Ensuring Competent Care for Transgender and Non-Binary People

While communities around the country observe Trans Awareness Week, in one Texas city, advocates have shifted the narrative. 

The Mahogany Project and Save Our Sisters, two Houston-based organizations, have founded Black Trans Empowerment Week to “not only to memorialize those who have been tragically taken, but to charge forward into the empowered future they envision for all transgender people.”

For Houston community health advocate Donte Oxun, it’s exciting to see. 

“Even in the light of so much transphobia and racism from our government and from some parts of society, to see my community be like, ‘You know what? We’re not just remembering our dead.’ We actually have so much more work to do, and we’re going to do all of it,’” they told HRC.

Oxun has worked in HIV and public health spaces since 2009, shortly after they were diagnosed with HIV — something that propelled them into speaking out.

“Like many people who are gender diverse and of color, my life was definitely touched by HIV even before I was living with HIV,” Oxun said. “I have family members who I lost to HIV when I was pretty young.”

“I’ve always been a bit of a loudmouth and a person who understands and relates with people who struggle,” they continued. “So, the way I dealt with my HIV diagnosis was to be really public about it at first. It’s important to humanize our perspective and really show that people can live regular lives and that we deserve to have our stories told.”

In their work with Legacy Community Health in Houston, Oxun is a lead patient advocate, primarily helping patients — particularly trans and non-binary patients — living with HIV or Hepatitis C to navigate the health care system and receive the care they need. Legacy has been offering gender-affirming, LGBTQ-competent care for young people and adults for more than 30 years, Oxun said.

“Competent care is a challenge,” they said. “We shouldn’t have to negotiate between parts of our identities when seeking care is already a challenge.”

Texas has one of the highest populations of uninsured people, reminds Oxun. Obstacles to accessing care range from poverty and socioeconomic status to fear of stigma or violence — something on the minds of many as we draw closer to commemorating Transgender Day of Remembrance. 

Of the 22 known transgender or gender non-conforming people killed this year, four of those victims were killed in Texas. All four of the trans people killed in Texas this year were Black transgender women — something that matters when talking about how to support and provide services for the local transgender community.

“Violence affects people’s health care,” Oxun said. “When a person doesn’t feel safe to catch the bus to walk down the street, they’re going to be less likely to see a doctor. They’re going to be less likely to pick up their prescriptions. They’re going to be less likely to get access to care.”

Until those barriers are dismantled and addressed, transgender and gender non-conforming people will continue to face higher rates of discrimination, poverty, homelessness and violence not just in Texas but around the country.

“No matter who you are, if you’re working in any form of health care, you’re going to interact with somebody who’s gender diverse,” Oxun said. “You may not know it, they may not be comfortable reporting it to you, but you are. It’s about seeing them as a whole person.”

For information for LGBTQ people seeking to learn more about access to care, particularly under the Affordable Care Act, click here.

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