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The combination of social stigma, institutional discrimination, economic hardship, and distrust of medical professionals creates a major barrier to connecting transgender women with HIV-related care.
Transgender women are the fastest-growing population of HIV-positive people in the country, according to Miss Major, a 70-year-old transgender woman of color and the executive director of TGI Justice Project, a San Francisco–based advocacy organization that fights for the rights of transgender, intersex, and gender-variant people who are in prison or have served jail time.
Most experts agree with Major’s assertion, but hard data backing up that reality is hard to come by since HIV data collection methods often either mistakenly categorize transgender women as men who have sex with men, or don’t distinguish between transgender and nontransgender women.
“You can deny a person employment or you can terminate someone who is transitioning on the job merely because they are transgender.” That kind of discrimination has a devastating effect on the economic well-being of transgender people.
According to a 2011 report from the National Center for Transgender Equality, transgender people were four times more likely than the general population to live in extreme poverty, with a household income less than $10,000 a year, and more than twice as likely as the general population to be homeless.
Further complicating efforts to combat HIV among transgender people is that population’s basic lack of access to medical care.