By: Jennifer Barnes-Balenciaga and Marquise Vilson
Physicians and other medical staff must ensure that when a transgender person decides to undergo hormone replacement therapy (HRT), that those initial interactions result in the person feeling comfortable, heard, and affirmed. This choice is considered a luxury in our community. Positive and affirming healthcare experiences need to become routinized, and to do that requires staff to be well trained in cultural competence and the nuances of gender identity. Engaging in healthcare is not a traditional practice for many persons of color, let alone transgender persons of color. Medical staff must ensure that the use of proper pronouns and/or preferred names are standard practice among all staff, including those who conduct intake processes, and that medical records and healthcare databases are updated to include this information in a front-facing way as well. Past gender history information should not be accessible to all staff, just those that need to know the information to provide care to people. Routine and regular trainings with medical staff on appropriate interactions with patients and clients, and providing medical staff simple but effective ways to absorb the training and information would be most effective.
At present, there is little healthcare information specific to HIV prevention and/or treatment adherence for trans-masculine bodies. The usage of hormone replacement therapy causes thinning and dryness to the lower region (vaginal mucosa), so having penetrative sex puts trans men at a higher risk for HIV than cis women who engage in the same kinds of sexual practices/behaviors. Medical professionals have to better understand the trans-masculine community, and have more dialogue about not only their bodies but also their sexual practices/behaviors, and their sexual partners.
In my experience as a trans-masculine person of color, it has been rare that medical professionals have spoken to me directly about HIV beyond pre-test counseling before an HIV test. Often times, studies have not involved or included people with trans-masculine bodies, and it is mostly assumed that trans men aren’t at risk. In a recent study from the CDC1, 361 trans men were newly diagnosed with having HIV, and of the 361 men 84% of those diagnoses were men of color; 58% were Black (15% were Latino, and 11% were listed as “other” making them ‘non-White’.) There’s a huge gap between the HIV medical community, clinical trials and study groups, and the trans-masculine community.
1Clark, H., Babu, A. S., Wiewel, E. W., Opoku, J., & Crepaz, N. (2017). Diagnosed HIV infection in transgender adults and adolescents: results from the National HIV Surveillance System, 2009–2014. AIDS and Behavior, 21(9), 2774-2783.