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Navigating HIV Care
Navigating HIV Care as a Transgender Woman: A Call for Compassion and Competency in Healthcare

Released: November 24, 2025

Elle Morton-Rogers
Elle Morton-Rogers
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Key Takeaways
  • Equitable HIV care for transgender individuals relies on cultural humility, affirming environments, strong antidiscrimination policies, holistic care approaches, and community engagement.
  • By embracing inclusivity and respect, healthcare professionals can help reengage marginalized populations in care and bridge gaps in healthcare.

As an African American transgender woman living with HIV, my journey through the healthcare system has been marked by challenges that extend far beyond managing a complex medical condition. The intersection of my identity and health status exposes me to a unique set of barriers—bias, discrimination, homophobia, and transphobia—that too often undermine the quality of care I receive. Drawing from over 35 years of professional experience in operations management, coaching, diversity, equity, and inclusion (DEI), and faith-based sectors, coupled with my personal experiences, I want to shed light on what must change in healthcare to truly serve transgender individuals living with HIV.

Understanding the Challenges
Transgender people with HIV face stigma on multiple fronts. Not only do we confront societal prejudices related to gender identity and HIV status, we also frequently encounter ignorance and bias within healthcare settings. This can manifest as misgendering, invasive or irrelevant questioning, and assumptions about our lifestyles or adherence to treatment. Such experiences discourage us from seeking care consistently, which is detrimental to our health outcomes.

For me, securing healthcare in Atlanta, a city with a rich history of diversity yet persistent disparities, has involved navigating healthcare professionals (HCPs) who may lack cultural competence or awareness of the nuances specific to transgender HIV care. The fear of being judged or misunderstood often outweighs the urgency of managing my health, creating an unnecessary burden. 

Key Messages for HCPs

1. Foster an Affirming Environment: Simple actions, such as using chosen names and pronouns consistently, displaying inclusive signage, and having gender-neutral restrooms, can transform a clinical setting into a safe space. Respect is not optional; it is foundational.

2. Cultivate Cultural Humility and Competence: HCPs must commit to ongoing education about transgender identities and the social determinants that impact our health. This includes understanding hormone therapies, the interaction with antiretroviral treatments, and the psychological impact of stigma. Training should move beyond basics to incorporate the lived realities of transgender patients.

3. Implement Nondiscriminatory Policies and Practices: Institutions should establish clear policies that prohibit discrimination based on gender identity or HIV status and ensure that these policies are actively enforced. Staff at all levels, from receptionists to specialists, must be held accountable for maintaining respectful interactions.

4. Integrate Holistic, Patient-Centered Care: Transgender individuals often have intersecting healthcare needs beyond HIV management. HCPs should collaborate with mental health professionals, social workers, and community organizations to address issues like housing insecurity, employment discrimination, and mental health as factors that can significantly influence treatment adherence and well-being.

5. Engage and Empower the Community: Healthcare organizations should involve transgender people living with HIV in program design and evaluation. Our voices are vital in shaping services that are truly responsive and effective.

A Personal Plea
From my vantage point, the healthcare system must move from a transactional model to one that is relational and affirming. Transgender people living with HIV deserve care that acknowledges our full humanity, respects our identities, and supports our dignity.

Atlanta's HCPs have an opportunity to lead by example in dismantling barriers and fostering equity. It starts with listening to our stories, our struggles, and our strengths, and translating that understanding into compassionate action.

Conclusion
The path to equitable HIV care for transgender individuals is clear: cultural humility, affirming environments, strong antidiscrimination policies, holistic care approaches, and community engagement. These are not abstract ideals but practical steps that can transform healthcare experiences and outcomes.

HCPs hold immense power to heal beyond the physical. By embracing inclusivity and respect, they can restore trust and hope to those of us who have too often been marginalized. This is not just good medicine, it is a moral imperative.

Your Thoughts
What is your experience with implementing compassionate care in your practice? Leave a comment to join the discussion!

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