Friday Philosophy: Transwomen and AIDS

Helena Bushong was diagnosed with AIDS in 2002.  She probably had been HIV+ since 1985.  She also has Hepatitis C and is a survivor of spinal cancer.

But she has one hell of a strong backbone.

This past week she was interviewed about being transgender, black and poz.  Do yourself a favor and go see what she has to say for herself.  The video is not embeddable.

I felt comfortable in my own skin for the first time in my 56 years.

–Helena Bushong, about going on homone therapy

But y’all come back, y’hear!

And there is more…

Helena was selected to be a member of the Illinois Alliance for Sound AIDS Policy (IL ASAP) and in 2009 was chair of Illinois Gender Advocates…and as such was chosen to visit the White House last November to participate in a conference about Women & HIV/AIDS.  In essence, she became our face on issues of transwomen living with AIDS.  The report of her experience made the news first here.

Ms. Bushong herself wrote about that experience in A Tranny Girl goes to the White House: a personal account by Helena Bushong.

A recent meta-analysis by Jeffrey Herbst of the U.S. Centers for Disease Control and Prevention and colleagues estimated a U.S. HIV prevalence of 27.7% among MTF, based on four studies in which HIV status was confirmed by testing

–This and the following several quotes are from Transgender Health and HIV

Precarious economic status, substance use, low self-esteem, social vulnerability, and lack of social support are common barriers to adopting and maintaining safer behaviors that can prevent the acquisition or transmission of HIV.

Would enacting ENDA help?  You betcha.

Fate is just the weight of circumstances.

Forty-two percent of MTF in a recent meta-analysis reported participation in commercial sex work, as did 59% of transgender youth in another study.

Those of us who have not engaged in commercial sex work know that is probably only due to good fortune on our part and the vagaries of circumstance.

Pump Parties

Unable or unwilling to acquire silicone injections or implants in a medical setting, some transgender women gather at “pump parties,” typically held at an acquaintance’s home, to have a non-professional inject silicone into their breasts, cheeks, hips, and/or buttocks.

The dangers of pump parties are clear. Clean needles and a sterile environment may not always be available, putting participants at risk for HIV, hepatitis, and other infections. Silicone procured outside of a medical setting is often not medical grade but industrial — in fact, it may have come straight from the plumbing department of a hardware store — and is sometimes mixed with paraffin, motor oil, cooking oil, antifreeze, or other non-sterile materials to make it flow more easily through the syringe and into body tissues.

Most such silicone injections are ultimately disfiguring, as the silicone migrates, changes shape, or hardens over time. Despite a long history of fatalities, infections, severe local tissue damage, and disfigurement, injecting “street” silicone is still seen as a viable way to feminize the face and body and help a transgender woman “pass,” and thus avoid discrimination, gain employment, and attract intimate partners.





Not only is HIV prevalence high among MTF engaged in sex work, it also appears that their infection rates are as much as four times higher than those of genetically female sex workers.

Men feel we don’t have to fear getting pregnant, so use of a condom can be dispensed with.  Right?

But sex work isn’t the only source of HIV.

Hormones procured outside of a medical setting (on the street, for example) are typically injected rather than taken orally, and needle sharing may lead to increased risk for acquiring or transmitting HIV and or other bloodborne diseases.

Also see the insert to the right.  Stuff like that is all too common when people have no job, no family, and no health care.

I hope, however, that people don’t come away with the vision that all transwomen pump themselves full of silicone.  That is most definitely not the case.  In many cases, hormones are sufficient.  Unfortunately, the young are often impatient.

It could be worse though, I hear some of you thinking.  The US must have a leg up on other places, right?

You mean like Cuba?

In 2008 sex change operations were legalized in Cuba, 20 years after they were frozen following the operation on local trailblazer Mavi Sussel.  They are now free and performed by Cuban experts trained by European specialists.  There is a documentary which will soon be available from Marilyn Solaya.

True, it didn’t hurt that one of the main proponents was sexologist Mariela Castro, daughter of President Raul Castro.

Now there is a fierce advocate when you need one.


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    • Robyn on August 21, 2010 at 00:03

    …has a very useful site for anyone wanting more information.  Here’s a couple of selections:

    African American Transgenders and HIV (PowerPoint)

    I’m a bit peaved to discover that researchers do not distinguish between MtF transgender people and MSM (men who have sex with men).

    HIV Among Transgendered People (PDF)  

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