MIAMI — Florida fails to deliver basic HIV services to many transgender women, endangering their health and contributing to an uncontrolled HIV epidemic in the state, Human Rights Watch said in a report released this week. Florida and federal HIV officials talk a lot about the importance of reaching “high risk” groups like transgender women. Human Rights Watch investigated whether the reality on the ground is matching the rhetoric — it isn’t.
The 88-page report, “Living at Risk: Transgender Women, HIV and Human Rights in South Florida,” documents the harmful impact of state and federal policies on transgender women in two Florida counties (Miami-Dade and Broward) that have the highest rates of new HIV infection in the United States. Many women interviewed said they experience disrespect, mistreatment and in some cases, denial of services from government-funded clinics. Florida’s inaccurate and incomplete data collection on HIV among transgender people leaves them undercounted and excluded from government programs to address the epidemic, the Watch said in a press release.
“After decades of neglect, Florida and the federal government are still failing to address the HIV crisis in the transgender community,” said Megan McLemore, senior health researcher at Human Rights Watch and the report’s author. “Transgender women are struggling to find affordable health care, including HIV prevention and treatment, that respects their gender identity and where they feel safe.”
The Trump administration is attempting to roll back anti-discrimination provisions based on gender identity under the Affordable Care Act, part of a broader rollback of federal LGBT rights protections. Reversing existing legal protections could have devastating consequences for access to health care for transgender women. Nationally, one in four transgender women, and half of African-American transgender women, are living with HIV, compared with less than one percent of the U.S. population as a whole, the Watch said in a press release.
Human Rights Watch interviewed 125 transgender women in south Florida, as well as state and federal officials, medical providers, law enforcement officials, public defenders, public health experts, and community advocates. Many of the transgender women interviewed, particularly African-American and Latina women, live in extreme poverty, lack stable housing, fear violence daily, and have no health insurance, placing them at high risk of HIV infection.
Florida, with the third-highest rate of HIV infection in the country, receives millions of dollars annually in federal funding for HIV prevention and treatment. There is no shortage of HIV clinics in Miami-Dade or Broward Counties, but state and federal HIV policy fails to protect transgender people from discrimination in these settings, limiting options for treatment, the Watch said in its press release.