COFFEE BRE AK
ne cannot help but be in awe of anyone that faces down stigma and emerges victorious on the other side. My guest today epitomises the strength and fortitude which sends boorish and bigoted attitudes back to the dark ages. It’s not about daring to be different, but about being yourself, as we’re about to find out. What are you up to, Juno? I divide my time between Spain and England. At my place in Spain I can write and build campaigns with no distractions. I come back to carry out campaigns in Britain, and I’ve also got a book deal and am working on some films about the trans community. What is the sexual healthcare situation for trans people? I’m a transwoman and I’ve been HIV positive for 25 years. When you’re trans and HIV you have very fractured healthcare. I would go to my HIV doctor and ask about hormones, or to my gender doctor and ask how my hormones interact with HIV medicine, and they’d say, ‘I don’t know anything about that’. I would also ask my GP how it’s possible to have safe sex as a transwoman and they wouldn’t know anything either. It struck me that the dots were clearly not joined up. What are the consequences? The rates of infection for transwomen are still very high. If you’re a transwoman, you’re 49 times more likely to contract HIV than any other group and it is estimated that 19% of all transwomen worldwide are HIV positive. From my own experience, I am quite privileged; I work, write and have access to free healthcare in England, which means my HIV meds and gender
“When we band together we BECOME POWERFUL – trans people are proud of who they are and no longer willing to hide”
realignment have been provided. The way transwomen are treated on the NHS, however, needs considerable work. How are you helping to change this environment? A couple of years ago I looked at trans people in education; teachers and pupils. This involved putting on round tables and getting funding for outreach work. The Paul Hamlyn Foundation supported this drive and we put on events called ‘Finding My T-Spot’. This helped to push research, because there is no data in this country about trans people and HIV, and last year, I put on an event at Gilead, establishing what we needed to discover. Sounds like pioneering stuff. It was attended by Valerie Delpech from Public Health England, several senior consultants in the country, transactivists and the media. An advisory committee emerged, which looked at all the research going on involving trans people and sexual healthcare, and from that came two research projects which look at the sexual healthcare experience of transwomen in this country. How has this evolved? I am patron of the sexual healthcare charity cliniQ, one of only two centres solely devoted to trans people. I received a pot of funding, in order to do
outreach work, and now we’ve trained all the GPs in the South East, and staff from several sexual health clinics across the UK. I have also made the ‘Finding My T-Spot’ cliniQ film, which is designed to highlight the work to areas outside London. I am now looking to make a film specifically about transwomen who are HIV positive. How can the health risks to trans people be reduced? People talk about trans people as being a high-risk section of society, but no one group in society is inherently risky. What does pose a risk is the inconsistencies in healthcare structures. The gaps between GP, gender clinician and HIV clinician mean they don’t have shared knowledge, and that’s where people fall through the cracks. We still have people turning up at cliniQ with AIDsdefining illnesses, because they're not being picked up early. It seems that healthcare professionals urgently need an upgrade in this area. Time and time again I’ve heard GPs saying, ‘I’ve never met anyone like you’, and I feel like saying, ‘Well I’ve never met a 64-year-old GP with those particular spectacles before’. It’s not good enough - part of their remit is to know about me, and I hope through the legacy of the work I’m doing, a more cohesive network will be created. It is noticeable in the last few years that trans people have emerged from the shadows. For a long time, we were presented as victims and even classified as having a mental illness. That made it easy for people to categorise us as second-class citizens. In turn that placed us in a very passive position in relation to our healthcare. A decade ago, trans
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