In many ways they mirrored my own experience as a child growing up gay—the feelings of isolation, of separation, of not fitting in.
I learned that transgender is much more than a man wanting to become a woman, or a woman wanting to become a man. It doesn’t start or end there, but encompasses an entire rainbow and spectrum of experiences and behaviors. And more often than not, the lines between gender and sexual orientation are constantly being blurred, with terms like gender queer and bi-gender inching their way into my vocabulary. This made the entire subject not only more challenging, but also immensely rewarding and fulfilling.
During the course of the three interviews I undertook for this issue, I would find that my emotions would surface unexpectedly, and for no apparent reason. My eyes would suddenly fill with tears, even though all three interviews were very different from one another. There seemed to emerge a common thread of humanity and soul-searching in all of these stories that follow. I feel an enormous sense of pride in my brothers and sisters for the courage and grace that they have displayed in sharing them with us.
All of it makes for what I believe is a fascinating exploration of HIV, human sexuality, and gender expression—and to the place where they intersect with our humanity. I want to thank the many people who have graciously given of their time, energy, and talents to contribute to this issue. It is my hope that you, too, will discover the commonality amidst the struggles in these stories, struggles which our communities share, and which one day we can overcome if we join together in the fight.
Take care of yourself, and each other.