A shifting narrative

LEIGH ANN VAN DER MERWE — Coordinator, SHE, Social, Health and Empowerment Feminist Collective of Transgender and Intersex Women of Africa

Transgender communities are often most marginalized in the response to HIV. Needless to say, this has exacerbated HIV and the risk of gender-based violence. There are a number of unique factors that shape HIV vulnerability for transgender women, such as the likelihood of performing sex work, family rejection, lack of access to gender-affirming care and criminalization of gender-diverse identities. I have born witness to the death of so many transgender women, and I continue this fight not only for HIV programming for transgender women but also for the equitable resources to create an enabling environment for myself and other transgender women.

The biggest lesson for me as a transgender woman and activist over the past 15 years is that inappropriate, or exclusion from HIV and gender-affirming care further fuels the epidemic among transgender women. One particular example to mention is that the inclusion of transgender women in programmes for men who have sex with men was not useful (or even appropriate) for transgender women. If anything, it really misplaced the health needs of transgender women. One big lesson to take from this is that transgender women, like any other key population, should be at the centre of the response. Further to that, the criminalization of diverse gender identities and sex work continues to hamper HIV programming for transgender people. I have learnt that there needs to be radical policy change and political commitment towards social justice and change for transgender women.

My biggest hope for the future is scientific advances in HIV prevention. I am also hopeful about the shifting narrative for myself and my community around acceptance, love and sisterhood with women in all their diversity. I sincerely hope that the next development framework will stray from heterosexual and gender-normative language and practice and will encapsulate the issues of all women.

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