In April I posted about a study by Stefan Baral and his colleagues at Johns Hopkins that purported to show that “Transgender Women 49 Times More Likely to Have HIV.” Baral acknowledged in a comment (I have no reason to doubt that it’s really him) that “these are pretty bad stats!” but went on to say that he felt his publication would help trans communities in the long run, and pasted the limitations section that he had ignored in his statements to the Huffington Post.
In theory I agree that it’s worth disseminating potentially inaccurate information if you believe that it’s going to help people regardless. In practice it’s never easy to predict what effect your actions will have. In this particular case, I think that reports like these do more harm than good for a very specific reason: they obscure important differences.
Baral’s study was actually a “meta-study” that combined studies done in cities all over the world. All of these studies investigated non-random samples of transgender people, usually focusing on subgroups that are at particular risk for violence or disease. They all include disclaimers saying “NON-REPRESENTATIVE SAMPLE NO NO DO NOT GENERALIZE RESULTS!!!”
One of the source studies turned out to be the study that I participated in here in New York, led by Larry Nuttbrock of the National Development and Research Institutes (NDRI). In November I criticized the study for overgeneralizing, but as I mentioned in May, the study does reveal some important things, which may very well be found in other communities.
In particular, the NDRI study reveals the deep divide here in New York between the lives of middle-class white trans people and lower-class black and Hispanic trans people. The difference in HIV infection rates (3.5% vs. 48-50%) between the two groups of participants in the study is huge. In another paper, the NDRI researchers indicate that HIV infection tends to correlate with unprotected anal sex, which in turn tends to correlate with gender abuse and symptoms of depression, as well as with attraction to men and nonwhite ethnicity.
What that means, in turn, is that middle-class white trans people like me are not at significant risk for HIV infection, or gender abuse, or depression. To use a fancy social science term, it’s intersectional: if you’re black or Latina, if you’re feminine, if you’re attracted to men, if you’re poor, if you’re a prostitute, it all adds to your risk. And as Hwahng and Nuttbrock observed, it’s all about power: the power to say no to unprotected anal sex.
That’s why you won’t see me using this study to get anything for myself. These high HIV rates don’t apply to me. I don’t deserve any of the money that governments and donors want to spend on it. I don’t know which donors Baral is trying to convince, or what he wants them to spend the money on, but it shouldn’t be middle-class white people.
This is not a problem of “trans women” or even of transgender people in general. It is a problem of disempowered black and Latina transvestites, and it can only be solved by re-empowering them. As Erica so eloquently put it, nihil de nobis sine nobis.
Of course I’m concerned about these high HIV rates, because I care about my fellow transvestites, and my neighbors. That’s why I’m prepared to act in support and solidarity, and I hope you are too. But don’t talk to mainstream transgender organizations that aren’t doing anything about this issue. Talk to organizations that empower sex workers of all genders, like the Red Umbrella Project.