Due to stigma, misgendering, and a lack of standard data collection methods, transgender women are often left out of conversations about women impacted by HIV. In fact, transgender women are often listed in health assessments as “men who have sex with men” (MSM). It is unclear exactly how many transgender women are living with HIV, but according to the Human Rights Campaign, transgender women are 34 times more likely to be infected with HIV than any other women.
There are many economic and societal factors contributing to high rates of HIV in transgender communities, including lack of sexual and cursory education due to education systems being unprepared and hostile towards transgender people; poverty due to employment and housing discrimination; sexual violence; and stigma. In a report by the National Gay and Lesbian Task Force and the National Center for Transgender Equality, 19% sampled individuals reported being refused medical care due to their transgender or gender non-conforming status, with even higher numbers among transgender people of color in the survey. Transgender people may not be safe at school, may be rejected by family members and by medical professionals—with some even being denied care. This may increase risk-taking behaviors in order to survive, make money, or gain access to housing. However, in a study by Craig-Dalsimer of The Children's Hospital of Philadelphia, religion may act as a protective factor for young transgender women. Additional protective factors include community connection and social support. Across the United States, transgender women are finding and creating community, organizing themselves and their communities and developing and enhancing social supports to provide safe spaces for education, sexual health and refuge from the violence they experience in the world. This community support acts as a strong protective factor.