Transgender people

Relief work is not the Humsafar Trust’s specialty, but COVID-19 has changed that.

A few days after the lockdown measures in India went into effect, the Humsafar Trust’s teams received desperate calls from people with no place to live and no income, explained Vivek Anand, Chief Executive Officer of the Humsafar Trust, a lesbian, gay, bisexual, transgender and intersex (LGBTI) people community-based nongovernmental organization based in Mumbai, India. An urgent team meeting was called to determine what to do. “After much back and forth evaluating needs, we agreed, “Let’s start with giving people food support,”” he said.

They pooled money together among themselves and bought food and other essentials.

They then reached out to their communities, telling them that the Humsafar Trust had started an emergency COVID-19 fund. In three days, more than 700 people had asked for support. “With donations from communities, allies, businesses and some donor agencies, we have helped more than 2000 individuals with food, access to medical care, like HIV medicine, financial aid and applying for government support,” Mr Anand said, beaming as his air conditioner sent waves of cold air blowing through his small home office.

He feels that during the pandemic response the LGBTI community is being overlooked. “Seventy per cent of our community comes from lower socioeconomic backgrounds with no savings,” he said.

The bulk of the Humsafar Trust’s aid is focused on transgender people, who, he said, have been the hardest hit. “Not only do they usually survive on a meagre income, a lot of them have no legal papers, making them invisible to government aid,” Mr Anand said.

The lockdown has translated into financial distress and has also resulted in mental stress. Mr Anand recounted that one member of his transgender team at the Humsafar Trust cannot introduce herself during their online outreach sessions because she is living with her parents, who consider her a boy. Others are being pressured to marry, while many have been mistreated and beaten.

Standing outdoors by a vegetable vendor to maximize cellphone connectivity, Shreya Reddy said she always wanted to be a woman. Despite being born a boy and constant ridicule and shaming, she never gave up. At the age of 13 years, she ran away and joined a hijra community, comprised mostly of transgender people. Four years later, she started transitioning gender with money she made as a sex worker. After a while, Ms Reddy said, she realized that to succeed, she needed to study. Her social work degree and background led her to the Humsafar Trust, for which she has become a peer educator and outreach worker. COVID-19 has set her back a bit for a number of reasons.

“It has been terrible, because I cannot get my hormones and I have lost weight and was bleeding,” she said. She added that because of the lockdown, no one can get regular check-ups with gynecologists. “And my community cannot understand all the rules and the science language. Basically, a lot of people like me are struggling a lot, from not being able to pay rent to buying bare necessities,” Ms Reddy said.

Speaking more and more quickly, she added, “People are not that educated, they are scared and there are lots of mistruths.”

Ms Reddy has since become better and said that she is dedicated to her outreach work. One of her transgender peers told her, “Better that I die,” once the woman’s income had melted away. "I empower myself by talking to people,” she said. “We are all so vulnerable and as a small-income population we need support.”

OutRight Action International's recent report, Vulnerability amplified: the impact of the COVID-19 pandemic on LGBTIQ people, said that the challenges faced by LGBTI people across the world as a result of the virus and containment measures were amplified compared to the broader population. Jessica Stern, Executive Director of OutRight, said, “For us the situation is dire. I fear how many LGBTI people will lose their lives because of the amplified vulnerability we face.”

Pointing to market vendors behind her, Ms Reddy said, “I have helped them too figuring out the masks and sanitizers. I help everyone, but I am scared about the future.”

Mr Anand echoed her sentiment. He has had to extend the emergency fund until August.

“Every day, there is a new challenge,” he sighed. His teams, usually out and about, can’t all work online. In addition, he mentioned that more and more people are going underground, making outreach difficult.

Recalling his youth, he explained that he was a late bloomer. “I didn’t know anyone who was gay,” he said. When his secret relationship of nine years ended, he had no one to talk to. He felt lonely and abandoned. “From then on, the Humsafar Trust became my home and my family.” He added that he would not judge anyone in these tense times, reiterating that his first duty was to help others.

What he really wants is that the transgender community be part of the narrative. “Give them a voice, let them be seen and include them in the picture,” he said.

GENEVA, 8 May 2020—Both international and European human rights bodies have affirmed the right of people to legally change their gender and name to match their gender identity, recognizing that the right is fundamental to the enjoyment of many other rights. UNAIDS is therefore concerned that the Government of Hungary is proposing to remove the right of the people of Hungary to legally change their gender on legal documents.

The 2016 United Nations General Assembly High-Level Political Declaration on Ending AIDS recognizes that such legislative discrimination can create barriers to people’s health and well-being, barriers that governments have committed to removing. The proposed change to the Hungarian Registry Act would replace the term “sex/gender” with the term “birth sex”, defined as “biological sex based on primary sex characteristics and chromosomes”, and will not allow changes to “birth sex” once recorded. A step such as this has the potential to cause serious harm.

UNAIDS is also concerned that the proposed changes are being made using emergency powers at a time where communities are unable to effectively protest against the proposed legislation or participate in public discussions on it, thus circumventing proper democratic processes and the right to political participation. Especially during the COVID-19 pandemic, the focus should be on removing barriers to health care, not building them.

“All countries have an obligation to empower people to be recognized for who they are, without discrimination or stigma. I encourage all countries to continue to ensure that people are able to legally change their gender and name,” said Winnie Byanyima, UNAIDS Executive Director.

Stigma and discrimination, including discriminatory laws, against transgender people has been shown to increase violence, abuse and harassment against transgender people and to cause significant harm to their physical and mental health and well-being, their inclusion in society and their ability to access work and education. Transgender people are 12 times more at risk of acquiring HIV than other people and are being left behind in their access to HIV testing, treatment and care services. Evidence shows that where people are able to legally change their gender and name, they experience less discrimination, violence and stigma and have greater inclusion in society.

UNAIDS recommends that countries provide for legal gender recognition, with clear processes and requirements that are in line with international human rights obligations.

“This proposed step from the government traumatizes the transgender, gender diverse and intersex community. It puts people at risk of stigma, discrimination, abuse, harassment and violence for who they are,” said Barnabás Hidasi, of the Transvanilla Transgender Association.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS and MPact call on governments and partners to protect, support and respect the human rights of LGBTI people during the response to COVID-19

GENEVA, 27 April 2020—UNAIDS and MPact Global Action for Gay Men’s Health and Rights are extremely concerned that lesbian, gay, bisexual, transgender and intersex (LGBTI) people are being singled out, blamed, abused, incarcerated and stigmatized as vectors of disease during the COVID-19 pandemic. UNAIDS and MPact are also deeply troubled that this discriminatory action is compounding the challenges that LGBTI people already face in accessing their rights, including safe and quality health services.

“HIV has taught us that violence, bullying and discrimination only serve to further marginalize the people most in need,” said Winnie Byanyima, Executive Director of UNAIDS. “All people, regardless of their sexual orientation, gender identity or gender expression, are entitled to the right to health, safety and security, without exception. Respect and dignity are needed now more than ever before.”

In Belize, reports have detailed abuse by the police of a gay man who was arrested, humiliated and beaten for breaking a curfew imposed to curb the spread of the coronavirus. The 25-year-old was living with HIV and is believed to have died as a result of complications sustained from injuries inflicted by the police.

“We are receiving reports that government and religious leaders in some countries are making false claims and releasing misinformation about COVID-19 that has incited violence and discrimination against LGBTI people,” said George Ayala, Executive Director of MPact. “Organizations and homes are being raided, LGBTI people are being beaten, and there has been an increase in arrests and threatened deportation of LGBTI asylum seekers.”

In Uganda, 20 LGBTI people were recently arrested in a raid on a shelter, which police authorities claimed was due to their disobeying social distancing procedures. In the Philippines, three LGBTI people were among a group who were publicly humiliated as punishment for breaking the curfew. After segments of the incident went viral online, the police captain was forced to apologize for singling out the LGBTI group members and asking them to dance and kiss each other.

“There is also growing concern over privacy and confidentiality in the way governments are using Internet-based technologies and smartphones to monitor people’s movements during lockdowns or curfews,” Mr Ayala added. “Gay men and gender non-conforming people are often the first targets and among the most impacted by increased policing and surveillance efforts.” 

For some LGBTI people, self-isolation and physical distancing can be particularly challenging, even dangerous. Many LGBTI people face violence and/or ill-treatment while sheltering in homes with unaccepting family members. LGBTI people may also suffer from intimate partner violence while staying at home, without the ability to report cases of abuse to the police owing to fear of repercussions. Isolation can also exacerbate pre-existing mental health challenges, common among LGBTI people, including loneliness, depression, anxiety and suicidal ideation.

The COVID-19 pandemic leaves many gay men and transgender women without adequate tools for taking control of their sexual health and rights. Gay men account for nearly 20% of all new HIV infections and are 22 times more likely to become infected with HIV than other men. Transgender women shoulder a risk of acquiring HIV that is 12 times higher than the general population.

Stay at home orders, especially when implemented without flexibilities, compound the difficulties these groups already experience in accessing antiretroviral therapy and HIV prevention and gender-affirming services, including hormone therapies. This is especially true for LGBTI people who are poor, unemployed, homeless or marginally housed.

UNAIDS and MPact are urging countries to:

• Denounce misinformation that scapegoats, slanders or otherwise blames LGBTI people for the spread of COVID-19.
• Stop raids on LGBTI-led organizations, shelters and spaces and desist from arresting people based on their sexual orientation, gender identity or gender expression.
• Ensure that all measures to protect public health are proportionate, evidence-informed and respect human rights.
• Prevent the use of state surveillance on LGBTI people’s personal communication technologies.
• Invest in the COVID-19 response, while safeguarding funds and HIV/sexual health programmes that are inclusive and sensitive to the needs of LGBTI people.
• Safeguard continued access to life-saving medical support, including harm reduction, condoms and lubricant, preexposure prophylaxis, antiretroviral therapy, hormone replacement therapies and mental health services for LGBTI people.
• Provide flexible service delivery options, from multimonth dispensing to community delivery and virtual consultation and support options.
• Consider designating community-led service organizations as essential service providers so that they can provide flexible, safe delivery of key services.
• Include LGBTI people in national social protection schemes, including income support.
• Increase access to appropriate emergency and safe housing for homeless and recently evicted LGBTI people.
• Engage LGBTI people in public health planning and messaging around COVID-19.
• Implement safety monitoring and hacking mitigation during virtual meetings.

Now more than ever, we must stand together to protect and promote the health and human rights of LGBTI people worldwide.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

MPact

MPact Global Action for Gay Men’s Health and Rights was founded in 2006 by a group of activists concerned about HIV-related disparities as well as stigma discrimination, violence, and criminalization experienced by gay men and other men who have sex with men in all parts of the world. MPact is now an established international advocacy network dedicated to ensuring equitable access to HIV services to all gay men, while promoting health and human rights. Directly linked with nearly 150 community-led organizations across 62 countries and thousands of other advocates through its various social media platforms. MPact accomplishes its mission by: watchdogging governments, funders, and other decision makers; strengthening capacities of community-led organizations and healthcare providers; supporting the proliferation of networks led by gay men; conducting and commissioning research; and facilitating inter-regional information exchange.

Sitting near her broken window, Ashee Malik (not her real name), a transgender woman who lives in Punjab Province, Pakistan, is counting her earnings, realizing that her income has fallen sharply. Her only source of money is dancing, begging and entertaining her clients, but since the lockdown imposed on 20 March to stop COVID-19, she hasn’t been able to leave her home. Her bright clothes are in her wardrobe, as is her makeup kit, laying unused for weeks. “We are concerned about our well-being, as we do not have enough resources to support ourselves and our families,” she said.

Ms Malik’s story is similar to that of most transgender people living in Pakistan, who face stigma, discrimination and social isolation. Access to health services, education and employment is one of the many challenges that transgender people face in the country, despite the passing of the Transgender Persons Protection of Rights Act 2018. And COVID-19 and the associated lockdown are making matters worse. As of 15 April, there were more than 5900 confirmed cases of COVID-19 in Pakistan and 107 deaths. 

Owing to the restrictions on the movement of people, there is a real risk of a disruption to critical services for people living with HIV, which disproportionality affects transgender people in Pakistan.

The Khawaja Sira Society (KSS), which works with transgender people, has stepped in to provide support, working with the most marginalized and promoting knowledge about how to prevent HIV and COVID-19.

“The transgender community is even more vulnerable due to the prejudice and stigma and discrimination against them. We need to develop a COVID-19 prevention model by keeping in mind the dynamics and issues of the community in this pandemic,” said Mahnoor Aka Moon Ali, the Director of Programmes for KSS.

During discussions that KSS had with 150 transgender people, of whom approximately 30% are living with HIV, several issues were repeatedly raised, including the lack of income and the small size of Dheras, community homes for transgender people, in which four or five transgender people live together, making social distancing difficult. Since most of the transgender people contacted are illiterate, public health campaigns on how to prevent infection by the coronavirus are not getting through. Fear of the disease is high, which is impacting on mental health. The Government of Pakistan has announced that food aid will be made available, but transgender people face challenges in accessing the scheme, which is dependent on verification based on the national identification card, something that most transgender people in the country simply don’t have.   

Social media is increasingly being used during the lockdown and together with UNAIDS Pakistan, KSS is disseminating information on hygiene, preventive measures and social distancing on social media and is engaging with the community on COVID-19. KSS, together with provincial government authorities, is also working to ensure that people living with HIV can get multimonth refills of antiretroviral therapy delivered to their home.

“We as transgender people living with HIV feel we are at risk by visiting government-run antiretroviral therapy centres. We need antiretroviral therapy to be delivered to us,” said Guddi Khan, a transgender woman who is living with HIV.

Since an uninterrupted supply of antiretroviral therapy is essential for people living with HIV, the Pakistan Common Management Unit for AIDS, TB and Malaria, in collaboration with UNAIDS and other partners, has established virtual platforms and helplines in order to ensure that coordination is continued. An emergency stock of antiretroviral therapy has been made available for people living with HIV for the next two months and a buffer stock is being made available through the Global Fund to Fight AIDS, Tuberculosis and Malaria in order to avoid interruptions in the event that imports of medicines are disrupted.  

“We are working closely with the Association of People Living with HIV, federal and provincial governments and the UNAIDS family to monitor the situation and quickly help address barriers in accessing life-saving HIV services in these extremely challenging times of the COVID-19 crisis,” said Maria Elena Borromeo, the UNAIDS Country Director for Pakistan and Afghanistan.

The COVID-19 pandemic has disrupted people’s lives around the world, including those of many marginalized people, who suddenly face additional burdens and vulnerabilities.

Many areas in Indonesia, which as of 6 April had 2491 confirmed cases of COVID-19 and 209 deaths, have put in place measures, such as physical distancing, to curb the spread of COVID-19. While effective in responding to the disease, many people have been impacted by the effects of physical distancing on the economy.

Out of 1000 people living with HIV and members of key populations surveyed by the Indonesian Positive Network, more than 50% are experiencing severe impacts on their livelihoods, including many transgender women. Sanggar Swara, a civil society organization of young transgender women in Jakarta, conducted a rapid assessment that found that more than 640 transgender people in greater Jakarta have lost their jobs, leaving them unable to support themselves. “On several occasions when the distribution of basic food staples took place, many of them could not access it as they do not have their identity cards on hand or simply due to their gender identity,” said Kanzha Vinaa, the head of Sanggar Swara.

Seeing the critical need for support, the Crisis Response Mechanism (CRM) Coalition, fronted by the civil society organizations LBH Masyarakat, Arus Pelangi, Sanggar Swara and GWL Ina, with support from UNAIDS Indonesia, decided to raise funds for the transgender community. “Since 28 March, we spread the information about the fundraising to communities and partners. Our plan was to collect the funds and distribute them to transgender women in need, with support from focal points in the areas,” said Kanzha Vinaa.

In less than a week, the CRM Coalition had collected more than IDR 67 000 000—around US$ 4100—and distributed food and hygiene packages to more than 530 transgender women in greater Jakarta. The packages cover the basic needs for one week. Ryan Kobarri, the head of Arus Pelangi, said, “Initially we only expected our close networks to respond to this call for donations. We were elated to see that the support and enthusiasm was much more than we expected. Not just from local networks, but even international networks gave their support. Someone even donated 100 kg of rice!”

Although there is uncertainty over how long the current COVID-19 situation will last, it is very likely that the need will persist in the coming weeks and months. The CRM Coalition continues to welcome donations from all around the world in order to keep the community afloat during these difficult times.

Since its establishment in 2018, the CRM Coalition has worked to coordinate and mobilize resources to respond to the persecution and discrimination faced by lesbian, gay, bisexual, transgender and intersex people in Indonesia, one of the most vulnerable communities in the country.

Donations to help keep this vital work going can be made by PayPal at paypal.me/kanzha or through Ryan Kobarri at ryan@aruspelangi.or.id.

“Is it safe to do their work?” Renaè Green and Donique Givans go silent for several seconds. “I am still scared,” says Ms Green, the Associate Director for Policy and Advocacy at TransWave Jamaica. “I don’t like to go to certain spaces. If anyone wants to participate in one of our campaigns, we explain the risks. You don’t know what kind of backlash you might experience.”

Ms Givans, who is the organization’s community liaison officer, knows this all too well. She wasn’t up front about her gender identity with her father when she began becoming more visible in her advocacy work.

“He doesn’t want anything to do with me now,” she says, her voice shaking a little. “He told me to go and not to come back to his house. So, we do let people know they might have difficulties.”

TransWave was formed in 2015 following a lesbian, gay, bisexual and transgender health and gender-based violence training, conducted by WE-Change and supported by the Jamaica Forum for Lesbians, All-Sexuals and Gays and Jamaica AIDS Support for Life.

TransWave’s Executive Director, Neish McLean, is the only transgender man at the helm of a Caribbean transgender organization. Recently Mr McLean discussed his personal journey publicly, exploring issues ranging from the distinction between gender identity and sexuality to top surgery. This is largely unchartered territory in a Caribbean nation famed for its social conservatism.

“For a long time, people actually said that transgender people didn’t exist in Jamaica because people could not put a face to them or identify anyone who was transgender. Now we have so many people who identify. It has helped in terms of explaining who transgender people are,” explains Ms Green. 

In addition to increasing transgender visibility, TransWave advocates on a wide range of subjects that affect the community—the lack of access to transgender-oriented housing, education and employment, for example, as well as initiatives to reduce poverty and violence. HIV is a huge challenge. A 2018 Integrated Biological and Behavioral Surveillance Survey conducted by the University of San Francisco found that 51% of Jamaican transwomen tested were living with HIV.

TransWave advocates strongly for all members of the community to access health care.

“Many are aware that they are HIV-positive but don’t seek treatment. They are just waiting to die. People cannot stomach not being able to live their lives as their real selves and won’t put themselves through the distress of going to a clinic,” says Ms Green. “It becomes difficult because all eyes are on you and you are putting yourself at risk for people to attack or hurt you,” explains Ms Green.

In July, UNAIDS Jamaica supported TransWave’s Transgender Health and Wellness Conference. The event helped launch a toolkit on how health-care providers can provide holistic, non-discriminatory services, along with dialogue around the rights and inclusion of transgender people. The organization has also met some employers to gauge the degree of acceptance for the inclusion of transgender workers.

Ms Givens paints a mixed picture of what life is like for transgender people in Jamaica. 

“It is very difficult, but people try to align themselves with society’s gender norms. They might do a little makeup to feel comfortable, but they don’t go heavy. Some workplaces allow people to be themselves, but you don’t have transwomen wearing skirts,” she said.

Public transportation is often challenging. When TransWave books a taxi, for example, they are never sure if the driver will be tolerant. Renting an apartment can be a landmine. Lower-priced housing often means living in a less safe area. Landlords and neighbours can be judgemental.

At the extreme, homelessness remains a major problem, with some young transgender people being thrown out of their homes before they even become teenagers. This is often the starting point for a frightening array of vulnerabilities, including a lack of schooling, poor job prospects and bad health, with some turning to sex work.

Asked about their hopes for the future, Ms Givans and Ms Green list adequate funding for TransWave and being able to further their education. Ms Green adds that she would like to emigrate.

“But not everybody wants to leave Jamaica and not everybody should leave,” she says pointedly. “That’s why we are working so hard. So that we can get to a point where everybody is accepted.”

The global distribution of new HIV infections in 2018 crossed a threshold: the majority of global new infections were among key populations and their sexual partners.

This change is a result of the strong progress in settings with high HIV prevalence in eastern and southern Africa, combined with a mixture of progress and setbacks in lower prevalence regions.

Key populations make up a small proportion of the general population, but they are at extremely high risk of acquiring HIV infection. Available data suggest that the risk of HIV acquisition among gay men and other men who have sex with men was 22 times higher in 2018 than it was among all adult men. Similarly, the risk of acquiring HIV for people who inject drugs was 22 times higher than for people who do not inject drugs, 21 times higher for sex workers than adults aged 15–49 years and 12 times higher for transgender women than adults aged 15–49 years.

Lesbian, Intersex, Transgender and other Extensions (LITE) started out in 2016 as a support group for lesbian, gay, bisexual, transgender and intersex (LGBTI) people in Lilongwe, Malawi. “There was so much commonality in the challenges facing lesbian, gay, bisexual, transgender and intersex people that this motivated me to form a nongovernmental organization addressing these issues,” says Lawrence Phiri Chipili, Executive Director of LITE, who is a transgender man.

Since its formation in 2016 and its formal registration in 2017, LITE has navigated its way into important national platforms, including the Malawi National AIDS Commission’s technical working group that guides the multisectoral AIDS response.

In May 2019, LITE, along with five other LGBTI organizations in Malawi, formed the Diversity Forum to collaborate on their common goal of ensuring that LGBTI rights are promoted, protected and respected in Malawi. LITE is also the Deputy Chair of the Southern Africa Trans Forum, which brings together 18 transgender organizations from the Southern African Development Community. In 2019, LITE and Mr Chipili were recognized by the Human Rights Campaign as one of their global innovators.

None of this recognition has come easy to the organization. Using his academic background in economics, Mr Chipili has pushed for evidence to support the organization’s advocacy.

“We decided as we were forming the organization that we needed a baseline understanding of what the needs of transgender people are in both the rural and urban areas of Malawi,” he says. “We didn’t want to base our assumptions on a small group of people living in Lilongwe. We conducted a needs assessment with communities and we realized the overarching challenges they have in accessing health-care services, education, employment, legal services and the enjoyment of safety and security.”

The research has helped the organization to design its advocacy strategy, which involves rendering transgender people’s issues visible in the public and policy space.

The organization also uses policy and the law to shape its advocacy. In 2015, the Malawian Government accepted that LGBTI people should have access to health and security. However, according to Mr Chipili, these recommendations are not implemented on the ground. Thus, using these recommendations as a basis, LITE designs its strategy to generate research so that it can strategically engage with the government.

No one knows more about these challenges better than Mr Chipili. He has been thrown out of home, school and university. His resilience and determination seem only to have grown stronger from his experiences.

“I risk my life; I risk the lives of people in my immediate circles, but these are problems that we experience in our everyday lives so we must speak about them. Hate speech towards my community pains my soul but it motivates me because people don’t understand the impact of their words. My mission is to work hand in hand with these people and help them to understand,” he says.

Mr Chipili acknowledges that while it has been a lone struggle by the LGBTI community to become more visible, the role of partners, including UNAIDS, has been critical. “UNAIDS has assisted us in understanding where our gaps are in our organizational policies and helping us to shape the direction in which we should go,” he says. “It has advocated for our inclusion in national platforms and helped us to strategically engage with the government, with the ethos of leaving no one behind firmly at the centre.”

The work has just started for Mr Chipili and his organization. “We need more technical support, human resources and financial resources. One of the major issues is transgender programming and funding globally is limited. A lot of resources are given to organizations that work with men who have sex with men and female sex workers,” he says. “Transgender people are usually invisible, yet we are the people who are experiencing so much hate and stigma, making us even more at risk of HIV infection,” he says.