We Are Here: Trans Men and HIV

Mainstream visibility of transgender men living with HIV is nonexistent. There’s plenty of anecdotal evidence that gay and bisexual trans men get HIV as often as their nontrans peers, but little scientific research addressing their increased risk, and even in the LGBT media, you still won’t find stories about poz trans men.

That’s something Teo Drake wants to see changed. Drake, an activist, educator, and artist in Greenfield, Mass., is also an HIV-positive, queer trans man who hopes to bring visibility to the issue with the help of the Transgender Law Center’s newest project, Positively Trans. Drake is the only man on the national advisory board for the project, dubbed T+, which is conducting a groundbreaking community needs assessment of HIV-positive transgender and gender-nonconforming people in the U.S.

“Sometimes I think we are the mythical unicorns of the HIV-positive community,” Drake says of being a poz trans man. “We aren’t talked about. There isn’t research looking at our experiences with HIV. It’s very hard to find educational materials to help us talk with prospective partners about risks and prevention options in ways that honor our gender identity and accurately reflect our anatomy in whatever configuration that is.”

The activist says the isolation is “sometimes hard. I haven’t met that many trans men living with HIV. There is something powerful and healing in shared experience that I miss.”

Drake, who was invited by the TLC’s senior strategist, Cecilia Chung, to bring the perspective of a trans man with HIV to T+, a project that already has plenty of strong, vocal trans women involved (including Dee Dee Chamblee, Tommy Luckett, and Octavia Lewis). The purpose of the project is to form a network, tell stories, and develop advocacy strategies “in response to inequities, stigma, and discrimination over punitive laws and lack of legal protections” that affect trans people, according to its website. 

“For me, the invitation to take part in T+ and the needs assessment project came at a meaningful time,”  Drake says. “July is the 20th anniversary of my HIV diagnosis. I believe that following a spiritual calling of service to my community has brought me hope and meaning over the last 20 years. That hope and sense of purpose has kept me alive.”

As the National Center for Transgender Equality reported in its “Injustice at Every Turn” survey, transgender people face intense discrimination in employment, housing, education, and health care. The Centers for Disease Control and Prevention also points out that “because data for [the transgender] population are not uniformly collected, information is lacking on how many transgender people in the United States are infected with HIV.”

Compared to trans women, the CDC reports, “little is known about HIV risk and sexual health needs among transgender men. One meta-analysis of 29 studies involving transgender people showed that only five of them had separate data concerning transgender men.”

“I would like people to know we exist. That we are gay, straight, bi, and queer just like nontrans people with HIV,” Drake says. He worries “that HIV-negative trans men who are either new to the experience of transition and negotiating dating or sex with cisgender men will see HIV as a marker of being accepted a gay man,” something many activists have heard anecdotally. Early trans activist Lou Sullivan once quipped, after he acquired HIV, that naysayers had told him he couldn’t live as a gay man, but he would now die as one.

“I want trans men to make choices that are authentic to them about wrapped or raw and not be pressured into choices for fear of being rejected,” Drake adds. He continues to use his experiences with HIV to help others, and he’s sure to not let his status define who he, or the community he identifies with, is. “I’m grateful to still be alive. I’m grateful that I lived long enough to become the man I am. Feeling more comfortable and at home in my own skin after gender transition is still magical every day,” he says.

Living with HIV for decades, Drake says it was coming out as trans and living life as a queer man that helped him get healthy. “I know how healing living authentically can be,” he says. “In 2002, prior to choosing to transition, I had 33 T cells and a viral load above the limits of detection. No treatment worked. The side effects were all too severe, and I didn’t have it in me to fight for a life that wasn’t the one I wanted to be living. I made the decision to transition as a last kindness to myself because I didn’t think I would survive another few years. The paradox is that as I stepped more and more into an authentic expression of my inner self, my health improved. I was able to tolerate the medication side effects because I had the life I finally felt was worth fighting for. Turns out that loving yourself is a powerful healing force.”