Living at Risk: Transgender Women, HIV, and Human Rights in South Florida, Human Rights Watch (2018)

Transgender women face myriad barriers to accessing the services and health care that they need, this Human Rights Watch study from South Florida demonstrates.

While the finding that transgender women face heightened barriers is not surprising, this study offers more detailed insights providing empirical support for that widely-suspected premise. The study was conducted by 15 trained peer interviewers employing peer-reviewed survey methodology. Between June 2017 and June 2018, the researchers surveyed 125 transgender women in Miami-Dade and Broward counties.

The study’s findings confirm many anecdotally-reported concerns. Half of the transgender women surveyed did not have health insurance and a significant proportion of the women who do not regularly access medical care cite cost as the major barrier. More than one in three of the women living with HIV did not have health insurance.

While the study finds that the Florida counties had adequate numbers of HIV service providers, it found a scarcity of providers offering trans-informed health care—especially access to hormones—as well as providers that integrated such care with HIV treatment.

Another barrier illustrated in the study is poor understanding of the interaction between gender-affirming hormone treatment and PrEP, resulting in under-prescription of PrEP to transgender women. The study further confirmed that involvement in the criminal justice system exacerbated disparities in accessing appropriate HIV-related health care.

While the findings are not novel in and of themselves, it is still extremely useful to have empirical evidence documenting the issues that the advocacy community already knew existed. Additionally, the report provides useful analysis arguing that there are sufficient resources to address these disparities, but that resources are misapplied because local, state, and federal governments fail to collect data specific to transgender women. Advocates should use this body of data to push for better, evidence-driven programs.