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Fight Back Against the Assault on Trans Health


Trump and co. are inviting discrimination back into health care. Don't sit back and watch, writes Kiara St. James.

Our right to have agency over our bodies, our healthcare, and who we choose to love and make a family with should be non-negotiable.

But yet again, people in power — mostly cisgender white men — have proven that they want to decide for transgender, lesbian, bisexual and gay community members what is in our best interest.

News broke last week that this administration plans to pass a new rule to undermine the Affordable Care Act’s protections for transgender people like me. For too long, our government has made decisions about health care for trans people of color living with HIV without even hearing our input, our experiences, and our stories.

That’s why I am coming together with other trans people living with HIV to make our voices heard and to say: we are #ACApositive. We rely on the Affordable Care Act to survive and thrive, and any attack on the ACA and the protections it provides us is an attack on our existence.

As an advisory board member for Transgender Law Center’s Positively Trans program, I see our #ACApositive campaign as an opportunity for transgender people living with HIV to finally have our share of the national conversation about health care — a conversation that disproportionately impacts us.

Forty-four percent of trans people living with HIV surveyed by Positively Trans have faced discrimination in health care because of their gender identity; 41 percent of us have gone six months or more without medical care since our HIV diagnosis. And 43 percent of us earn less than $12,000 a year — a number that jumps up to 78 percent when you look just at trans people of color living with HIV.

So many of us are barely making enough to live on. Without the Affordable Care Act and the rights it provides, we’d be put in a position with impossible decisions. Do I pay rent, or do I get treatment?

It’s said that you can judge a nation by how it treats the most vulnerable among us. The new rules out of this administration are mean-spirited, un-Christian, and invite discrimination against the most marginalized among us. 

Whether one is transgender or not, we all deserve to be uplifted, supported, affirmed, and accepted as part of the complex tapestry called humanity. Trans people living with HIV are speaking out about our experiences with health care, and it’s time for our country to hear us.

Find out how to fight back at

KIARA ST. JAMES is the executive director of New York Transgender Advocacy Group, a trans-led social justice nonprofit organization that addresses policies that affect the TGNC community through initiatives such as trainings, speakouts/town halls, and TGNC mental health workshops.

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